Pennsylvania Medicaid waiver
The OBRA waiver
A Medicaid waiver that pays for hands-on help at home for adults under 60 with a severe physical disability — so that living in your own home stays an option.
The OBRA waiver is narrower than most Pennsylvania home care programs, and because of that it is one of the least known. If a disability began early in life, or a serious one has developed before 60, it is worth asking about.
What it is
A Medicaid waiver administered by Pennsylvania's Office of Long-Term Living. It exists so that people who would otherwise need an institutional level of care can receive that support at home instead.
Like Act 150, it is fee-for-service — billed directly to the Commonwealth, with no managed care plan in between.
Who qualifies
- Age 18 through 59. Participants enrolled before turning 60 can continue afterwards.
- A severe developmental physical disability requiring an Intermediate Care Facility / Other Related Conditions level of care.
- Substantial functional limitations in three or more of these major life activities: self-care, communication, learning, mobility, self-direction, and the capacity for independent living.
- Financial eligibility for Medicaid.
- Pennsylvania residency.
The Commonwealth determines eligibility after an assessment. If you are not sure whether a condition fits, that is a normal question and the enrollment broker can answer it — guessing on your own is the one thing not worth doing.
What it covers
Alongside personal assistance services, the OBRA waiver covers a broader set of supports than Act 150:
- Personal Assistance Services — bathing, dressing, toileting, transfers and mobility, meals and daily tasks
- Respite care, so a family caregiver can rest
- Service coordination
- Therapy and counselling services, community integration, supported employment
- Home adaptations, assistive technology and specialised equipment
- Personal Emergency Response System
Not every participant uses every service. Your plan is built around what you actually need.
Act 150 or OBRA — which one?
They overlap and families mix them up constantly. The short version:
- OBRA is Medicaid. You have to qualify for Medicaid financially, the disability standard is stricter, and the range of covered services is wider.
- Act 150 is state-funded, for people whose income is too high for Medicaid. There is a sliding weekly fee, and the covered services are narrower.
You do not have to work out which one applies before you call anyone. The assessment sorts it out. More on Act 150 here.
How to enroll
- Call Pennsylvania's Independent Enrollment Broker at 1-877-550-4227. It is the front door for both programs.
- An assessment establishes the level of care needed.
- If eligible, you choose a service coordination entity from a list.
- Your service coordinator helps you choose the provider agency — and you can ask for one by name.
Your family member may be able to be the paid caregiver
A licensed agency can hire the participant's own family member or friend. Not a spouse, legal guardian or Power of Attorney — but an adult child, parent, sibling, niece, nephew, friend or neighbour. How that works.
Working with us
Bright Future Home Care is an enrolled OBRA waiver provider for Personal Assistance Services in Lehigh, Northampton and Monroe counties, and we are accepting new participants now. Our caregivers speak English, Spanish, Russian, Ukrainian and Farsi.
Call 610-466-5715. We will tell you where you fit, and we will tell you plainly if the answer is a different program.
About us: Bright Future Home Care is licensed by the Pennsylvania Department of Health as a Home Care Agency, License #85343601, and is an enrolled Pennsylvania Medical Assistance provider for Personal Assistance Services under the OBRA Waiver and the Act 150 Program.