Medicaid Transition Complete — PA Moves Final 79,272 into HealthChoices

On July 27, 2015, Gov. Tom Wolf announced that remaining individuals receiving Medicaid through the Healthy PA plan have transitioned to HealthChoices. The nearly 80,000 newly transitioned individuals — who will start receiving coverage from Medicaid HealthChoices on Sept. 1 — add to the 440,000 who are now receiving Medicaid through the newly expanded Medicaid program.

The Department of Human Services (DHS) has updated its systems and processes in order to transition the final Healthy PA plan members and to begin accepting new HealthChoices applications.

The HealthChoices website has a Providers tab, which contains training and informational guides to help providers with the transition. Provider resources include:

  • Understanding the Eligibility Verification System
  • Benefit Package Coverage and Limits
  • Transition Information
  • Copayment Changes
  • Continuity of Care Guidance
  • Health Screening Changes
  • Resources/Links
  • PCO Contact Number Quick Reference Guide
  • Medical Assistance Providers Quick Reference Guide
  • Managed Care Organization Directory

The HealthChoices website also includes information on getting covered, who is eligible, how to apply, consumer resources, FAQs, and more.

HealthChoices allows Pennsylvanians to be a part of a streamlined Medicaid program that covers both behavioral and physical health. Future applications will now go through this new program that is more user-friendly and efficient.

In the state’s press release on the transition, it said that the “HealthChoices expansion moves Pennsylvania to a single, streamlined, and comprehensive adult benefit package that provides individuals enhanced coverage for both physical and behavioral health,” and that “individuals previously enrolled in the Healthy PA Private Coverage Option (PCO) have been move to HealthChoices’ adult benefit package.”

“The seamless transition to HealthChoices means that more Pennsylvanians than ever before can see a doctor when they are sick and receive preventive health care,” said Gov. Wolf. “Ultimately that translates to the opportunity for more Pennsylvanians to live healthier lives.”

More than 89 million households and over 31 million children nationwide receive benefits from Medicaid.