Community Health Choices

Community HealthChoices (CHC) is a new mandatory Medicaid managed care program. It is for people who qualify for both Medicare and Medicaid and individuals with physical disabilities. CHC uses health plans to coordinate physical health care and long-term services and supports (LTSS). A health plan will give you better access to health care.

CHC will improve health services for many thousands of people in Pennsylvania. It will give them the chance to have a better quality of life.

Who qualifies for CHC?

CHC is a mandatory program for people who are age 21 or older and qualify for:

• Both Medicare and Medicaid; or
• Medicaid LTSS because you need the level of care provided in a nursing facility or through one of the home and community-based waivers

To learn about who can enroll in the program, go to Who qualifies for CHC?

What does CHC cover?

CHC covers the same physical health benefits you have now in your Medicaid Adult Benefit Package. With CHC, all of your Medicaid and prescription drug benefits are in one health plan. To see a list of services covered by all plans, go to Physical and behavioral health benefits.

If you receive LTSS, you will now get those services and supports through your CHC health plan. To see a list of LTSS covered by all plans, go to Long-term services and supports.

All health plans have care coordination to manage your health care. To learn more, go to Care coordination.

What happens next?

You will choose a health plan and primary care practitioner (PCP).

• Your health plan uses groups of doctors, hospitals, clinics, and other health care providers. They work together to meet your health care needs.
• Your PCP is a doctor or other provider who gives you most of your health care.

Use this website to help you choose the best health plan and PCP for you. 

Please note: If you have Medicare and Medicaid and are enrolled in a Medicare Advantage plan, you will not have to change your Medicare PCP.