On April 27, 2015, the Pennsylvania Department of Human Services (DHS) announced that it had moved 121,234 individuals from the previous Healthy PA plan to the adult benefit package delivered through the traditional HealthChoices Medicaid managed care program.
Physicians may get questions from their patients as patients are often unsure what questions should be directed to their physician versus the insurer.
To help you in answering your patients’ questions, here are a few highlights from DHS’ announcement:
- The individuals who moved to HealthChoices were those formerly eligible for Medical Assistance or the SelectPlan for Women Program in December 2014. By Sept. 1, 2015, DHS will complete the Medicaid expansion by moving the remaining 137,723 individuals enrolled in Healthy PA to the traditional Medicaid HealthChoices program.
- The Interim Healthy and Healthy Plus benefit plans have been discontinued. All individuals in these plans have been moved to the Adult benefit package.
- The first group of individuals in the Private Coverage Option (PCO) have been moved into Medicaid and will receive the Adult benefit package. This group includes all PCO recipients who were in Medical Assistance as of December 2014. These individuals will have coverage by both Medicaid and the PCO through May 30, 2015. Their coverage by a Medicaid HealthChoices plan will start June 1, 2015.
- Notices are being mailed during the next few days.
- No newly eligible individuals will be placed in the PCO. They will automatically be placed in Medicaid.
- PCO recipients will transition at different times during the next few months. In July 2015, all remaining PCO recipients will be moved to a Medicaid HealthChoices plan and receive the Adult benefit package. These individuals will have coverage by both Medicaid and the PCO from July 28 to Aug. 31, 2015. Their coverage by a Medicaid HealthChoices plan will start Sept. 1, 2015.
View and listen to a brief training about Pennsylvania’s Medicaid expansion.
Check out the Provider Information tab on www.HealthChoicesPA.com for information on eligibility verification systems, benefit package coverage and limits, recipient benefit packages, transition information, copayment changes, health screening changes, continuity of care guidance, and more.