Allentown Senior AdvisorDoes Medicare pay for long-term care?
No: Medicare pays for short skilled nursing stays after a qualifying hospital admission, home health visits and hospice, but not long-term help with daily activities in a personal care home, nursing home or at home.
Long-term care is paid privately, by long-term care insurance, or by Medical Assistance for those who qualify.
What are the 2026 Medical Assistance limits for nursing home care?
Income up to $2,982 a month (300% of the SSI rate) for the nursing facility and waiver categories, and resources up to $2,000 plus a $6,000 disregard for those at or below that income.
A community spouse keeps $32,532 to $162,660 in resources in 2026.
What is Community HealthChoices?
Community HealthChoices is Pennsylvania's Medicaid managed long-term care program, run by AmeriHealth Caritas, PA Health & Wellness and UPMC Community HealthChoices, for dual eligibles and adults who need nursing-facility-level care.
Enrollment: Independent Enrollment Broker, 1-877-550-4227.
What is LIFE?
LIFE is Pennsylvania's PACE program: all-inclusive care for adults 55 and older at nursing facility level of care, provided in the Lehigh Valley by SeniorLIFE Lehigh Valley in Bethlehem for Lehigh and Northampton residents.
DHS lists no LIFE provider serving Carbon County.
What is the look-back period?
Pennsylvania reviews asset transfers in the 60 months before a long-term care Medical Assistance application, and gifts in that window create a penalty period.
Document payments to family caregivers with a written agreement.
Where do we apply for Medical Assistance?
Apply online through COMPASS, by phone at the Consumer Service Center, 1-866-550-4355, or at the county assistance office; the Area Agency on Aging does the level-of-care assessment.
Start the application before savings run out completely; approval takes time.
Does Medicare pay for a stay in rehab?
Yes, after an inpatient hospital admission of at least three days: Medicare Part A covers up to 100 days of skilled nursing care per benefit period, the first 20 in full and the rest with a daily copayment, while skilled care is needed.
Observation days do not count toward the three-day requirement.
Can I have both Medicare and Medical Assistance?
Yes: people who qualify for both are dual eligibles; Medicare stays the primary health insurance, and Medical Assistance, usually through Community HealthChoices, covers long-term services and many costs Medicare leaves.
Medicare Savings Programs can also pay Medicare premiums for people with limited income.
Who helps compare Medicare plans for free?
PA MEDI counselors at each county's Area Agency on Aging compare Medicare Advantage, Medigap and Part D plans at no cost and screen for Extra Help and PACE/PACENET.
Open enrollment runs October 15 to December 7 each year.
