Estate Planning for Seniors in Pennsylvania

Estate planning changes materially after 65. The documents you signed in your 40s or 50s were built for a different life stage — young children, working income, no immediate long-term-care risk. By your late 60s and 70s the concerns shift to capacity, healthcare decision-making, Medicaid eligibility, and passing assets to adult children as tax-efficiently as Pennsylvania law allows.

This guide is written specifically for Pennsylvania residents and covers what to review, when, and why.

The four documents every Pennsylvania senior should have current

1. A current will that reflects your present family, executors, and asset picture — not the one from 20 years ago.
2. A Pennsylvania durable financial power of attorney that complies with Act 95 of 2014 (see below). POAs signed before 2015 are routinely rejected by banks and brokerages.
3. An advance healthcare directive combining a living will and healthcare power of attorney under 20 Pa.C.S. §§ 5421–5488.
4. A HIPAA authorization naming the people your doctors are allowed to speak with. Without this, adult children and even spouses can be blocked at the hospital.

For most Pennsylvania seniors, a revocable living trust is worth serious consideration on top of the will — especially if you own real estate in more than one state or want your children to avoid Register of Wills probate.

Why pre-2015 POAs stop working

Act 95 of 2014 rewrote the Pennsylvania POA statute (20 Pa.C.S. § 5601 et seq.). It requires a statutory Notice, an Acknowledgment by the agent, two witnesses, and notarization. It also created the "hot powers" list — actions like changing beneficiary designations, making gifts, or creating trusts that the POA must explicitly authorize.

Banks and brokerages know this. A POA signed in 2008 that lacks the current statutory Notice will typically be refused, even if it was valid when signed. Anyone over 65 with an older POA should assume it needs to be redone. See our Pennsylvania power of attorney guide for the full requirements.

Healthcare directives and the HIPAA gap

Pennsylvania's advance directive statute lets you appoint a healthcare agent and specify end-of-life preferences. But a healthcare POA alone is not a HIPAA release. Hospitals routinely tell adult children "we can't discuss your father's condition" even when a healthcare POA exists, because HIPAA requires its own written authorization. See our PA HIPAA authorization coverage for how to structure this correctly alongside a living trust.

For a hospitalization checklist, keep these documents together and give copies to your named agent, your primary care physician, and — if applicable — the assisted living or skilled nursing facility.

Medicaid planning and the five-year look-back

Long-term care in Pennsylvania averages roughly $12,000–$14,000 per month for skilled nursing. Medicaid (Medical Assistance) will pay, but only after you have spent down to roughly $2,400 in countable assets, and only if you have not made disqualifying transfers in the prior 60 months.

The five-year look-back is why Medicaid planning has to start early. Common strategies for Pennsylvania seniors include:

• Irrevocable Medicaid asset protection trusts — the classic five-year plan.
• Spousal transfers and community-spouse resource allowances — protecting the well spouse.
• Caregiver child exemption — for an adult child who moved home and provided care for at least two years.
• Life-estate deeds — with careful attention to the inheritance tax consequence at death.

Started at 65, these tools have room to work. Started at 82 after a stroke, most of them are unavailable.

Pennsylvania inheritance tax planning for retirees

Pennsylvania is one of six states that still imposes an inheritance tax. Children pay 4.5% on what they inherit, siblings pay 12%, and everyone else pays 15% (spouses are exempt). For a retired couple with $1.5 million in assets, that is a real, foreseeable tax bill.

Common senior-stage strategies:

• Lifetime gifting — gifts made more than one year before death are outside the PA inheritance tax base. There is no Pennsylvania annual gift tax.
• Pre-59½ retirement account strategy — moot for most seniors, but relevant for those who inherited an IRA.
• Beneficiary designation cleanup — naming individuals directly on life insurance and non-retirement accounts.
• Family-owned business exemption — under 72 P.S. § 9111(t), a qualifying business interest can pass fully exempt.

The full rate table and mechanics are in our Pennsylvania inheritance tax guide, and you can model your family's exposure using our PA inheritance tax calculator.

Beneficiary designation review — the most overlooked step

Retirement accounts, life insurance, annuities, and transfer-on-death accounts pass by beneficiary designation, not by will. In our experience roughly one in three seniors we meet has at least one stale designation — an ex-spouse, a deceased sibling, or "estate" listed as the beneficiary (which is almost always the wrong answer for inheritance tax purposes).

Pull every account statement and confirm the primary and contingent beneficiaries in writing. This is a 20-minute exercise with a large tax payoff.

A practical review cadence

• Every 3–5 years — full document review.
• After any major life event — death of a spouse, remarriage, birth of a grandchild, sale of a home, move to another state.
• After age 70 — add a Medicaid-planning conversation to the review.
• After age 75 — confirm the named financial and healthcare agents are still willing and able to serve.

Next steps

If you are a Pennsylvania resident age 60 or older and it has been more than five years since your documents were last reviewed, a no-cost consultation is the right starting point. We serve clients across Pennsylvania by phone and video, with in-person signings at our Camp Hill office or a convenient location near you.