Page Reviewed / Updated - May 2019
This webpage will help Pennsylvania residents understand the costs associated with assisted living, home care, and adult day care throughout the state. It also explores the various payment options and financial assistance programs available to assist in caring for the elderly, be that in residential care or for aging in place at home.
The programs outlined here are comprehensive of what is available from the state of Pennsylvania, but is not comprehensive of what is available at a national level. When searching for assistance, it is important to explore all avenues to find the most appropriate program for the situation. To aid in this search and to find assistance nationwide, our Resource Locator Tool is invaluable.
The statewide average monthly cost of assisted living in 2019 is $3,750. This marks an increase of a few hundred dollars per month since 2015. The geographic areas of the state with the most expensive assisted living are the urban centers of Philadelphia, Erie, Harrisburg, Chambersburg, Lebanon, and Lancaster. In these areas, the average monthly costs are approximately $4,350 - $5,318. The areas of Allentown and Altoona are consistent with the statewide average with the average monthly cost at $3,750. The least expensive regions for assisted living include Pittsburgh, Scranton-Wilkes-Barre, East Stroudsburg, Gettysburg, Williamsport, and Reading, where the costs are approximately $2,400 - $3,463 per month.
Individuals with Alzheimer's who reside in assisted living memory care units, which provide an increased level of care and security, should expect to pay an additional $1,125 each month.
Statewide in 2019, PA residents can expect to pay an average hourly rate for home care of $22.00. While the areas of East Stroudsburg and Pittsburgh have a more affordable cost of assisted living than the state average, these areas have higher than state average cost / hour for home care. Here, the average cost is $23.50 - $24.25 / hour. State College, Williamsport, the York area, and Philadelphia also average over the statewide average at $23.00 - $24.75 / hour. More affordable home care can be obtained in Johnstown, Lebanon, and Scranton where the hourly rate is as low as $19.00. By far, the most affordable home care can be found in Altoona, where the average hourly cost is only $17.75.
Home health care, provided by health care professionals, is also an option for elderly care and costs approximately $.65 / hour more statewide than home care. The two areas that have a much larger discrepancy in cost are Altoona and Lebanon, where medical home care can cost as much as $2.25 - $3.50 / hour more than for non-medical home care.
Non-residential adult day care is the most affordable option for individuals who wish to remain living at home, but require some supervision or assistance. Statewide, as of 2019, the average cost is $65 / day, with the range running from $40 in State College to $88 in Lebanon. Outside of Lebanon, the costliest area for adult day care is in Philadelphia at $77 / day. Aside from State College, the most affordable adult day care is in Johnstown, which also has an average daily rate of $40. Adult day care costs, more than other forms of eldercare, is impacted by the lack of local competition and population density.
Medicaid (not to be confused with Medicare) is a program that is jointly administered by the federal government and the state of Pennsylvania. Via this program, assistance is provided to low-income elderly residents. The state Medicaid plan pays for nursing home care and some personal care. However, there are also Medicaid Waivers that provide services to the elderly and disabled in their homes or community in order to prevent or delay nursing home placement.
Programs and Waivers
A new managed care waiver program, Community HealthChoices (CHC), is being implemented in phases and began in January 2018. It is expected that this program will be put into effect throughout the entire state by January 2020. CHC calls for automatic enrollment in this program of all those receiving services via the Department of Aging (PDA) Waiver. Via CHC, the same long-term care services offered via PDA will be available, as well as other medical and behavioral health services.
The Department of Aging (PDA) Waiver covers a broad range of home care and support services which can enable an individual who might otherwise require nursing home care to remain living at home. Services include personal care, personal emergency response systems, home delivered meals, respite care, and home / vehicle modifications. As the Community HealthCare program (mentioned above) is implemented across the state, individuals will automatically be enrolled in this new program and the PDA Waiver will be phased out.
Another program, Services My Way (SMW), gives beneficiaries the flexibility to determine their own care requirements and to select the individuals or organizations that will provide the services they require. While not technically a waiver, this program allows waiver participants an option to self-direct their care. With this option, certain family members, such as adult children, may be paid as caregivers.
Medicaid has restrictive eligibility requirements based on an applicant's income and their financial resources. Applicants are permitted monthly income of up to $2,313 as of 2019. This figure is set at 300% of the Federal Benefit Rate (FBR). They are also permitted to have up to $8,000 in countable resources (assets). Some assets, such as a motor vehicle and home are considered non-countable assets, provided they are in use by their owners and the equity value of the home is not greater than $585,000. Household furnishings, personal items, and burial plots are also considered exempt assets.
The eligibility rules differ for married couples with just one spouse applying for nursing home Medicaid or a Medicaid waiver. Married applicants are able to allocate a portion of their income (up to $3,160.50 / month) to their non-applicant (community) spouses. This rule is to prevent non-applicant spouses from having too little income from which to live. In addition, non-applicant spouses are able to retain up to $126,420 of the couple’s joint assets. This not only proves beneficial to community spouses, but also lowers applicant spouses’ countable income and assets.
Persons who exceed these above mentioned income and / or limit(s) may still qualify for PA Medicaid. However, it is advised they contact a Medicaid Planner prior to application to receive assistance in re-structuring their finances to ensure eligibility.
Pennsylvania offers a non-Medicaid assistance program, which is offered as an alternative to assisted living or home care. The PA Domiciliary Care Program, which is often referred to as PA Dom Care, pays a fixed amount to help seniors live in the homes of caregivers. Personal care assistance is covered in addition to room and board.
Another program is the PA Options Program, through which home support and services are provided. Benefits include personal care, home health, home modifications, durable medical equipment, assistive technology, counseling, and adult day care.
In the area of prescription assistance, PA offers the Pharmaceutical Assistance Contract for the Elderly (PACE, PACE Plus Medicare, and PACENET) programs. These programs are designed for lower income, elderly state residents who do not qualify for Medicaid. Learn more about these programs here.
To make home modifications or purchase assistive technology for the home, there are zero interest and low-interest loans, as well as grants from the Pennsylvania Assistive Technology Foundation (PATF).
Another option is LIHEAP, which provides reduced energy costs for heating and cooling one's home. Read more.
In addition to the state specific options that help pay for care, there are many non-profit and federal options. Use our Resource Locator Tool to find other programs that help pay for or reduce the cost of care. There are also programs that help veterans with assisted living and there are eldercare loans available in Pennsylvania.
Given the large variance Pennsylvania sees in the hourly cost of home care, the daily cost of adult day care, and the monthly cost of assisted living, one of the best ways to manage the cost of care is to find affordable care. To help families in doing so, we've partnered with several organizations that maintain large databases of care providers. These organizations all provide free services that match an individual's specific care needs with care providers in their preferred geographic area. Click here to find affordable care.
For more information about the costs and resources available in Pennsylvania cities, click on the links below.