Changes coming in Pennsylvania's Medicaid Plan.

Community HealthChoices: Managed Long-Term Services and Supports

If you are a Medicaid recipient or may be in the future, you should know about the changes coming in Pennsylvania’s Medicaid Healthcare Plan. The State is implementing a new plan called Community HealthChoices. Enrollment in the plan for Southwest Pennsylvania will be finalized in 2018.

The purpose of the new plan is to provide opportunities for adults to receive the services they need to be able to remain living in their home.

Under Community HealthChoices, adults on Medicaid must select either, the local LIFE Program (if eligible) OR a managed care organization (MCO) to coordinate their physical health care and long-term services and supports (LTSS).

The program will be mandatory for Medicaid recipients who are:

  • Adults 21 and older;
  • Persons with physical disabilities;
  • Persons who are dually eligible for Medicare and Medicaid

Current Programs Being Replaced

The following programs will be replaced by Community HealthChoices. If you are currently in one of these programs, you must choose a LIFE Program or a managed care organization. Those that do not choose a new plan will be automatically assigned to one in 2018.

Programs to be replaced by Community HealthChoices:

  • Aging Waiver
  • Attendant Care Waiver
  • CommCare Waiver
  • Independence Waiver
Community HealthChoices: Managed Long-Term Services and Supports

What is the LIFE Program?

The LIFE Program which stands for Living Independence for the Elderly is a Home and Community-Based model of care designed to provide all medical, social and personal support services to eligible Pennsylvanians so they can continue to live in their home and avoid nursing home placement.

To be eligible for the LIFE Program, participants must:

  • Be 55 years of age or older
  • Require long-term services and supports to assist in staying in their home
  • Be able to be safely served in their home

There is no cost for any of the services provided by the LIFE Program for persons who are Medicaid eligible.

Senior LIFE is the local and State authorized LIFE Program in this area.

Senior LIFE is an approved option under Community HealthChoices.

Participants can enroll in Senior LIFE at any time.

Senior LIFE services include:

Doctors, nurses and specialists
Prescription medications
Physical, occupational and speech therapies
Social services
Activities
Meals
Homecare services
Medical equipment and supplies
Transportation
Housekeeping
Personal care services
Plus an on-call nurse 24 hours a day, 7 days a week

Senior LIFE coordinates members' Medicare and Medicaid services all under one roof.

All services with the exception of emergency care are provided and/or coordinated by Senior LIFE. Participants or family are responsible for the cost of any services used from outside the network.

Why Choose Senior LIFE over a managed care organization to provide care?

  • Senior LIFE is an approved option under the Community HealthChoices Plan.
  • Senior LIFE is a long-established proven model of care. The LIFE Program began 40 years ago in the state of California and came to Pennsylvania 18 years ago. Senior LIFE has been serving seniors in Western Pennsylvania communities for over 10 years and is the largest LIFE provider in the state.
  • Senior LIFE provides EXCEPTIONAL QUALITY & CARE and a very personal, hands-on approach.
  • Senior LIFE treats its members with respect and dignity, addressing all of their health and personal care needs as they continue to live independently in their home.
  • Senior LIFE is run by local organizations, uses local facilities and employs local people. All care is provided in members’ homes and neighborhoods by local healthcare professionals.
  • Senior LIFE provides medical services, medications, social services, recreational activities, personal care, home care, therapies, transportation, durable medical equipment and much more. All services with the exception of emergency care must be approved by the LIFE Provider.
  • Senior LIFE is a Prescription Drug provider and delivers medications directly to members’ homes.
  • Senior LIFE members are 99% satisfied with the overall care they receive and would recommend Senior LIFE to a friend or family member. Source: ISAT Satisfaction Survey conducted by Vital Research 2014.
  • Senior LIFE provides transportation for all members from their home to the local LIFE Center and to all medical appointments.
  • Senior LIFE works with each member to develop a care plan designed to meet their specific needs. The care plans are developed, coordinated and reviewed consistently with members at their local LIFE Center.
  • Senior LIFE is available 24 hours a day, 7 days a week, and doctors and nurses make house calls.
  • Senior LIFE has LIFE Centers located in the following areas: Greensburg, Uniontown, Washington, Waynesburg, Johnstown, Ebensburg, Indiana, Altoona, York, Reading and Bethlehem.

Frequently Asked Questions about Community HealthChoices

  • When will I need to choose a provider?
    Adults in the following counties will need to choose a provider in 2018: Westmoreland, Washington, Fayette, Greene, Somerset, Cambria, Indiana, Blair, Bedford, Allegheny, Butler, Beaver, Lawrence and Armstrong.
  • What happens if I don’t choose a provider?
    The State will automatically assign a provider to those who have not voluntarily selected one in 2018.
  • What providers do I have to choose from?
    You can choose the LIFE Program (Senior LIFE in your county), or one of the approved managed care organizations.
  • If I choose the LIFE Program as my provider, do I need to wait until 2018 to go into the program?
    No, you can enter the LIFE Program at any time. Call a LIFE Representative in your area or call 877-998-LIFE (5433)   TTY: 711 for more information. You can join today!
  • What if I am currently receiving home care or other services through the Pennsylvania Aging Waiver program?
    The state will replace the Pennsylvania Aging Waiver program effective in 2018 with Community HealthChoices. Participants in this program must choose the local LIFE Program or a stateauthorized managed care organization to provide their care. For more information on Community HealthChoices, visit the Pennsylvania Department of Human Services website.

Sign up for Senior LIFE today!

To learn more about the Senior LIFE program, fill out the form on the right or call 1-877-998-LIFE (5433)   TTY: 711.

Learn more about Senior LIFE »