Medicaid Home Care in Pittsburgh: Programs, Eligibility, and How to Apply

Pittsburgh families have access to the same Medicaid home care programs as Philadelphia — but the local infrastructure is different. Different MCOs, a different Area Agency on Aging, and in many cases different provider networks. This guide covers everything specific to getting Medicaid home care in Pittsburgh and Allegheny County.

The CHC Southwest Zone

Pittsburgh falls within Community HealthChoices’ Southwest Zone, which covers Allegheny County and surrounding counties. Three MCOs administer CHC in the Southwest Zone.

AmeriHealth Caritas operates in both the Southeast (Philadelphia) and Southwest (Pittsburgh)zones, giving them statewide perspective.  PA Health & Wellness also operates in both zones.  UPMC Community HealthChoices is unique to western Pennsylvania and brings the UPMC health system’s clinical infrastructure into the managed care equation.

In our experience at CareChoice, the MCO choice matters more in Pittsburgh than in Philadelphia because of the UPMC factor. Families whose loved ones receive medical care through UPMC providers often find that UPMC CHC provides stronger care coordination — the home care team and the medical team operate within the same system. For families outside the UPMC network, AmeriHealth Caritas and PA Health & Wellness offer comparable home care services without the UPMC integration.

What’s Covered

The same services available in Philadelphia are available in Pittsburgh through CHC: personal care (bathing, dressing, grooming, toileting, eating, mobility), homemaker services (meal preparation, housekeeping, laundry), respite care for family caregivers, adult day services, home modifications, assistive technology, personal emergency response systems, and community transition services for individuals leaving nursing facilities.

And the same paid family caregiving pathway applies:  Participant-Directed Services allows your loved one to choose a family member as their caregiver, and Agency with Choice handles employment.

Eligibility

Same statewide criteria: Pennsylvania resident, enrolled in Medicaid, nursing-facility level of care as determined by a functional assessment, able to live safely at home with supports. The COMPASS application process is identical. The eligibility rules for family caregivers are the same statewide.

The Allegheny County AAA

The Allegheny County Area Agency on Aging at (412) 350-5460 is the local equivalent of Philadelphia’s PCA. They provide information, referrals, assessment coordination, caregiver support, and connections to community resources. For Pittsburgh families, the AAA is the best first call.

In our experience, the Allegheny County AAA is responsive and well-connected to the local provider network. They can triage your family’s situation quickly and point you to the right program — whether that’s CHC home care, a paid family caregiver, adult day services, or another community resource.

Pittsburgh-Specific Considerations

Housing stock.  Pittsburgh’s hillside neighborhoods and older housing create accessibility challenges. Steep staircases, narrow doorways, and bathrooms not designed for mobility aids are common. Home modifications through CHC (grab bars, ramps, bathroom conversions) can address these issues — raise them during the assessment and care planning process.

UPMC dominance.  UPMC’s role as both a healthcare provider and an MCO creates an integrated care environment unique to Pittsburgh. If your family is already in the UPMC system, leveraging UPMC CHC can streamline communication. If not, don’t feel pressured to switch medical providers to access home care — all three MCOs provide equivalent CHC services.

Regional healthcare culture.  Pittsburgh families tend to have long-standing relationships with their medical providers. In our experience, families here value continuity of care highly — which is exactly what paid family caregiving through PDS provides. The caregiver doesn’t change. The relationship doesn’t rotate. The care is consistent.

How to Apply in Pittsburgh

Step 1:  Apply for Medicaid through COMPASS or the Allegheny County Assistance Office.

Step 2: Contact the Allegheny County AAA at (412) 350-5460 for information and referrals.

Step 3:  Enroll in CHC and select an MCO.

Step 4:  Request a functional assessment through the MCO.

Step 5:  During care planning, request Participant-Directed Services and name your family caregiver.

Step 6:  Complete Agency with Choice onboarding and start receiving care and payment.

CareChoice serves Pittsburgh families across Allegheny County and beyond. Whether you’re in Squirrel Hill, the South Hills, the North Side, or further out, the same programs and the same support apply.

Contact CareChoice → Pennsylvania team

Written by Sophia Aloia, Content & SEO Manager | CareChoice