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Does Medicaid Pay for Assisted Living in Pennsylvania?

Updated September 4, 2026. Quick answer: yes, through Community HealthChoices (CHC) 1915(c) HCBS Waiver (PA.0386.R05.01). Medicaid does not pay the facility’s room and board either way; only the care and service component.

What Pennsylvania covers

Waiver / state plan optionCommunity HealthChoices (CHC) 1915(c) HCBS Waiver (PA.0386.R05.01)
Covers an assisted living setting?Yes: “Licensed Settings are settings in which four or more individuals reside and are licensed as Personal Care Homes (reference 55 PA Code Chapter 2600) or Assisted Living Residences (reference 55 PA Code Chapter 2800).”
Room and boardNever covered by Medicaid, in Pennsylvania or any state; see below.

The room-and-board split

Federal law is the floor every state builds on: “The Secretary may by waiver provide that a State plan approved under this subchapter may include as “medical assistance” under such plan payment for part or all of the cost of home or community-based services (other than room and board) approved by the Secretary” (42 U.S.C. §1396n(c)(1), Social Security Act §1915(c)). The words in parentheses do the work: whatever a state’s waiver pays for inside an assisted living community, it is not the rent, the meals, or the room itself. That portion stays the resident’s own to fund, out of income, savings, or a family contribution; the waiver only ever reaches the care and service layer on top of it. Pennsylvania’s own materials say the same thing directly: “In accordance with 42 CFR 441.310(a)(2), the Commonwealth does not pay the cost of room and board and did not include costs associated with room and board in the capitation rate development process. The CHC-MCOs will negotiate rates with each residential service provider based upon the assessed medical and functional needs and circumstances of each participant receiving services in a residential setting. These rates specifically exclude room and board.” (PA Community HealthChoices 1915(c) HCBS Waiver Application PA.0386.R05.01, Appendix I-5).

The waitlist

Open: state does not limit the number of participants served at any point in time : “The state does not limit the number of participants that it serves at any point in time during a waiver year.” (as of 06/29/2026 (CHC waiver application PA.0386.R05.01, effective Jul 01, 2026))

What you get to keep: the personal needs allowance

Not published in the materials reviewed this session. This is the amount of a waiver participant’s own income the state lets them keep for personal spending after the rest goes toward the cost of their care; it varies by state because each state sets its own figure inside the federal floor.

Paying for care is the harder half

What a waiver covers is only part of the problem, because room and board still has to come from somewhere, and an adviser can look at income, savings and the likely timeline together before a placement decision is made.

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What this doesn’t answer

The CHC waiver document explicitly names Assisted Living Residences (55 Pa. Code Ch. 2800) and Personal Care Homes (55 Pa. Code Ch. 2600) as licensed settings for Residential Habilitation, and explicitly excludes room and board from MCO capitation rates. The personal-needs-allowance dollar figure is unverified: the waiver ties the allowance to ‘the special income level for institutionalized persons’ rather than stating a dollar figure, and that referenced standard was not itself read this session. Note the separate Attendant Care Waiver is home/apartment-only and does not reach assisted living: CHC is the mechanism that does. Pa.gov pages fetched without issue this session (no 403s encountered, unlike prior sibling kits).

Sources

Read September 4, 2026.

Same question, other states: Rhode Island · South Carolina.

Related: what assisted living actually costs · assisted living vs. staying home vs. a CCRC · why home care has a waitlist and a nursing home doesn’t.

General information drawn from each state’s own Medicaid agency and federal statute, not legal, tax or financial advice. Medicaid is administered state by state; waiver names, coverage decisions, waitlists and allowance amounts change by state budget and legislative action. This page cannot see your own state’s current caseload. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.

Related: Pennsylvania’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.

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