Nov. 15 is deadline to enroll in Community HealthChoices
A major shift in the way Medicaid-funded long-term services are provided is coming to Southeast Pennsylvania – Philadelphia, Bucks, Chester, Delaware and Montgomery counties – in January in the form of Community HealthChoices (CHC). Enrollment is underway now through Nov. 15. CHC will cover individuals who are:
- Dually eligible for Medicare and Medicaid,
- Medicaid eligible and residing in a nursing facility, or
- Enrolled in the Attendant Care, Independence, COMMCARE, or Aging Waiver program.
Three organizations to choose from
Under CHC, both physical health care and long-term services and supports will be coordinated through three state-selected managed-care organizations (MCOs): Keystone First CHC, Pennsylvania Health & Wellness, and UPMC Community HealthChoices. If you are eligible for CHC, you will have to choose one of these MCOs by November 15 to coordinate your care. If you do not select an MCO by the deadline, one will be assigned to you. However, you can change your MCO at any time, whether you selected it yourself or were auto-enrolled.
Below are some key questions and answers about CHC.
How do I enroll?
First, consult the enrollment packet you should have received in the mail. The packet explains CHC, provides information on the three MCO health plans and benefits, and provides enrollment information.
For more information or to select a plan, you can call the CHC Enrollment Center at 844-824-3655 (or TTY: 833-254-0690), weekdays from 8 a.m. to 6 p.m., or go to the website enrollchc.com. You can enroll by phone, email or mail using the information and form included in your packet.
If you call the CHC Enrollment Center, a representative will ask you about your current providers and preferences. (It’s a good idea to make a list of your providers before calling.) Upon enrollment with your selected MCO, you will receive materials from the MCO in the mail, including an MCO participant identification card.
What is the purpose of CHC?
The program’s intent is to help keep seniors and others covered by the program at home, in the community, for as long as possible and give them a better quality of life by centralizing health and community based services, known as long-term services and supports (LTSS). These are the services they currently receive under the state’s Aging Waiver and other waiver programs.
Will CHC affect my Medicare benefits?
Enrollment in CHC or the choice of an MCO will not affect your Medicare coverage or benefits. Dual-eligibles can keep their existing primary care physicians and will have all the same Medicare options, including Original Medicare and Medicare Advantage plans. Your Medicare plan will not change unless you decide to change it. The MCO will work directly with Medicare providers to coordinate your services. Questions about Medicare can be directed to the Apprise insurance counseling program at 800-783-7067.
How will CHC affect the in-home care services I receive through PCA?
During the first six months of 2019, known as the “continuity of care period,” you will automatically keep the same service coordination agency, which helps to manage a person’s care. Philadelphia Corporation for Aging (PCA) provides service coordination and will work with all three managed-care organizations. If you wish to remain with PCA as your service coordination provider, the MCO of your choice can help you stay with PCA.
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