In order to develop an accurate estimate of assets that would potentially be used for care the following information is needed:

All personal bank accounts, investments, retirement funds, annuities, and other financial assets NOT held in a business name. You must list all accounts in your spouse's name as well. Most accessible financial assets in the applicant's name are fully countable toward paying for LTC. Retirement accounts in the community spouse's name are generally protected; those in the applicant's name may be countable depending on payout status. Please note: Do not enter account numbers into this form, account name and balance are sufficient for this calculator.

All personally-owned motor vehicles, boats, snowmobiles, trailers, ATVs. Pennsylvania Medicaid exempts ONE vehicle per household. All others are countable. We ask for outstanding loan balances as well, because equity value (not FMV) is what Medicaid actually counts as a resource. Farm/business vehicles will be listed in Section 11.

Enter your primary residence only — the home where you or your community spouse lives. This is usually the single largest exempt asset. Second homes, vacation properties, and any non-income-producing personal land belong in Section 5. Rental properties, investment real estate, farmland, and any property held in a business name belong in Section 12.

List any other real estate you own personally that does NOT generate income — vacation homes, hunting camps or vacant land. These are generally countable assets. If a property generates rental income or is held in a farm/business name, enter it in Section 12 instead. If you're not sure which section something belongs in, enter it here and note the uncertainty — your attorney can reclassify. Real estate listed on a deed is one piece of property.

Life insurance policies owned by the applicant or spouse. Term life has no cash value and isn't countable. Whole life, universal life, and any life insurance policy with a cash value are countable based on cash surrender value (CSV). Policies irrevocably assigned for burial expenses are listed in Section 7 instead. Long-Term Care Partnership policies have special Pennsylvania rules where the policy acquisition date matters — these are flagged for attorney review automatically.

Prepaid funeral contracts, burial trusts, burial plots, and life insurance irrevocably assigned to a funeral home. Pennsylvania exempts a limited amount per person for irrevocably-designated burial reserves — anything over that amount, or any revocable arrangement, is counted as an accessible asset. Both the applicant and spouse get their own exempt limit. The amounts allowed vary by county and change each year. This calculator does not include burial reserves in the math - your County Assistance Office will confirm what's exempt in your county.

Pennsylvania applies a 60-month (5-year) look-back to ALL transfers — personal and business. Gifts, below-market value sales, and transfers to trusts and annuities can all trigger a penalty period of Medicaid ineligibility. List every transfer and use the "business asset?" flag to mark farm/business transfers. This is often the most consequential section for farm families — gifting land or equipment to children, even for good reasons, can mean months or years of ineligibility. Some transfers are exempt (to a spouse, caretaker child, or sibling with equity in the home) — these need attorney review to confirm.

Accounts closed due to spending on nursing facility costs, in-home nursing care, or other qualifying long-term care (LTC) or medical services and equipment. These are NOT disqualifying transfers — maintain documentation of all such expenses, proof of payment and documentation of source of funds used for payment.

Accounts used in a trade or business. Please note that you will be required to provide documentation that there is income from the business going to the applicant or spouse.

All business-owned or farm-owned tangible assets: tractors, combines, planters, livestock (cattle, hogs, poultry, etc.), stored grain, and other commodities. Under Pennsylvania's business-asset exemption, property which produces income or is essential to self support may be excluded regardless of value. For example, tools, equipment, uniforms, and similar items required by an employer and non-business assets that are used exclusively to produce items for home consumption can be exempt.

Property used in a trade, business, or is essential to self-support of the individual or spouse. Documentation of income to applicant or spouse will be necessary. If property is not used in trade or business list it in Section 5.