Managed Care, What is Next?

The Department of Human Services’ new mandatory Community Health Choices (CHC) Managed Care Organization (MCO) program is quickly approaching the designated Zone 3, which includes the Lehigh/Capital, Northeast and Northwest Pennsylvania regions. The Southwest Region, or Zone 1, moved into Managed Care January 1, 2018, with the Southeast Region, Zone 2, following suit January 1, 2019. What are the next steps for the transition to CHC and Managed Care?

All participants receiving home care through the Aging Waiver, Independence Waiver, and Attendant Care Waivers will be transitioned into Managed Care and asked to choose one of the three MCOs to manage their care. The three MCOs are:

1. AmeriHealth Caritas

2. PA Health & Wellness

3. UPMC Community Health Choices

The timeline for the roll out of Managed Care is as follows:

  • Participants start receiving notices regarding Managed Care -July 2019
  • Participants will start receiving invitations to “Aging Well” Events – August 2019
  • Pre-Transition Notices & Enrollment Packets will be mailed to participants – August 2019
  • lService Coordinators will begin to reach out to Participants to inform them of CHC – August 2019
  • Participants must select a plan by 11/13/2019, if not they will be auto-enrolled in a plan. If a participant is auto-enrolled and they do not like the plan that was chosen, they have until 12/20/2019 to select another.
  • New CHC Plans go into effect – January 1, 2020

Stay tuned for more information as we get closer to Community Health Choices implementation on January 1, 2020.

Community Health Choices PA


1. “DHS Details.” Pennsylvania Pressroom, 13 May 2019, www.media.pa.gov/Pages/DHS_details.aspx?newsid=379.

2. Timeline information from http://www.healthchoices.pa.gov/providers/about/community/presentations/index.htm

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