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Community Health Choices Waiver
The Community Health Choices (CHC) Waiver is a managed care program for older adults and individuals with physical disabilities who are dually eligible for Medicare and Medicaid. This can apply to those living in managed care homes or those living independently with long-term services and supports (LTSS). The CHC waiver is meant to expand those peoples’ options and access to quality health care, as well as give them a long-term plan for managing their health and greater opportunities for independence. Implementation began January 1, 2018, and was phased in until it was officially put into effect on January 1, 2021.
This waiver will provide health care services to hundreds of thousands of Pennsylvanians, ranging from general care by physicians, physical therapy, emergency, and non-emergency transportation to medical offices, mental health, family planning, and maternity services, prescription medications, and much more. There are also benefits and supports specifically available to those who qualify for LTSS and reside in a nursing home or care facility.
Eligibility Criteria
Generally, those enrolled are of two populations: individuals who are dually eligible for Medicare and Medicaid, and/or those who are enrolled in LTSS at either a nursing home or through a waiver at home.
The qualifiers for eligibility include:
If an individual is enrolled in CHC but is also qualified to participate in the Living Independence for the Elderly (LIFE) program, they may switch. Similarly, those currently enrolled in LIFE will remain enrolled unless they prefer CHC, in which case they can apply to switch programs.