A Pennsylvania long-term-care plan has to account for income, resources, level of care, and that five-year review of any below-market transfers. Because DHS offers both the $2,982 300%-FBR pathway and a medically needy spend-down path, it's a mistake to plan around Pennsylvania as if it enforces one universal hard income cap.
Spousal protections matter here too. For the relevant 2026 period, federal standards put Pennsylvania's CSRA between $32,532 and $162,660, with an MMMNA floor of $2,705.00 per month for the spouse remaining at home.
And any Pennsylvania plan has to reckon with the state's active filial responsibility statute — 23 Pa.C.S. § 4603 — which the Superior Court has actually applied against an adult child in *Health Care & Retirement Corp. of America v. Pittas*, making family liability a real consideration rather than a theoretical one.