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Community HealthChoices
Community HealthChoices (CHC) is a mandatory managed care program overseen by the Pennsylvania Department of Human Services. It was developed on the behalf of the hundreds of thousands of dually eligible (Medicare + Medicaid) and/or physically disabled adults living in Pennsylvania, with two goals:
- To improve and streamline access to medical care coverage through any one of three managed care organizations (MCOs):
- AmeriHealth Caritas
- PA Health & Wellness
- UPMC Community HealthChoices
- To increase independence and quality of life through long-term services and supports (LTSS), which assist in-need adults with daily activities at home, such as bathing, getting dressed, meal prep, and administering medication
All benefits offered through the Medicaid Adult Benefit Package are available through CHC.
Who can be enrolled in CHC?
The Community HealthChoices program is open to adults 21 and older, who fall into one of the following five categories:
- Recipient of both Medicare (federal assistance for adults with disabilities and/or 65 and older) and Medicaid (state low-income assistance)
- Recipient of LTSS via the Attendant Care, Independence, or Aging Waivers
- Recipient of services through the OBRA (Omnibus Budget Reconciliation Act) AND considered clinically eligible to live in a long term care facility
- Recipient of care in a long term care facility through Medicaid
- Recipient of Act 150 services (in-home LTSS)
Who cannot be enrolled in CHC?
An individual is determined ineligible for Community HealthChoices if they fall into one of the following four categories:
- Receiving LTSS via the OBRA Waiver but do not meet eligibility requirements for living in a long term care facility
- Enrolled in the Act 150 program but are not eligible for BOTH Medicare and Medicaid
- Receiving services for their intellectual or developmental disability through the Department of Human Services’ Office of Developmental Programs
- Live in a state-operated long term care facility, such as a state veterans’ home
How to enroll in CHC
Individuals can enroll in CHC online, by mail, and phone (1-866-5550-4355), or in-person at the Erie County Assistance Office (1316 Holland St.)
ECCM coordinates services for CHC waiver participants through our conflict-free care management system.
Where To Find ECCM
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