Philadelphia-area residents who receive Medicare and Medicaid benefits will be automatically enrolled in a new managed care program in 2019, but there’s still time to choose the right plan for themselves.
The state’s Community HealthChoices program is designed for “dual-eligibles” who receive Medicare and Medicaid, as well as adults with physical disabilities that require long-term care — about 131,000 people in Philadelphia and Bucks, Chester, Delaware, and Montgomery Counties.
People who will be covered by the program and didn’t choose their managed care organization (MCO) by Nov. 14 were assigned to one of three organizations contracted by the state. The three MCOs people can choose from are Keystone First Community HealthChoices, PA Health and Wellness, and UPMC Community HealthChoices.
Enrollees can change their MCO at any time, but state regulators are encouraging people to choose their own plan for the beginning of the year as a way to be more engaged in their care management. Friday is the deadline to make changes that will take effect when the program starts Jan. 1.
“I strongly encourage participants to consider all plans available, ask questions, and make sure they are enrolled in a plan they are confident will meet their individual needs,” said Human Services Secretary Teresa Miller in a statement.
Community HealthChoices launched in the state’s southwestern counties last year, with 80,000 enrollees. Eventually it is expected to cover about 420,000 Pennsylvanians, 94 percent of whom are eligible for Medicare and Medicaid.
The program hands over management of Medicaid and long-term care services for those individuals to private organizations, in an effort to improve quality and streamline care.