Pennsylvania’s Options Program (also called “Help at Home”) provides aging residents with care services in their homes, such as personal care, home health, and home delivered meals. Assistance is also provided to family caring for a loved one at home, such as adult day care, respite care, and specialized medical transportation assistance.
The Options Program begins with a comprehensive assessment of the applicant’s health and physical abilities, as well as their income. The assessment determines their care needs and the amount of the participant’s share of the cost. Any Medicaid, Medicare or private insurance benefits must be used first before funds from the Options Program will be used.
The Options Program requires participants to be legal Pennsylvania residents, 60+ years old and have difficulty with daily functioning (activities of daily living).
Financial information is not used for eligibility, but rather to determine if the participant will need to contribute to the cost of services and just how much.
Those participants with incomes at or less than 133% of the Federal Poverty Level (FPL) are not responsible for cost sharing, also referred to as co-payments. Participants with incomes between 134% and 300% of the FPL have co-payments based on a sliding scale. In 2023, these percentages translate as follows:
Single or widowed applicants receive services at no charge if their monthly income is less than $1,616 ($19,391 / year). Individuals with income up to $3,645 / month ($43,740 / year) are eligible for some level of assistance. Married couples or two-person households receive services free of charge with monthly income up to $2,185 ($26,228 / year). Should the couples’ monthly income exceed $4,930 ($59,160/ year), they are no longer eligible for financial assistance.
Each program candidate is assessed and approved for a different suite of services as their needs dictate. Benefits can include any of the following, but not all services are available to all candidates, nor are there always funds available for services. Some of these services can be self-directed, meaning the service recipient has the choice to choose their service provider.
It is estimated the maximum amount in monthly services an individual can receive in 2023 is $765. The max can be increased to $1,900 a month for two circumstances: a senior with a needs assessment score at or above 56 points, or a senior who receives older adult daily living services.