Philadelphia vs. Montgomery, Bucks, Delaware, and Chester Counties: Choosing Where to Look for Senior Care

By Philly Senior Advisor Care Team — Benefits & Costs Team · April 14, 2026

Philadelphia is one government; the collar counties are four separate ones

Philadelphia is Pennsylvania's only consolidated city-county — city government and county government are the same entity, and every Philadelphia ZIP code sits inside that single jurisdiction. That's the mirror image of some other big metros where the core city is a small piece of a much larger surrounding county; in Philadelphia's case, the city itself is the whole county. The Philadelphia Corporation for Aging (PCA) is the Area Agency on Aging for the entire city-county, coordinating everything from care management referrals to the county-level piece of Community HealthChoices enrollment support.

Ring the city, and the picture changes completely: Montgomery County, Bucks County, Delaware County, and Chester County are each their own independent county government, each with its own Area Agency on Aging (Montgomery County Aging and Adult Services, Bucks County Area Agency on Aging, Delaware County Office of Services for the Aging, and Chester County Department of Aging Services), its own County Assistance Office network, and its own mix of facility inventory. A family searching just outside the city limits — say, in Abington or King of Prussia in Montgomery County — is dealing with a different local aging-services structure than a family in Northeast Philadelphia, even though both are DHS/DOH licensed under the exact same statewide rules.

What actually differs, and what stays the same

DHS and DOH licensing standards, Community HealthChoices eligibility rules, and VA benefits processes are statewide — they don't change because a family crosses from Philadelphia into Montgomery County or from Delaware County into Chester County. What does change is facility density and price. Philadelphia proper has the largest concentration of Personal Care Homes and a good supply of Assisted Living Residences spread across neighborhoods from Roxborough to South Philadelphia; Montgomery County's Main Line suburbs and Bucks County's central corridor (Doylestown, Newtown) skew toward higher-end options; Delaware County has a strong mix of mid-market communities near Media and Springfield; and Chester County, especially around West Chester and Downingtown, tends to run on the higher end with newer construction.

For a Philadelphia family whose parent lives just over the city line, it's often worth comparing options on both sides — a Philadelphia PCA-connected community and a nearby Montgomery or Delaware County option — since travel time for visits usually matters more day-to-day than which county line a building happens to sit on.

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