Pennsylvania's Community HealthChoices (CHC) program provides Medicaid-funded home care at no cost to eligible families. To qualify, you must meet three requirements: income at or below $2,982/month (2026 limit), countable assets under $8,000, and a clinical need for nursing-level care (assistance with 3+ daily activities). The enrollment process takes 30 to 90 days. Below is everything you need to know.
Community HealthChoices is Pennsylvania's Medicaid managed care program for long-term services and supports. It serves older adults (65+), people with physical disabilities, and individuals who are dually eligible for Medicare and Medicaid. The program covers over 420,000 Pennsylvanians statewide.
Through CHC, eligible individuals can receive home care services instead of moving to a nursing facility. The program is administered by Managed Care Organizations (MCOs) that coordinate care, authorize services, and manage provider networks.
The three MCOs currently operating in Western Pennsylvania's Southwest Zone are:
You can choose your MCO when you enroll, and you can switch MCOs at any time if you are not satisfied with your care coordination.
The income limit for CHC waiver services equals 300% of the Federal Benefit Rate (FBR). This threshold is adjusted each January.
| Year | Federal Benefit Rate | Income Limit (300% FBR) |
|---|---|---|
| 2026 | $994/month | $2,982/month |
| 2025 | $967/month | $2,901/month |
Key details about income eligibility:
In addition to income, Pennsylvania Medicaid evaluates your countable assets. The limits differ based on your income level and marital status.
| Situation | Asset Limit (2026) |
|---|---|
| Single applicant, income at or below $2,982/month | $8,000 |
| Single applicant, income above $2,982/month | $2,400 |
| Married (community spouse resource allowance) | $32,532 to $162,660 |
Many of the things families worry about are actually excluded from the asset calculation:
When only one spouse applies, the at-home (community) spouse can generally protect half of the couple's countable assets, up to $162,660 in 2026. The minimum protected amount is $32,532. This is called the Community Spouse Resource Allowance (CSRA). Your home is not at risk.
Financial eligibility alone is not enough. You must also be determined "Nursing Facility Clinically Eligible" (NFCE). This means your care needs are significant enough that you would otherwise require nursing home placement.
The clinical determination involves two components:
To meet NFCE criteria, you must need hands-on assistance with at least 3 activities of daily living (ADLs) due to a diagnosed illness, injury, or disability. The ADLs evaluated include:
Many families assume their loved one "isn't sick enough" to qualify. The standard is needing regular hands-on help with daily activities, not being completely dependent. If your parent needs someone to help them bathe, dress, and prepare meals each day, they may well qualify.
The enrollment process involves multiple agencies and typically takes 30 to 90 days from start to finish. Here is what to expect at each step.
Call 1-877-550-4227 (PA IEB) or apply online through COMPASS at compass.state.pa.us. The IEB manages the intake process and coordinates between the various agencies involved.
The IEB will request a Physician Certification Form from your loved one's doctor. This form confirms the medical conditions that create the need for home care services. Ask your doctor's office to prioritize this, as delays here slow everything down.
An assessor from your local Area Agency on Aging will visit the applicant's home to conduct the Functional Eligibility Determination (FED). This assessment evaluates physical and cognitive functioning and typically occurs within 10 business days of the initial contact.
The PA IEB reviews both the FED assessment and the physician certification to determine clinical (NFCE) eligibility. If the applicant meets the clinical threshold, the process moves to the financial review.
The application is forwarded to your County Assistance Office (CAO) for financial eligibility determination. The CAO evaluates income and assets against the limits described above. The CAO must provide a decision within 90 days.
Once approved, you choose a Managed Care Organization (PA Health & Wellness, AmeriHealth Caritas, or UPMC CHC). Your MCO assigns a service coordinator who develops a person-centered care plan and connects you with a home care agency to begin services.
Once enrolled, your MCO authorizes and funds the following services at no cost to you:
| Service | What It Covers |
|---|---|
| Adult Day Care | Supervised daytime programs with activities and meals |
| Home Modifications | Ramps, grab bars, bathroom modifications for safety |
| Personal Emergency Response (PERS) | Medical alert systems for fall detection and emergencies |
| Assistive Technology | Devices that help with independence and daily tasks |
| Meal Delivery | Home-delivered meals for nutrition support |
| Chore Service | Heavy household chores (added January 2025) |
| Transportation | Medical and community transportation |
| Community Integration | Support for social participation and community access |
Yes. Through the CHC program, eligible family members can become paid caregivers for their loved ones. The family member must meet caregiver screening requirements and work through a licensed home care agency.
Who can qualify:
Who generally cannot:
For a detailed guide on this program, see our resource: Get Paid as a Family Caregiver in Pennsylvania →
Pennsylvania's CHC program is divided into geographic zones. Western Pennsylvania falls within the Southwest Zone, which includes 14 counties. Willow Home Care Services operates in 8 of these counties:
| County | Willow Service Area | CHC Zone |
|---|---|---|
| Allegheny | Yes | Southwest |
| Armstrong | Yes | Southwest |
| Beaver | Yes | Southwest |
| Butler | Yes | Southwest |
| Fayette | Yes | Southwest |
| Greene | Yes | Southwest |
| Washington | Yes | Southwest |
| Westmoreland | Yes | Southwest |
All three MCOs (PA Health & Wellness, AmeriHealth Caritas, and UPMC CHC) operate in the Southwest Zone, so families in these counties have full choice of managed care plans.
Willow Home Care Services is a licensed home care agency based in Monroeville, PA, serving 8 counties across Western Pennsylvania. We provide both Medicaid-funded and private pay home care, and we specialize in helping families navigate the CHC enrollment process from start to finish.
Have questions about eligibility? Call us at (412) 701-7000 for a free, no-pressure conversation.
We help families figure out eligibility every day. Call us for a free consultation and we will walk you through your options.
Call (412) 701-7000 →The income limit is $2,982 per month (300% of the Federal Benefit Rate). Only the applicant's income is counted. A non-applicant spouse's income is not included in the calculation.
For a single applicant with income at or below $2,982/month, the asset limit is $8,000 in countable resources. Your primary home, one vehicle, household goods, and certain burial funds are excluded from this count.
The full process typically takes 30 to 90 days. The County Assistance Office must provide a financial eligibility decision within 90 days. Getting the physician certification completed promptly can help speed things up.
Yes. Adult children, siblings, grandchildren, and other relatives can become paid caregivers through the CHC program. Spouses are generally excluded. The family member works through a licensed home care agency. See our detailed guide: Get Paid as a Family Caregiver in PA.
NFCE means you need a level of care that would otherwise be provided in a nursing home. To qualify, you must need hands-on help with at least 3 activities of daily living (bathing, dressing, eating, toileting, or walking) due to a diagnosed medical condition.
You may still qualify through a Medicaid spend-down or a Miller Trust (Qualified Income Trust). These are legal strategies that can help you meet the income threshold. Consulting an elder law attorney is recommended if your income is close to or above the limit.