Pennsylvania Medical Assistance Updates!

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Beginning January 1, 2015, Pennsylvania is expanding the Medical Assistance Program. You may qualify for free health insurance coverage.

Enrollment begins on December 1, 2014. 

 

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If you already have Medical Assistance (MA):

–          The Department of Public Welfare (DPW) will send out notices to current MA recipients to let them know what plan they will have.

o   DPW will place you into one of three plans:

  • Healthy Plus Plan
  • Healthy Plan
  • Healthy PA Private Coverage Option (PCO) Plan
  • The Healthy Plus plan is for:
    • Individuals on SSI or in disability categories, including Healthy Horizons and MAWD
    • People in nursing homes or receiving long term care at home
    • Pregnant women
    • People over 65
    • Anyone who is “Medically Frail”

o   Disabling mental disorder
o   Chronic substance use disorder
o   Serious and complex medical conditions
o   Physical disability
o   Intellectual or developmental disability
o   Social Security disability determination

–          If you are placed into the Healthy Plan or the Healthy PA PCO plan but think you should be in the Healthy Plus plan, complete the Health Screening form which will be included with your letter. You can also complete the form online at https://www.compass.state.pa.us OR by phone at (866)-550-4355

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For New Medical Assistance Applicants

–          Enrollment begins on December 1, 2014   

o   You can sign up online at https://www.compass.state.pa.usby phone at 866-550-4355, or at the County Assistance Office.

o   If you need assistance, there are Certified Application Counselors who can advise you of your coverage options. To schedule an in-person appointment, call 1-855-486-9331.

–          A Health Screening form will be available at the time of application. It is very important to complete this form to the best of your ability as it will determine what plan you will have.

–          If DPW decides that you do not qualify for the Healthy Plus Plan but you feel you do qualify, you have the option of filing an appeal . An appeal form will be included with your decision letter.

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Switching Plans

–          If you need to switch plans between redeterminations, have your medical provider complete the PA 1663, Employability Assessment Form .The form is available online at (link to DPW website), or at the County Assistance Office

–          Complete the Health Screening form which you can find online at https://www.compass.state.pa.us OR by phone at (866)-550-4355

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