Medicaid recipients with managed care plans are approaching the deadline to select a new plan. Those who do not select a new plan may find themselves in one that is not the best match.
The Department of Human Services (DHS) is reminding all Medicaid recipients enrolled in a physical health managed care plan to select a new plan by August 16. If someone who needs to choose a new plan does not do so by the deadline, they will be auto-assigned to a new plan. No consumers will lose coverage,
“I am urging any Medicaid recipient who has not yet done so to review their options, look for plans that include doctors you use and hospitals in your area, and choose a plan that best meets your individual needs before August 16,” said DHS Acting Secretary Meg Snead. “We continue to strive for superior quality of care and services for vulnerable Pennsylvanians, so we want to be sure every Medicaid recipient takes the time to choose the plan that best suits them.”
As a result of new physical health managed care plan agreements, approximately 500,000 Medicaid (also called Medical Assistance or MA in Pennsylvania) consumers will have to select a new physical health plan by August 16 or be automatically assigned one when new physical health managed care agreements take effect September 1. While all enrollees can change their plan at any point, this plan selection period allows changes if a person’s plan will no longer be available or if they have new options in their region.
Notices have been mailed to all MA recipients enrolled in a physical health managed care plan to explain whether a person’s current plan will continue to be available after September 1. The notice includes all options for health plans in their region, important dates, and how to choose or change their plan.
If a person’s current plan will remain available and they do not change their plan, their current plan will continue after September 1. Pennsylvanians can review the changes to plans in their region and learn how to select a new physical health plan at www.dhs.pa.gov/planselection.
PA Enrollment Services, the commonwealth’s independent enrollment service, is here to help MA recipients consider their options and choose the best health plan for their needs. Visit PA Enrollment Services to get tips for choosing a health plan and compare health plans to find a plan that includes preferred doctors and providers during this enrollment period.
MA recipients must contact PA Enrollment Services to choose a new physical health plan or change from one physical health plan to another. Contact PA Enrollment Services by:
- Choosing a plan online at www.enrollnow.net
- Using the PA Enrollment Services mobile app (available at no cost through the Apple store or Google Play), or
- Choosing a plan over the phone 1-800-440-3989 (TTY: 1-800-618-4225) and select Option 6 to speak with a representative. Hours of operation are Monday through Friday, 8 am to 6 pm.
MA recipients should review the MCO selection materials they received from Pennsylvania Enrollment Services in late June and early July 2022. If they are unsure if they need to select a new MCO or haven’t received selection materials, they should visit the PA Enrollment Services website or contact Pennsylvania Enrollment Services at 1-800-440-3989, TTY: 1-800-618-4225 Monday through Friday, 8:00 am – 6:00 pm.
These changes will not impact members in the Children Health Insurance Program (CHIP) or who have Dual Eligible Special Needs Plan (DSNP) coverage, nor will they impact members enrolled in Community HealthChoices (CHC) or a Behavioral HealthChoices plan.