Trending
Navigating the healthcare provider system isn't always easy, but a seminar, held recently at the River Walk Senior Center in South Williamsport, on the changes coming to the state's new managed care program, hopefully will make it easier for those affected by the changes.
The state's Community Health Choices, a mandated managed care program for dually eligible individuals, is set to be rolled out in the Lehigh-Capital, Northwest and Northeast portions of the state, which includes Lycoming and surrounding counties, in January 2020. The Southwest and Southeast portions of the state have already enacted the program.
Joan Gillis, a representative of the Mendoza Group, a marketing group from Newtown Square, who conducted the seminar told the group of mostly seniors, that it was important that, if they are eligible, they choose a healthcare provider.
She stated that if they do not choose which provider they want by Dec. 20, the choice will be made for them.
Three insurance companies have signed up to participate in the program: AmeriHealth Caritas PA, PA Health and Wellness and UPMC Community Health Choices.
The main objective of the new program, Gillis noted, is to provide a means for older Pennsylvanians and individuals with disabilities to stay in their homes instead of long term care facilities and to also offer, an array of physical health services which are not covered by Medicare.
Gillis stressed that Medicare will not change, although the need for a supplemental insurance to cover the 20 percent that Medicare does not cover in healthcare costs, will be eliminated for eligible participants.
A person is dual eligible if they have Medicare and Medicaid. This could include seniors who have Medicare and require financial assistance in the form of Medicaid and persons with disabilities who are 21 years or older and are in need of long term care.
Gillis noted that persons who currently have Medicare and Medicaid will have a "seamless transition" to the new program.
According to Kait Gillis-Hanna, vice-president of Mendoza, about 450,000 persons qualify statewide for the program with 3,300 seniors and persons with disabilities in Lycoming County being affected by the changes.
In general Gillis-Hanna said that the roll-out has been well-received.
"It is going very well," she said. "People are getting the services and the coverage they need."