Pennsylvania Transitions 121,234 into New Expanded Medicaid Program

Harrisburg, PA – Governor Tom Wolf today announced the successful transition of 121,234 individuals from the previous Healthy PA plan to a traditional Medicaid expansion plan called HealthChoices. This transition provides greater health care coverage in a simpler and streamlined manner to Pennsylvanians who are most in need.  In addition to those existing clients who were transitioned, all future applications will now go through the new simplified HealthChoices system.

“Today is a critical step in the transition to a traditional Medicaid expansion.  The changes put in place today will make it easier for hundreds of thousands of Pennsylvanians to get access to the health care they need.  These changes get rid of the unnecessary red tape and complex processes that existed in the previous system,” said Governor Tom Wolf.

The HealthChoices expansion moves Pennsylvania to a single, comprehensive Adult benefit package that provides individuals enhanced coverage for both physical and behavioral health.  The Department of Human Services (DHS) completed the update to its data systems that enabled the transition to HealthChoices this weekend.

“Thank you to all the DHS staff that worked some very long hours to implement this phase of the Medicaid expansion,” said Acting DHS Secretary Ted Dallas. “Their teamwork is a great example of what the Governor means when he says that his Administration will be a government that works.”

The transition to HealthChoices is taking place in two phases, with Phase One beginning today.

“As of noon today, we have authorized 1,108 applications in the new system,” said Dallas.

Phase One implementation:

  • The Interim Healthy and Healthy Plus benefit plans that were part of the Healthy PA system have been discontinued. All individuals in these plans have been moved to the simplified and streamlined single Adult benefit package.
  • Individuals enrolled in the Healthy PA Private Coverage Option (PCO) have been moved into Medicaid and receive the Adult benefit package.  This first group includes all PCO recipients who were in Medicaid as of December 2014.
  • There were 121,234 individuals in these categories.
  • These individuals will receive notices of the transition over the next several days.
  • The “front door” to the PCO has been closed. As a result, all newly eligible adults will be placed in Medicaid and will be enrolled in the HealthChoices program instead of the PCO.

What are the next steps?

  • There are 137,723 individuals who are still enrolled in the PCO.  These PCO recipients will transition gradually at different times over the next few months.
  • The transition will be complete and their new coverage in the Medicaid HealthChoices plan will start by September 1.

Visit www.HealthChoicesPA.com to see a copy of the notices and a draft of the new Adult benefit package.

MEDIA CONTACT: Kait Gillis – 717-425-7606

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