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 option | Community 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 board | Never 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.
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 waiver states no personal-needs-allowance dollar figure: Appendix B-5 selects the special income level for institutionalized persons at 300% of the SSI Federal Benefit Rate, which works out to $2,982 a month at the $994 individual benefit rate shown in OKDHS Appendix C-1 effective 7/1/2026 (our arithmetic; Pennsylvania does not state the dollar amount, and the SSA rate page could not be read). 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).
Figures verified against the Community HealthChoices 1915(c) waiver application PA.0386.R05.01 (effective July 1, 2026), the Attendant Care waiver application PA.0277.R05.00, and 42 U.S.C. §1396n(c)(1) (law.cornell.edu) on September 30, 2026; the dollar value of the personal needs allowance was not re-checked against an SSA source.
Sources
- PA Community HealthChoices 1915(c) HCBS Waiver Application PA.0386.R05.01
- PA Attendant Care 1915(c) Waiver Application PA.0277.R05.00 (confirms home/apartment-only scope, no residential/AL settings)
- PA DHS: Office of Long-Term Living Info page
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.
For your own numbers, run the Medicaid Spend-Down Calculator: Income Trust or Spend-Down, by State.
See Medicaid Estate Recovery by State: What Each State Can Reach (2026) for the full state by state breakdown.