Pennsylvania’s beautiful landscapes and proximity to popular east coast destinations attract a population of around 13 million people, 18.7% of whom are aged 65 and over. The Keystone State is home to over 250,000 seniors who suffer from Alzheimer’s or other dementias, and that number is expected to increase to over 300,000 by the year 2025. Already, Alzheimer’s is the 6th leading cause of death in Pennsylvania, with 4,150 deaths recorded in 2019.

Retirees may appreciate the senior-friendly tax laws in the state, including exemptions from the 6% sales tax rate for food, clothing and certain medical prescriptions, allowing greater flexibility for lower budgets. For memory care, the average cost you should expect to pay is around $5,125 per month. Lancaster, PA, was recently voted as No. 5 in the US News & World Report’s list of best places to retire.

Memory care can either be offered on its own in a community designed especially for those with dementia or Alzheimer’s, or, more often, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.

Within this guide, you’ll find information on Pennsylvania’s memory care costs and how they compare to other senior long-term care options. You can also learn more about available financing options, important regulations the state has in place for memory care programs and available resources to aid seniors who require assistance with their memory care needs.

The Cost of Memory Care in Pennsylvania

Note: Memory care costs are not tracked in the United States, as they are traditionally classified as a service that is added to assisted living. Average costs are generally 20-30% above assisted living prices. To create our estimates, we’ve used the assisted living rates listed in Genworth’s 2021 Cost of Care Survey and increased them by 25%.

When compared to the surrounding states, the average cost of $5,125 per month for memory care in Pennsylvania is a bargain. West Virginia comes in only slightly higher at $5,200, but monthly costs in Ohio ($5,794), Maryland ($6,125) and New York ($5,725) are significantly more expensive.

$5125

Pennsylvania

$5625

The United States

$5794

Ohio

$6125

Maryland

$5725

New York

$5200

West Virginia

The cost of memory care in Pennsylvania can vary greatly depending on the area, ranging from average monthly fees of $3,594 in Scranton up to $7,106 in Philadelphia. Lower prices can also be found in Pittsburgh ($4,063) and Williamsport ($4,208), while Erie ($5,731) and Harrisburg ($6,035) are both on the higher end of the spectrum.

$3594

Scranton

$4063

Pittsburgh

$4208

Williamsport

$5731

Erie

$6035

Harrisburg

$7106

Philadelphia

Aside from memory care, there are a number of additional senior long-term care services available in Pennsylvania. For in-home assistance, monthly fees average around $4,957 for both home care and home health care. Adult day health care comes in lowest at $1,625 per month, while nursing home care is the most expensive at $10,403 for a semiprivate room and $11,157 for a private room. Traditional assisted living sits on the lower end at only $4,100 monthly.

$1625

Adult Day Health Care

$4100

Assisted Living

$4957

Home Care

$4957

Home Health Care

$10403

Nursing Home (semiprivate)

$11157

Nursing Home (private)

Does Medicaid Cover Memory Care in Pennsylvania?

Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in Pennsylvania.

Some aspects of memory care services are covered by Pennsylvania Medicaid through the Community HealthChoices program. This managed care program is designed to help with access to long-term support services for seniors who are both Medicaid and Medicare-eligible. Participants must also meet the criteria for nursing home placement, though enrollment in a nursing home is not required.

Community HealthChoices was created to help seniors to remain in their homes. Used to replace the Pennsylvania Aging Waiver, services are generally intended to be used at home rather than in an assisted living facility. However, those who entered the program under the old waiver system while in an assisted living facility are sometimes able to keep their services.  

What Memory Care Services Are Covered by Medicaid in Pennsylvania?

Community HealthChoices can be used to provide a number of assistive services, such as recreational and social programs, assistance with activities of daily living and medical supplies and mobility devices deemed essential. General Medicare will also provide up to 100 days of in-home skilled nursing care in certain circumstances, though custodial nursing care is not offered long-term. Medicare will also cover in-home hospice care for memory care patients deemed eligible by their doctors.

How to Know if You’re Eligible for Medicaid in Pennsylvania

To be eligible for Pennsylvania Medicaid, seniors must meet income and resource limits shown in the table below. Income used in this calculation includes:

  • Social Security payments
  • Pensions
  • Savings and investment interest and dividends
  • Rental income
  • IRA withdrawals
  • Spousal income (if residing together)
  • Veteran’s benefits (except MAGI MA)

Resources include most valuable assets. A few exceptions exist, such as your home, one vehicle, burial reserves that meet specific limits and a burial marker and space. Counted assets include:

  • Cash
  • Checking and savings accounts
  • Savings certificates
  • Stocks and bonds
  • Trust funds
  • Life insurance
  • Additional vehicles
  • Non-resident properties

2022 Medicaid Income Limits for Pennsylvania Seniors



Income Limits

Resource Limits

Single Applicant

$18,075

$2,000

Two-person Household (One applicant)

$24,353

$3,000

Two-person Household (Both applicants)

$48,706

$3,000

Aside from income and assets, seniors must meet a number of other eligibility requirements to participate in Medicaid programs. Additional requirements include:

  • Full-time Pennsylvania residency as a U.S. citizen, permanent resident, legal alien or national
  • Social security number
  • Identification such as a driver’s license, state-issued identification card or passport
  • Specific household composition requirements

How to Apply for Medicaid in Pennsylvania

There are four options to apply for Pennsylvania Medicaid:

  1. The easiest way to apply for Medicaid in Pennsylvania is online through the COMPASS online application portal.
  2. If you prefer to submit a paper copy, the application can be downloaded and printed from the Health Care/Medical Assistance page, where you will also find additional information on how to apply. 
  3. You can apply over the phone by calling the Health Care Coverage Consumer Service Center at 1-866-550-4355.
  4. Apply in person by visiting your local county assistance office (CAO).

Information You Will Need

To make the application process easier, you will need supporting evidence and documentation. Make sure to gather all the information and documents you’ll need in advance:

  • Evidence of household income from all eligible sources
  • Federal tax filing information
  • Birth dates and Social Security numbers for everyone in the household
  • Information from your current or most recent health insurance policy
  • Home and utility information
  • Proof of citizenship or documents demonstrating lawful U.S. residency
  • Information on resources, such as life insurance policies, extra vehicle titles, bank accounts, etc.

How to Get Help Applying for Medicaid

Seniors who need assistance with their Pennsylvania Medicaid applications have options available to them online, over the phone and in person. A helpline is available for anyone needing help completing the online COMPASS application, and the county assistance offices are available to assist with applications in person or over the phone. For those using alternative application methods, the Consumer Service Center for Health Care Coverage offers phone consultations, or an appointment can be made at the appropriate county assistance office.

Program

Contact

Services Provided

Online or by phone at (800) 692-7462

The website offers instructions and applications online. Agents are available by phone to assist with application questions.

Consumer Service Center for Health Care Coverage

(866) 550-4355

Agents can assist with applications over the phone and answer any questions.

County Assistance Office (CAO)

Contact information found online

Caseworkers are available to take applications and renewals and can answer any questions in person or over the phone.

Does Medicare Cover Memory Care in Pennsylvania?

The short answer is that no, Medicare does not cover the cost of memory care in Pennsylvania. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Pennsylvania.

Other Financial Assistance Options for Memory Care in Pennsylvania

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Memory Care affordable.

 

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Pennsylvania

Seniors who require memory care services may also be eligible for several free or low-cost resources in their local area to help with other aspects of daily living. These can include programs to help with home meal delivery, peer support groups, counseling and legal advice. Some are state-sponsored services, while others are run by non-profit organizations and volunteer groups.

 

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy.

COVID-19 Rules for Memory Care in Pennsylvania

The following information is based on research done on several government websites, including dhs.pa.gov and health.pa.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 4/27/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Pennsylvania Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Pennsylvania Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Pennsylvania Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes (Conditions Apply)

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Memory Care Laws and Regulations in Pennsylvania

Pennsylvania assisted living communities that offer memory care services and dedicated residential memory care programs are regulated by the Pennsylvania Department of Human Services. State-licensed assisted living residences and personal care homes can offer memory care services.

MEMORY CARE LAWS AND REGULATIONS IN PENNSYLVANIA
Scope of Care
Memory care facilities and programs may only admit and retain residents with medical, behavioral and emotional needs that can be safely met at the facility. Personal care homes cannot admit residents who require the level of care normally provided in a nursing home setting. Residents who are ventilator-dependent, require 24/7 skilled nursing care or who exhibit aggressive behavior that can only be safely managed with the use of physical restraints are also excluded from admission to an assisted living residence or personal care home.
Care Plan Requirements
Assisted living residences and personal care homes must conduct comprehensive preadmission assessments, which are used to develop a personalized care plan. A second written assessment and care plan must be created within 30 days of admission, and memory care residents must have their care plan reviewed by a registered nurse or licensed physician annually.
Medication Management Requirements
ALRs and PCHs can provide assistance with self-administration of prescription and over-the-counter medication if that medication has been ordered by a medical professional. Facilities can offer medication administration services if the service is provided by a licensed staff member who has the required certification and training.
Staff Screening Requirements
Staff must demonstrate the skills, knowledge and aptitude needed to provide safe, respectful care to those living with memory loss. Most facilities require that direct care staff pass a criminal record check, although this is not mandated by the state.
Staff Training Requirements
Direct care staff must complete at least 16 hours of approved training related to memory care each year, and new hires need to complete at least 8 hours of dementia-specific training within 30 days of commencing work at a memory care facility. Program administrators must complete a minimum of 24 hours of continuing education each year.
Medicaid Coverage
Pennsylvania's Community HealthChoices program covers the cost of memory care services for Medicaid-eligible seniors.
Reporting Abuse
Suspected abuse, neglect or exploitation of a senior in a Pennsylvania memory care community must be reported to the Long-Term Care Ombudsman by calling (717) 783-8975. Situations where a senior is at immediate risk of harm must be reported to local law enforcement officials or by calling the statewide elder abuse hotline at 1-800-490-8505.

Frequently Asked Questions

How Much Does Memory Care Cost in Pennsylvania?

On average, the cost of memory care services in Pennsylvania is around $5,125 per month. This amount varies by location with average monthly costs as low as $3,594 in Scranton or as high as $7,106 in Philadelphia.

Does Pennsylvania Medicaid Pay for Memory Care?

Pennsylvania’s state Medicaid plan will cover care costs for beneficiaries who need specialized residential care services due to a progressive-degenerative memory condition, such as Alzheimer’s disease, through Community HealthChoices, a Medicaid managed care program. Medicaid does not pay the associated room and board costs.

What Is the Difference Between Memory Care and Assisted Living?

Memory care and assisted living differ in that assisted living communities are designed for seniors who are largely free of any major cognitive issues, such as dementia, while memory care programs are geared towards those diagnosed with dementia. Memory care programs offer a higher staff-to-resident ratio, structured daily programming and an environment that’s designed to prevent dementia-related wandering, confusion and agitation.

What Security Features Are Present in Memory Care Facilities?

Memory care facilities have specialized security features designed to minimize wandering among residents with Alzheimer’s disease and other types of dementia. These features often include delayed-egress fixtures, digital locks on exterior doors, interior and exterior security cameras and motion sensors. Many communities offer fully enclosed outdoor areas, such as courtyards, and some facilities are equipped with WanderGuard, a discrete, wireless monitoring system that allows caregivers to track the whereabouts of each resident. All memory care facilities in Pennsylvania must have 24/7 awake staff on-site.

What Types of Facilities Offer Memory Care?

Memory care services may be offered as part of an assisted living community, within a nursing home, or as a stand-alone community. When memory care is provided in a community with multiple levels of care, the memory care program is usually delivered in a separate wing or on a specific floor that’s designed to meet the unique needs of those living with Alzheimer’s and dementia.