Kristen Matthews Law > Practice Areas
Medicaid Planning in Pennsylvania
At Kristen Matthews Law, we help you protect your home, your savings, and your spouse before a nursing home crisis forces impossible choices.
The Reality of Long-Term Care
$10,000-$15,000/month
Nursing home care in Pennsylvania often costs this much. Most families assume Medicare will cover it. In many cases, it will not. Medicare covers only short-term rehabilitation after a hospitalization.
Medicaid is the primary public program many Pennsylvania families turn to for long-term nursing home care when a person qualifies. It is needs-based, highly technical, and governed by strict Pennsylvania rules.
Without proper planning, families can spend down a lifetime of savings far beyond what is necessary. With proper guidance, families are often able to preserve significantly more than they expected.
How Medicaid Planning Works in Pennsylvania
Pennsylvania's Medicaid rules include built-in protections most families never know about.
Depending on your specific circumstances, protections may apply to the primary residence, a healthy spouse living at home, certain retirement accounts, income protections, structured asset conversions, and properly drafted trusts.
Every family’s situation is different. The outcome depends on how assets are structured, how much time is available, and how quickly appropriate planning begins. Families who attempt to navigate this system without experienced guidance often trigger unnecessary penalty periods, overlook spousal protections, or file incomplete applications.
Kristen R. Matthews is a Certified Elder Law Attorney (CELA), one of approximately 70 in Pennsylvania and one of only three with a primary office in Chester County. Medicaid planning is the core of her practice.
If your family is facing a long-term care decision, whether you are planning ahead or already in crisis, this is what you need to understand.
The Strategic Reality of Medicaid Planning:
Early guidance from a Certified Elder Law Attorney can make a meaningful difference in helping families understand their options, avoid costly mistakes, and preserve what the rules allow.
The CELA Difference
How Professional Guidance Can Change Outcomes
A Certified Elder Law Attorney navigates:
- How assets are titled and structured
- Whether there is a healthy spouse at home
- Income structure and sources
- The five-year look-back rule on asset transfers
- Language in trusts and powers of attorney
- Proper coordination with Medicaid caseworkers
Families navigating without guidance often:
- Trigger unnecessary penalty periods
- Overlook spousal protections
- Dismantle accounts that could be preserved
- File incomplete or improperly structured applications
- Miss the five-year lookback window entirely
- Spend significantly more than necessary
If you are unsure where your family stands, schedule a planning consultation before taking further action.
Built-in Pennsylvania Medicaid rules
Many families are surprised to learn that Pennsylvania's Medicaid rules include protections they never knew existed.
These protections don’t apply automatically. They require proper structure and timing. Here are common protections that may apply to your family:
The Primary Residence
In many cases, the home can be protected during the Medicaid application process for a spouse remaining at home.
Healthy Spouse Protection
Pennsylvania allows the community spouse to retain a portion of assets and income under specific rules — often more than families expect.
Certain Retirement Accounts
Depending on structure and distribution status, retirement assets may be counted differently than other savings.
Income Protections
Pennsylvania's income rules allow the community spouse to keep certain income streams that would otherwise seem at risk.
Structured Asset Conversions
In some situations, converting countable assets into exempt resources is a legitimate and effective strategy when done correctly.
Properly Drafted Trusts
In some situations, converting countable assets into Certain irrevocable trusts — if created far enough in advance — can remove assets from countable resources without triggering penalties.
Advance Medicaid Planning vs. Crisis Planning
Two distinct situations. Two distinct approaches. One firm that handles both.
Advance Medicaid Planning
Advance Medicaid Planning is when you plan for yourself or an aging parent knowing they will eventually need care — but that care is not yet needed. Planning five or more years before anticipated care opens the most options for asset protection and peace of mind.
Advance planning provides the greatest flexibility, structure, and protection. It is the approach Kristen most encourages families to pursue.
Crisis Medicaid Planning
Crisis Medicaid Planning is when your loved one already needs care or is in a nursing facility. While your options may be more limited than with advance planning, they are rarely exhausted. Crisis planning is an important part of Kristen’s practice.
- If you are in crisis, call us now: 484-874-2987
Certified Elder Law Attorney
Why Hire a Certified Elder Law Attorney For Medicaid Planning?
Not every estate planning attorney handles Medicaid, and that distinction can mean tens of thousands of dollars to a family facing long-term care costs.
While a general estate planning attorney can draft wills, revocable trusts, and powers of attorney, Medicaid planning introduces an entirely different level of complexity. It involves navigating look-back penalties, asset restructuring rules, spousal protections, application timing, coordination with long-term care facilities, and potential tax implications.
The reality is that strategies that work well for estate planning can create serious issues when Medicaid is involved. A well-intentioned gift may trigger a penalty period. A trust may disqualify assets. A power of attorney may be missing critical language required by Medicaid caseworkers.
This is where the distinction matters.
The Certified Elder Law Attorney (CELA) designation, awarded by the National Elder Law Foundation and recognized by the Pennsylvania Supreme Court, is held by fewer than 3% of attorneys in Pennsylvania. It requires demonstrated concentration in elder law, years of experience, peer recommendations, and passing a rigorous full-day examination.
What that means for your family is simple: a CELA doesn’t treat Medicaid planning as an occasional service. It is their core focus.
Kristen Matthews has structured her entire practice around elder law and Medicaid planning. She understands how these pieces intersect because she works within them every day, helping families make informed decisions that protect both their assets and their future.
Myths & Facts
Common Medicaid Planning Myths in Pennsylvnia
Many of these assumptions might sound familiar, and all of them can lead families to make costly mistakes.
Myth
Pennsylvania’s Medicaid rules allow many families to qualify while preserving far more than they expect, when assets are properly structured in advance.
Myth
“We’ll have to spend everything on the nursing home.”
Pennsylvania has robust spousal protection rules that can shield significant assets and income for a spouse remaining at home.
Myth
“We waited too long.”
Even in crisis situations, options often remain. An experienced CELA evaluates what protections are still available, and often more than families assume.
Myth
“We already gave money to our children.”
Gifts made within the five-year look-back period may trigger a penalty, but understanding the timing and structure determines the actual impact.
Locations We Serve
Serving Chester County & Southeastern Pennsylvania
Kristen Matthews Law serves families throughout:
Chester County
Montgomery County
Delaware County
Surrounding Southeastern Pennsylvania communities
Virtual consultations available. Distance is not a barrier to proper planning. We regularly assist adult children who live out of state while their parent is in Pennsylvania.
Our Firm
About Kristen Matthews Law
Kristen R. Matthews is a Certified Elder Law Attorney (CELA) devoted exclusively to elder law and estate planning.
She holds a J.D. and an LL.M. in Taxation from Villanova University School of Law. That advanced tax training provides a deeper understanding of the financial structures involved in Medicaid planning.
Kristen has been recognized as a Top Lawyer in Elder Law by Main Line Today every year since 2015, including as the #1 ranked elder law attorney in that category in 2016 and 2019. She has also earned the Pennsylvania Rising Star designation, awarded to fewer than 3% of attorneys in the Commonwealth, every year since 2017.
Her clients are homeowners, spouses, and adult children who want to protect what their families spent a lifetime building. She explains complex rules in understandable language and remains available long after the initial planning is complete.
Schedule a consultation
Ready to protect your family's future?
Contact Kristen Matthews Law for a planning consultation — in person in Exton or via video, wherever you are.