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Cost is often one of the biggest obstacles standing between a family and a home modification that would make daily life safer. Very often, individuals don’t know where to start and the options that are available to them. What often surprises people is how many funding paths actually exist in Pennsylvania. The challenge is not a lack of options, it is that those options are scattered across different agencies, programs, and paperwork, so families rarely hear about all of them at once.
Below are the realistic ways Pennsylvania families pay for home modifications, from Medicaid waivers to state and federal grant and loan programs, so you know where to start and what to expect from each path.
Does Medicaid Cover Home Modifications
Medicaid can cover home modifications in Pennsylvania, but not in the way most people expect. There is no separate Medicaid benefit you apply for called “home modifications.” Instead, coverage flows through a home and community-based services waiver, most commonly Community HealthChoices (CHC) for older adults and adults with physical disabilities, or the Intellectual and Developmental Disability (IDD) waivers for individuals with intellectual disabilities or autism. Under either waiver, modifications such as ramps, grab bars, widened doorways, or roll-in showers can be approved when they are needed to keep the person safely at home and are written into that person’s individualized service plan.
This distinction matters because it means a modification must be tied to an assessed need and an approved plan before funding is released. A support coordinator or service coordinator typically identifies the need during a functional assessment, documents why the modification supports the person’s health and safety, and submits it for approval through the waiver. Skipping this step, such as having the work done first and asking for reimbursement afterward, is one of the most common reasons families run into trouble getting a modification covered.
Families do not have to navigate this alone. A service coordinator through a CHC managed care organization, a support coordinator through an IDD waiver, or an independent care manager can all help identify whether a modification qualifies and start the paperwork. UDS works with families in exactly this way (more on that below).
Insurance and Other Coverage
Outside of Medicaid, coverage for home modifications is more limited and depends heavily on the circumstances behind the need.
Standard health insurance, including private plans and traditional Medicare, generally does not cover home modifications. Insurance is built around medical treatment and durable medical equipment, such as a wheelchair or hospital bed, not structural changes to a home. A few Medicare Advantage plans have begun offering supplemental benefits that cover home safety items like grab bars or shower seats for members with certain chronic conditions, but this varies significantly from plan to plan and has to be confirmed directly with the insurer.
Workers’ compensation and personal injury settlements can be a meaningful source of funding when the need for a modification is connected to a workplace injury or an accident. In these cases, the cost of necessary modifications is often built directly into a settlement or an ongoing workers’ compensation claim, and an attorney or case manager involved in the claim can help make sure that need is properly documented.
Grants and Low-Interest Loan Programs
Pennsylvania has several programs built specifically to help with home modification costs, though each one serves a slightly different situation.
The Pennsylvania Housing Finance Agency (PHFA) offers the ACCESS Home Modification Program, a zero-interest loan between $1,000 and $10,000 for homebuyers with a disability, or those who have a family member with a disability, who need to modify a home they are purchasing. It is used alongside a PHFA first mortgage loan, and repayment is deferred for as long as the borrower occupies the home as their primary residence. Because ACCESS is tied to a home purchase, it is best known for helping families buy a home that needs modification, rather than helping someone modify a home they already own.
For existing homeowners, the United States Department of Agriculture (USDA) Section 504 Home Repair Program is often the better fit. It offers loans of up to $40,000 at a fixed 1 percent interest rate over 20 years to very low income rural homeowners, and homeowners age 62 or older who cannot afford loan repayment may qualify for a grant of up to $10,000. Loans and grants can be combined for up to $50,000 in total assistance, and funds can cover a wheelchair ramp or similar accessibility work alongside other necessary repairs. Eligibility is limited to USDA designated rural areas, which cover a large share of the small towns and boroughs across central and eastern Pennsylvania, so it is worth checking a specific address rather than assuming it does not qualify.
Locally, Pennsylvania’s network of Area Agencies on Aging administers the state’s OPTIONS program, which offers home modification assistance on a sliding scale for residents age 60 and older, alongside other in-home services. Veterans may also have access to Department of Veterans Affairs (VA) grants built specifically for housing modifications, including the Home Improvements and Structural Alterations (HISA) grant for veterans with service-connected or non-service-connected disabilities, and the larger Specially Adapted Housing (SAH) and Special Home Adaptation (SHA) grants for veterans with more significant service-connected mobility or vision loss.
When You Don’t Qualify for Assistance
Not every family will qualify for the programs above, whether because of income, age, or where they live, and that does not mean modifications have to wait indefinitely.
Traditional financing, such as a home equity line of credit (HELOC), a personal loan, or a contractor’s in-house financing plan, remains an option, though it is worth comparing terms carefully since interest rates and repayment structures vary widely.
Phasing a project is often the most practical solution for a tighter budget. Rather than waiting to afford every change at once, many families start with the lowest cost, highest safety impact items, such as grab bars, non-slip flooring, and better lighting, and plan larger structural work, like a stairlift or bathroom remodel, in stages as funds become available.
How UDS Can Help
With this many programs, each with its own rules, paperwork, and timelines, most families need help figuring out where they actually fit before they can move forward. UDS works with families to identify which funding programs they are likely to qualify for, whether that is a Medicaid waiver, a PHFA or USDA program, VA benefits, or a combination of several, and helps coordinate the documentation each one requires.
UDS also provides home modification services directly, including grab bars and safety rails, stairlifts and platform lifts, widened doorways and hallways, and fully accessible bathroom upgrades such as walk-in showers and non-slip surfaces. Every project starts with a detailed livability assessment to determine which modifications will make the most difference for that specific person and home, followed by a clear cost estimate before any work begins.
For more information regarding how funding works for in-home care, and how UDS can help you explore your options, please fill out a request form and one of our specialists will be in contact with you within 24 hours, Monday through Friday, to help you get started.
