Medicaid Spend-Down in Pennsylvania

Pennsylvania uses the standard income-cap structure but is more generous than most states on the asset side, thanks to an extra exemption built into its asset limit.

Income limit

The 2026 income limit for a single Nursing Home Medicaid applicant in Pennsylvania is $2,982/month; for married applicants both applying, it's $2,982/month per spouse. Applicants over the cap generally need a Qualified Income Trust (Miller Trust) rather than an income spend-down.

Asset limit

Pennsylvania's 2026 asset limit for a single applicant is $8,000 — the $2,000 federal baseline plus an additional $6,000 exemption. If the applicant's income exceeds $2,982/month, the asset limit drops to $2,400 instead. For married applicants both applying, the combined limit is $16,000. Because this extra exemption is state-specific and the rules shift depending on income, it's worth confirming the exact figure that applies to your parent's situation with a Pennsylvania elder law attorney.

Community Spouse Resource Allowance

When only one spouse applies, the community spouse can typically retain 50% of the couple's combined countable assets, up to a maximum of $162,660 (2026) — with at least $32,532 protected even if 50% of the couple's assets comes to less than that.

What to do if your parent is over the limit

If assets are over the applicable limit, asset spend-down is the standard path, and our countable vs. exempt assets guide covers what actually counts. Pennsylvania has a 5-year look-back period — see spend-down vs. the look-back period before making any transfers. Our spend-down calculator can give a rough starting estimate, but confirm Pennsylvania's current, income-dependent asset limit with an elder law attorney before relying on any number.