Pennsylvania Medicaid home care: Community HealthChoices and Services My Way

Pennsylvania pays for long-term care at home mainly through Community HealthChoices (CHC), a Medicaid managed care program run by the Department of Human Services (DHS). Participants who choose to direct their own care can use Services My Way or an employer model to hire their own workers.

How care at home is paid for here

Pennsylvania calls Medicaid Medical Assistance. Medicaid.gov lists DHS as the state Medicaid agency. DHS's Apply for Community HealthChoices page says CHC is Pennsylvania's long-term services and supports managed care program for people who are eligible for both Medicaid and Medicare, as well as individuals 21 or older with physical disabilities. DHS's Office of Long-Term Living administers the CHC waiver.

The state's CHC waiver application says the program serves people 21 or older who are financially and clinically eligible for Medicaid long-term services and supports, in the community or in nursing facilities, and people 21 or older who are fully eligible for both Medicaid and Medicare. It runs across five zones covering all 67 counties. The application is a request for federal approval and lists a proposed effective date of July 1, 2026.

Services come through CHC managed care organizations. The 2026 CHC agreement requires each participant to have a person-centered service plan and a service coordinator.

Services My Way and self-direction

DHS describes Services My Way (SMW) as helping Pennsylvanians who need long-term care support manage their own services. SMW is an option for people who can mentally and physically manage their care and who need help with tasks of daily living. People must be assessed as needing a nursing facility level of care. DHS says SMW supports people who choose to live in the community by employing workers who help with their care, and its services include developing a service plan, help budgeting and finding workers, help meeting tax, labor and workers compensation requirements, and making financial transactions.

The 2026 CHC agreement goes further. It requires CHC plans to give participants who need personal assistance services the chance to self-direct them as the first option over the traditional agency model, and to document the reason if the participant declines. There are two main models: the Participant-Directed Employer Authority model, where the participant employs their own personal assistance or respite provider, and Services My Way, a budget authority model. A fiscal management services vendor processes timesheets, makes payments and manages tax withholdings, including FICA taxes, in both. The agreement also describes an Agency with Choice model, available upon federal approval.

Details are on Services My Way in Pennsylvania.

Act 150 for adults under 60

DHS's Act 150 program, Attendant Care, is for Pennsylvanians who are 18 to 59 with a physical disability. Eligibility on the DHS page includes being a Pennsylvania resident, meeting the skilled nursing facility level of care, being able to hire, fire and supervise attendant care workers and manage your own financial and legal affairs, having a medically diagnosed physical disability expected to last at least one year, and being financially ineligible for Medicaid. People may pay a co-payment based on income. DHS's Apply Now link goes to the Independent Enrollment Broker site.

How to apply

DHS says there are several ways to start.

1. By phone. Since June 16, 2025, the Consumer Service Center has taken long-term care and home and community-based services applications by phone at 1-866-550-4355.
2. Online. DHS links to COMPASS for applications.
3. County assistance office. The Apply for Community HealthChoices page tells people to call their local county assistance office (CAO).
4. Independent Enrollment Broker (IEB). For CHC, DHS says the IEB helps you apply for long-term services and supports, schedules an in-person assessment at home, in a hospital or in a nursing facility, and helps complete the Medicaid application, which goes to the CAO. If you do not choose a CHC plan, one is assigned to you.

Coverage with the CHC plan begins on the date you are determined eligible.

Who can be the paid caregiver

Under the self-directed employer model, the CHC agreement says the worker can be a family member, a friend, a neighbor or any other qualified personal assistance worker as determined by the Department. We could not read a DHS page that lists which relatives are excluded, such as a spouse. Ask your service coordinator. See paid family caregiver in Pennsylvania.

Questions to ask when you call

• Has my application for long-term care services reached the county assistance office, and who is handling it?
• Has the Independent Enrollment Broker scheduled my in-person assessment?
• Which CHC plans serve my zone, and can I keep my current providers?
• Will my plan present self-direction as the first option for personal assistance services?
• If I choose Services My Way, which relatives can I hire?

Terms you will see

• CAO: the county assistance office, which decides financial eligibility.
• IEB: the Independent Enrollment Broker, which helps you apply and schedules the assessment.
• CHC-MCO: a managed care organization that runs CHC for your zone.
• Service coordinator: the person who helps you build your person-centered service plan.
• FMS vendor: the fiscal management services vendor that processes timesheets and payments for self-directed workers.

What this page does not cover

The waiver application mentions waivers administered by the Office of Developmental Programs, which are outside CHC, and the LIFE program for people who are nursing facility clinically eligible, which the waiver application says is an alternative to CHC. We have not described them. See intellectual and developmental disability services in Pennsylvania for providers.

Where Carevo fits

Carevo is a connection platform and directory. We do not run CHC, decide eligibility or recommend a plan or provider. The care-type links below show providers that serve your area.

Programs in Pennsylvania

• Services My Way: Services My Way is Pennsylvania's budget-based self-directed option inside Community HealthChoices. You convert your service plan into a budget and can employ your own personal assistance workers, including family.

Find providers in Pennsylvania

• Home care in Pennsylvania
• Home health care in Pennsylvania
• Nursing homes in Pennsylvania
• Intellectual and developmental disability services in Pennsylvania
• Paid family caregiver in Pennsylvania