What is Community Health Choices?
Community Health Choices (CHC) is Pennsylvania’s mandatory managed care program for people who are dually eligible for both Medical Assistance and Medicare, older adults and adults with physical disabilities.
CHC uses managed care plans ( CHC plans)) to make sure that physical health services and home and community based waiver or nursing home services work together.
CHC plans will help to manage chronic health conditions , arrange for home and community- based services or nursing home care and coordinate care with Medicare , doctors and specialists.
Who is covered by CHC?
Adults age 21 and over who are :
- Eligible for both Medicare and Medicaid ( or Medical Assistance) . This is known as being dual eligible.
- Need the level of care provided by a nursing home
- Receiving services through a Medicaid home and community- based waiver
- Receiving services in a nursing home paid for by Medicaid.
CHC does not change Medicare at all.
Eligible individuals will get a letter in the mail that says " Important Information about your health care choices". Do not throw this envelope out. Open and read or ask for assistance.
The next step after receiving the letter is to enroll in CHC.
Pennsylvania uses an Independent Enrollment Broker ( IEB) to walk individuals though the enrollment process, to help in selecting a CHC plan, and to discuss options.
Individuals will need to make a list of their medical providers and use the Health Plan Comparison Chart in addition to contacting the Independent Enrollment Broker to see which managed care plan is best for them.
Eligible Individuals need to choose a plan by the date that is on the letter, 11/13/19. If no choice is made the State will choose one for the individual. Individuals can change plans in the future if they wish.
Where To Turn For Help:
Independent Enrollment Broker ( IEB)
Compare CHC Plans , look up your providers, enroll
1- 844- 824- 3655
APPRISE ( through Area Agency on Aging)
Compare Medicare plans, get free one on one help for Medicare
Lancaster County 717- 299- 7979
Long- Term Living Participant Hotline
Questions, concerns, about home based waiver services
1-800- 757- 5042