You’re Still Good With Gateway
How to Effectively Address Questions About
the Community HealthChoices Program
Overview
The
PA Department of Human Services (DHS) will be expanding its
Community HealthChoices (CHC) program to the 13 counties of the
Lehigh/Capital Zone. CHC is Pennsylvania's mandatory Medicaid
managed care program for individuals eligible for both Medicaid and
Medicare. This last phase of the rollout will be effective
January 1, 2020. DHS has begun to notify all impacted members by
mail. Gateway will conduct its own member outreach campaign in Q4
2019.
Key Messages to Communicate to Gateway Health Medicare
Assured D-SNP Members
As
a valued broker, we want you to be aware that our Medicare
Assured Dual Eligible Special Needs (D-SNP) members will not lose
coverage due to the CHC Medicaid program. Members are eligible to
receive D-SNP benefits if they receive both Medicaid and Medicare.
Yet, these members may have questions or concerns, given the
roll-out of the CHC Medicaid program.
In your role as a broker, you may be asked if the implementation
of the CHC Medicaid program will cause Medicare Assured D-SNP
members to lose their coverage with Gateway Health. It is
important to communicate that the CHC Medicaid program does not,
in any way, change or impact how members enrolled in Medicare
D-SNP plans access care.
Below are key messages to communicate when Gateway
Health Medicare Assured members ask questions about the status of
their Medicare coverage in relation to the CHC Medicaid program.
•
Members will not lose their Medicare coverage with Gateway Health
Medicare Assured once CHC rolls out.
•
No action is needed by Medicare Assured members and their
Medicare coverage will continue uninterrupted.
•
Members will continue to receive the same trusted quality of care
from Gateway Health Medicare Assured.
All CHC Managed Care Organizations (MCOs) will offer
Medicare D-SNP plan options.
•
Gateway Health members utilizing Long-Term Services and Support
(LTSS) benefits will need to enroll with one of three CHC MCOs,
or they will automatically be assigned to a plan.
•
If members are automatically assigned to one of three MCO plans,
they can continue with their Gateway Health Medicare Assured
coverage.
Gateway Health Medicare Assured covers over 47,000 D-
SNP members in PA, and you can continue to enroll prospects in
its Medicare Assured plans.
The 13 impacted
counties include Adams, Berks, Cumberland, Dauphin, Franklin,
Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton,
Perry and York.
Should you have
any questions:
Dan Misner
412-735-5592 dmisner@gatewayhealthplan.com
Rob London
412-651-5523 rlondon@gatewayhealthplan.com
Chris
Duggan cduggan@gatewayhealthplan.com
Brian
DeVinney bdevinney@gatewayhealthplan.com
Eric
Fleming efleming@gatewayhealthplan.com
