Pennsylvania OPTIONS Program for Seniors: Eligibility, Services & Costs in 2026

What the OPTIONS Program Actually Covers

Your parent doesn't qualify for Medicaid, but they can't safely live alone anymore. That gap — too much income for Medicaid, not enough to hire full-time help — is exactly where Pennsylvania's OPTIONS program sits.

OPTIONS is a state-funded program run through Pennsylvania's 52 Area Agencies on Aging (AAAs). It provides in-home services to residents aged 60 and older who have functional limitations that make independent living difficult but who don't meet the strict financial criteria for Community HealthChoices Medicaid. Services include personal care assistance with bathing, dressing, and meal preparation, plus home-delivered meals, adult day services, emergency response systems, respite care, and minor home modifications.

The funding comes primarily from the Pennsylvania Lottery and the federal Older Americans Act. Unlike Medicaid, OPTIONS doesn't require nursing-facility-level care needs — your parent just needs documented difficulty with activities of daily living.

Eligibility Requirements

The core eligibility criteria are straightforward:

• Age: 60 or older
• Residency: Pennsylvania resident
• Functional need: Documented limitations in at least one activity of daily living (bathing, dressing, eating, toileting, transfers, mobility)

There's no hard income cutoff to apply, which is the critical distinction from Medicaid. Instead, OPTIONS uses a sliding-scale cost-sharing model — everyone can apply, but what you pay depends on household income.

The Sliding-Scale Cost-Share

OPTIONS calculates your parent's copay based on where their income falls relative to the Federal Poverty Level (FPL). The 2026 scale works like this:

• 0% to 133% of FPL: No cost share — fully subsidized
• 134% to 150% of FPL: 10% cost share
• 151% to 175% of FPL: 20% cost share
• 176% to 185% of FPL: 30% cost share
• 186% to 200% of FPL: 40% cost share
• 201% to 220% of FPL: 50% cost share
• 221% to 240% of FPL: 60% cost share
• 241% to 260% of FPL: 70% cost share
• 261% to 280% of FPL: 80% cost share
• 281% to 300% of FPL: 90% cost share
• 301% and above of FPL: 100% cost share (your parent pays the full rate)

The percentage is applied to the cost of authorized services, not total income. So if the AAA authorizes $800 per month in personal care and your parent falls into the 20% bracket, they'd pay around $160 monthly. Medical and shelter expense deductions can reduce the calculation further.

How to Apply

Contact your local Area Agency on Aging directly — there's no state portal for OPTIONS the way COMPASS handles Medicaid applications. The AAA conducts an in-home assessment to document functional limitations and calculate the cost share.

One practical issue: many AAAs maintain waiting lists for OPTIONS services because funding is capped by the state's annual Aging Block Grant. If your parent is coming home from the hospital and needs immediate support, ask the discharge planner to make the AAA referral before discharge day so the intake process starts while your parent is still in the facility.

Caregiver Support Through OPTIONS

The OPTIONS Caregiver Support Program provides a separate set of services specifically for family members providing unpaid care. This includes respite care (temporary relief so you can step away), caregiver training, counseling, and supplemental services like assistive devices.

Key financial caps to know: the Caregiver Support Program limits monthly care plans to $600 and imposes a $5,000 lifetime cap on home modifications and assistive devices. These caps apply per care recipient, not per caregiver.

OPTIONS vs. Community HealthChoices

The two programs serve different populations and shouldn't be confused:

If your parent's health declines and they eventually meet Medicaid's financial and clinical thresholds, they can transition from OPTIONS to Community HealthChoices without interrupting services. The AAA can coordinate this transition.

What to Do Right Now

If your parent is being discharged from a Pennsylvania hospital and needs ongoing home support but doesn't qualify for Medicaid, call the Eldercare Locator at 1-800-677-1116 to find your local AAA. Start the intake process immediately — waiting lists are real, and a few weeks of lead time can mean the difference between coming home safely and scrambling for coverage.

For the full discharge-to-home transition process — including how to coordinate OPTIONS alongside Medicare home health, DME orders, and medication reconciliation — the Pennsylvania Hospital Discharge Guide walks through every step with PA-specific timelines and checklists.

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