PA 600L Medicaid Long-Term Care Application: Filing and Look-Back

The PA 600L is Pennsylvania’s Medicaid long-term care application — the form you use to establish financial eligibility for Medicaid coverage of a nursing facility stay or Home and Community-Based Services. It’s published by the Pennsylvania Department of Human Services and can be filed on paper or online through the COMPASS portal at compass.dhs.pa.gov.¹ The form asks for a detailed, five-year financial picture, and the thoroughness of your supporting documents largely decides whether your case closes in 30 days or stretches on for months.

One quick boundary before you start: the PA 600 (without the L) is the general Medical Assistance and SNAP application. If anyone needs help paying for a nursing home, assisted living through a waiver, or in-home personal care, the PA 600L is the correct form.² The PA 600L handles only the financial side of eligibility; a separate clinical assessment decides whether the applicant medically needs nursing-facility level of care. Both have to be approved before Medicaid pays.

Check Financial Eligibility Before You Fill Anything Out

Pennsylvania’s long-term care Medicaid has an income ceiling and a resource cap. It’s worth confirming the applicant is in range before investing hours in the paperwork.

For 2026, a single applicant’s gross monthly income generally cannot exceed $2,982, a figure set at 300 percent of the federal SSI benefit rate. Income includes Social Security, pensions, annuity distributions, and other recurring payments. If income is over the limit, a Qualifying Income Trust (sometimes called a Miller Trust) can divert the excess into a trust the state can later recover against.

Countable resources for a single applicant cannot exceed $2,000 under the SSI-based standard Pennsylvania applies to aged, blind, or disabled long-term care applicants.³ A $6,000 disregard applies in many long-term care cases, raising the working limit to roughly $8,000. Countable resources include bank balances, CDs, stocks, bonds, mutual funds, retirement accounts, cash-value life insurance above $1,500 in face value per insured person, and any real estate beyond the primary home.

Several assets don’t count:

The primary residence, as long as the applicant intends to return or a spouse or dependent relative still lives there.
One vehicle.
Household goods, personal effects, and medical equipment.
Irrevocable burial trusts and designated burial spaces.
Property used in a trade or business essential to self-support.

These exclusions come from Pennsylvania’s resource provisions under 55 Pa. Code Chapter 178.⁴

Married applicants get an important protection. When one spouse applies for long-term care and the other stays in the community, the community spouse can retain between $32,532 and $162,660 in countable resources for 2026, depending on the couple’s combined assets at the initial assessment. The community spouse also receives a Monthly Maintenance Needs Allowance from the institutionalized spouse’s income. Joint assets don’t have to be spent down to zero; the split is calculated as of the application.

Gather Your Documents First

The single biggest cause of a stalled case is incomplete documentation. Pull everything together before you open the form. You’ll need:

Proof of identity: Social Security card, driver’s license, state ID, voter registration card, or work ID. The applicant must present proof of identity at the interview.⁵
Proof of citizenship or immigration status: a birth certificate, U.S. passport, naturalization certificate, or for non-citizens, immigration documents and alien registration numbers.
Income verification: Social Security award letters, pension statements, annuity contracts.
Current statements for every checking account, savings account, CD, IRA, 401(k), stock or bond holding, mutual fund, and annuity owned by the applicant or spouse.
Life insurance details: policy number, company, face value, and current cash surrender value for each policy.
Real estate records: deeds, tax assessments, or appraisals for the home, rental property, and vacant land.
Vehicle information: year, make, model, plate number, and estimated value for every vehicle.
Burial arrangements: account statements for burial funds and the name of any funeral home holding a pre-need agreement.
Five years of transfer records: bank statements, property deeds, gift records, and any documentation of assets sold, given away, or moved into a trust within the past 60 months.⁶

If you’re filing for someone else, the form lets you designate an authorized representative — a spouse, relative, friend, attorney, or medical provider — who can sign the application and communicate with DHS about the case.¹

Working Through the Six Sections

The form has six parts. Work them in order.

Section 1: Getting Started

Enter the applicant’s name, Social Security number, date of birth, sex, marital status, and current address. Note whether the applicant has previously applied for cash, medical, or SNAP benefits in Pennsylvania or elsewhere, and whether they’ve previously lived in a nursing facility. Then pick what you’re applying for: facility care, Home and Community-Based Waiver services, or both. A citizenship and immigration subsection follows. There’s also a language preference field and a request box for an interpreter.

Section 2: Voter Registration

Optional. Register, decline, or ask for help. It has no bearing on the Medicaid decision.

Section 3: Spouse and Dependent Information

List any spouse or dependents with name, date of birth, Social Security number, and relationship. For married applicants, this section is what triggers the spousal protections above, so don’t leave it thin.

Section 4: Military Status

Note whether the applicant is a veteran, active-duty service member, National Guard or Reserve member, or the surviving spouse or dependent child of a veteran. Include branch, service dates, and any VA claim number.

Section 5: Resources

The longest section, with sub-parts for real estate, mobile homes, burial arrangements, life insurance, vehicles, and all financial accounts. For each asset, list the owner, current value, and relevant identifiers like account or policy numbers. Real estate entries ask whether the property produces income and whether anyone lives there. Vehicle entries ask for year, make, model, plate number, and any amount still owed. For accounts, list each one — checking, savings, CDs, IRAs, stocks, bonds, annuities, trust funds, mutual funds — with the current balance and the applicant’s ownership percentage.

Section 6: Transfers

The question is direct: within the past 60 months, has the applicant or their spouse closed, given away, sold, or transferred any assets? That covers homes, land, personal property, life insurance, annuities, bank accounts, CDs, stocks, IRAs, bonds, and trust funds. A separate question asks about transfers into a trust. Be complete. The caseworker will compare what you report against your bank records, and gaps generate follow-up requests or penalty calculations.

The 60-Month Look-Back

Pennsylvania reviews every asset transfer made within the 60 months before the applicant entered a nursing facility, was assessed as eligible for HCBS, and applied for Medicaid long-term care.⁶ A transfer made for less than fair market value — giving a house to an adult child, writing large checks to family, moving money into someone else’s account — creates a penalty period during which Medicaid will not pay for long-term care.

The penalty is calculated by dividing the total value of uncompensated transfers by Pennsylvania’s daily transfer penalty divisor, which for 2026 is $421.20 per day. A $42,120 gift inside the look-back window produces a 100-day penalty, roughly three and a half months during which the applicant pays privately. The penalty doesn’t start until the person is otherwise eligible and receiving long-term care, so an applicant can end up in a facility with no Medicaid coverage and no assets left to spend.

Some transfers are exempt. Transfers to a spouse, transfers of the home to a blind or disabled child, and transfers of the home to a sibling with an equity interest who lived there are generally exempt. So are transfers to a caretaker child who lived in the home and provided care for at least two years before the applicant entered a facility. Document each transfer thoroughly and explain the circumstances so the caseworker has what they need to apply any exemption.

How to Submit the Form

Three options:

Keep a full copy of the form and every supporting document. If you deliver in person, ask for a date-stamped receipt. The application date sets when the look-back is measured and when the processing clock starts.

After You Submit

The County Assistance Office has 30 days to process a completed application, plus up to 15 additional days if more time is needed to gather and review documentation.⁹ Most long-term care applications draw at least one round of follow-up: a missing bank statement, a question about a property transfer, an updated life insurance value. Responding quickly is the single biggest thing you can do to keep the case moving.

If you miss a document deadline, the application can be denied on procedural grounds — not because you’re ineligible, but because the office couldn’t verify your information. A technical denial means starting over with a new application or filing an appeal.

You can check status through COMPASS or by contacting the County Assistance Office directly.¹⁰

If the Application Is Denied

A denial letter will state the reason and explain how to appeal. Federal regulations require every state to offer a fair hearing to Medicaid applicants whose claims are denied or not acted on promptly.¹¹ In Pennsylvania you file the appeal with the DHS office that made the decision, within the time frame stated in the denial letter.¹²

Appeals must generally be in writing. At the hearing, you can present evidence, bring witnesses, and have a representative, including an attorney. Common winning arguments include miscalculated countable resources, overlooked transfer exemptions, and denials based on documents the applicant actually submitted. If the denial was procedural, filing a fresh application is sometimes faster than appealing.

Two Things to Know Before You File

If you check the HCBS box, be aware that Pennsylvania’s waivers have enrollment caps approved by the Centers for Medicare and Medicaid Services, and demand can create waitlists.¹³ You can be approved financially and clinically but still wait for a slot. Nursing facility Medicaid has no such cap: if you qualify, Medicaid pays.

Second, Pennsylvania’s Medical Assistance Estate Recovery Program seeks reimbursement after death from the estates of Medicaid recipients who were 55 or older and received nursing facility care, HCBS, or related services, including against the family home.¹⁴ Decisions you make while completing the PA 600L — especially around the home and other exempt assets — affect what the state can later claim, so it’s worth understanding both before you file.

1
Pennsylvania Department of Human Services. PA 600 L – Medical Assistance (Medicaid) Financial Eligibility Application for Long Term Care, Supports and Services
2
Commonwealth of Pennsylvania. Apply for Long-Term Care Services
3
Pennsylvania Code and Bulletin. 55 Pa Code 178.1 – General Policy on MA Resources Common to All Categories of MA
4
Pennsylvania Code and Bulletin. 55 Pa Code Chapter 178 – Resource Provisions for Categorically NMP-MA
5
Pennsylvania Code and Bulletin. 55 Pa Code 125.1 – Policy
6
Department of Human Services. Medicaid and Payment of Long-Term Services
7
Pennsylvania Department of Human Services. COMPASS – Commonwealth of Pennsylvania Access to Social Services
8
Department of Human Services. County Assistance Offices (CAO)
9
Pennsylvania Department of Human Services. Medical Assistance Long-Term Care Facility Application Process and Pending Documentation Guide
10
Commonwealth of Pennsylvania. Track Your LIHEAP, Medicaid, SNAP, and TANF Applications
11
eCFR. Fair Hearings for Applicants and Beneficiaries (42 CFR Part 431 Subpart E)
12
Commonwealth of Pennsylvania. Request a Hearing or Appeal from DHS
13
Commonwealth of Pennsylvania. Home and Community-Based Services (HCBS)
14
Pennsylvania Department of Human Services. Medical Assistance Estate Recovery Program