Protecting Assets from Nursing Home Costs in Pennsylvania

Written by Erik Spurlin

Facing a nursing home stay is tough enough without worrying about losing your life savings. Unfortunately, without private long-term care insurance, the high cost of nursing care often forces families to spend down assets until they qualify for Medicaid. But the good news is Pennsylvania law offers protections—especially for married couples—so you don’t have to lose everything.

Medicaid is a government program that pays for nursing home care once your assets and income are low enough. In the past, this meant couples had to drain nearly all their resources, leaving the healthy spouse at home financially stranded. Today, “spousal impoverishment” rules help protect the spouse who remains at home.

Here’s how it works: When one spouse enters a nursing home for at least 30 days, a “resource assessment” is completed by submitting a form to the County Assistance Office. This lists the couple’s assets as of the date of admission, but excludes things like the primary residence, household items, personal effects, and (in Pennsylvania) the healthy spouse’s IRAs.

The assessment determines the “spousal share”—typically half of the countable assets. For example, if the couple has $120,000 in countable assets, the healthy spouse keeps $60,000, plus the exempt items. However, there are limits. For 2025, the minimum spousal share is $31,584 and the maximum is $157,920. So even if the couple has $400,000 in assets, the healthy spouse can keep only $157,920 (plus the exempt property).

No special application is needed for these basic protections. But if you want to preserve more assets beyond the standard amounts, you should act fast and get expert legal advice after nursing home admission—there are often still options!

Income protections also exist. In Pennsylvania, the healthy spouse usually keeps all of their own income (like Social Security or pension). If it’s too low, some of the nursing home spouse’s income can be diverted to help support them.

Bottom line: Nursing home care doesn’t have to wipe you out. With the right steps—and the right help—you can protect much of what you’ve worked a lifetime to build.