Changes are coming to Medicaid beginning January 1, 2015. All current adult enrollees will be assigned to one of three benefits packages. The three benefits packages are Healthy, Healthy Plus, and Healthy PA PCO. All three packages provide less coverage than what is current available to most MA enrollees.
DPW has started sending letters with benefit package assignments to all 800,000 current adult MA recipients.
Medicaid recipients should be on the look-out for the letter. These letters must be reviewed to ensure that adults on MA with HIV have been assigned to the Healthy Plus benefits package.
According to PA’s Medicaid expansion plan, all adults living with HIV/AIDS should be assigned to HEALTHY PLUS.
If a person receives a letter assigning them to any plan other than HEALTHY PLUS, they must take IMMEDIATE action. To switch to Healthy Plus, they must complete a health screening questionnaire by November 26. These questionnaires are expected to be available on Compass or by phone at 1-844-290-3448.
As of this writing, neither the Compass site nor the phone number have information about the questionnaire. Questionnaires will NOT be available at County Assistance Offices. They will only be available online or by phone.
If assisting your clients, please help them answer the questionnaire as completely as possible, making sure they answer “yes” to HIV. The HIV question is part of a long list of medical conditions, so make sure it is not skipped over.
The final details of each benefit package have not been released, but the Healthy Plus package will provide the best coverage.
We are continuing to track Medicaid developments and will provide updates as new information becomes known.