Pennsylvania OPTIONS Program: Home Care for Seniors Over 60

Your parent earns too much for Medicaid but can't safely live alone anymore. Private home care runs $34 per hour in Pennsylvania — roughly $6,480 a month for full-time help. Before you drain savings or start researching nursing homes, there's a state-funded program most families never hear about.

The OPTIONS program (sometimes called "Help at Home") provides personal care, home-delivered meals, and adult day services to Pennsylvania seniors aged 60 and older. Unlike Medicaid, there are no income or asset limits to apply. The tradeoff: it's not an entitlement, so availability depends on your county's funding.

How OPTIONS Differs from Medicaid Home Care

The biggest distinction is who qualifies and what it costs.

Community HealthChoices (CHC), Pennsylvania's Medicaid home care program, requires strict financial eligibility — gross monthly income at or below $2,982 and countable assets under $8,000. It covers unlimited hours based on clinical need, and it's an entitlement: if you qualify, they must serve you.

OPTIONS has no income ceiling and no asset limit. Any Pennsylvanian aged 60 or older with functional limitations affecting daily activities can apply. But it's funded by the Pennsylvania Lottery and federal Older Americans Act dollars, which means your local Area Agency on Aging may have a waitlist when the annual budget runs low.

The cost-sharing structure is straightforward. If your parent's income falls below 133% of the federal poverty level (roughly $1,735 per month for a single person), services are free. Above that, copays scale from 10% to 100% on a sliding scale tied to FPL brackets.

What OPTIONS Actually Covers

The program funds five categories of in-home support:

Personal care assistance — help with bathing, dressing, grooming, toileting, and mobility. This is the core service most families need and the most expensive to buy privately.

Home-delivered meals — prepared meals brought to the home. Notably, meal delivery is exempt from cost-sharing; your parent pays nothing regardless of income. Seniors needing meals also get priority placement on waitlists.

Adult day services — structured daytime programs providing social engagement, supervision, and sometimes health monitoring. Useful when the primary caregiver works during the day.

Home modifications — grab bars, ramp installations, wheelchair-accessible bathrooms. These costs are excluded from the monthly care plan cap.

Care management — an AAA care manager coordinates services, monitors the plan, and adjusts as needs change. Also exempt from cost-sharing.

The Monthly Cost Cap

OPTIONS limits spending to $765 per month per participant, averaged over a rolling 12-month period. Home-delivered meals, assessments, care management, and home modifications don't count toward this cap.

For seniors with severe functional limitations (a Needs Assessment Score of 56 or higher) who use adult day services, the local AAA can approve an exception raising the cap to $1,900 per month. This exception is rare and requires documented clinical need.

How to Apply

Contact your county's Area Agency on Aging — Pennsylvania has 52 local offices. A care coordinator will schedule an in-home evaluation using the Needs Assessment Tool (NAT), which scores your parent's functional limitations and cognitive deficits to calculate a clinical priority score.

If the AAA has funding available, services can start within weeks. If your county's budget is exhausted, your parent goes on a waitlist ranked by their NAT score. The AAA is required to check in by phone at 3 months, conduct a home visit at 6 months, and do a full reassessment at 12 months.

When OPTIONS Isn't Enough

The $765 monthly cap translates to roughly 22 hours of personal care at private-pay rates — barely 5 hours per week. If your parent needs daily hands-on help, OPTIONS bridges the gap but probably won't replace full-time care.

Consider it part of a layered strategy: combine OPTIONS personal care with Medicare home health (for skilled nursing needs at no cost-share), home-delivered meals, and family caregiving to build a sustainable plan.

If your parent's needs outgrow what OPTIONS can fund, the next step is evaluating Medicaid CHC eligibility — which has no waitlist and no monthly cap, but requires meeting strict financial thresholds.

The Pennsylvania Home Care Navigator walks you through the exact eligibility comparison, application checklists, and spend-down strategies to determine which program fits your parent's situation — and how to layer both if needed.

See more Pennsylvania guides →