Act 150 in Pennsylvania: Home Care for Adults Who Don’t Qualify for Medicaid

Here’s a situation we hear regularly at CareChoice: a caller says, “I need home care, but I was told I make too much for Medicaid.” In many cases, that’s the end of the conversation — the family assumes there’s no help available and starts paying $25–$35 per hour out of pocket, or they go without care entirely.

But if the caller is an adult between 18 and 59 with a physical disability, there may be another option: Act 150, Pennsylvania’s state-funded Attendant Care Program.

What Act 150 Is

Act 150 is a state-funded (not Medicaid) program that provides attendant care services to adults with physical disabilities who are not financially eligible for Medicaid. It fills a critical gap: individuals whose income or assets are too high for Medicaid but who still need daily help with personal care and can’t afford to pay privately for the long term.

The program is administered by the Pennsylvania Department of Human Services through the Office of Long-Term Living (OLTL) — the same office that oversees CHC and OBRA. But because Act 150 is state-funded rather than Medicaid-funded, the eligibility rules and service structure are different.

Who Qualifies

Act 150 serves individuals who are 18 to 59 years old, have a physical disability, need attendant care services (personal care, homemaker services), are Pennsylvania residents, and are
not financially eligible for Medicaid. There may also be income-based sliding-scale cost-sharing depending on the individual’s income level.

This last point is key: Act 150 isn’t a free program for everyone. Depending on income, the individual may contribute to the cost of services on a sliding scale. But even with cost-sharing, Act150 is dramatically less expensive than full private-pay home care.

What Services Are Covered

Act 150 covers attendant care — personal care assistance with bathing, dressing, grooming, toileting, eating, and mobility — as well as homemaker services like meal preparation, light housekeeping, and laundry. The scope is similar to what Medicaid-funded programs cover, though the total authorized hours may be more limited.

How Act 150 Connects to CareChoice

In our experience, Act 150 inquiries often come from younger adults with physical disabilities —individuals in their 20s, 30s, and 40s who are working and earning income but whose disability requires daily attendant care. They earn too much for Medicaid but face a choice between spending their entire paycheck on home care or going without support.

Act 150 provides a middle path. CareChoice helps eligible individuals connect with the program and access the attendant care services they need to maintain independence.

How to Apply

Contact the Office of Long-Term Living (OLTL) or your local Area Agency on Aging. In the Philadelphia area, PCA at (215) 765-9040 can provide information and referrals. For Pittsburgh, the Allegheny County AAA at (412) 350-5460 is the starting point.

Act 150 has historically had limited funding, which means slots may not always be available.  Apply early and ask about waitlists and interim options.

Contact CareChoice →Pennsylvania team

Written by Carolyn Choates, Assistant Marketing Manager | CareChoice