Medical Assistance (Pennsylvania's Medicaid program) will pay for long-term care — but only after you've spent down most of your assets. Strategic planning, started early enough, can protect the family home and a meaningful portion of your savings.
The five-year lookback
Transfers of assets in the five years before a Medicaid application can trigger a penalty period during which the applicant is ineligible. The Medicaid Asset Protection Trust (MAPT) is the most common tool — once funded and the lookback runs, the trust assets are off the table.
Crisis vs. proactive planning
Proactive planning, five or more years out, gives the broadest options. Crisis planning — when a loved one is already in care — is narrower but still useful. Spousal protections, caregiver-child transfers, annuities, and gifting strategies all play a role.