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Special Alert: Benefit Change Letters Mailed to 800,000 Current Adult Medicaid Enrollees

On November 5th, DPW began mailing all adult Medical Assistance (MA) recipients a letter introducing them to upcoming benefit changes. As part the Healthy PA initiative, DPW is reducing the benefit package for all adults who receive Medical Assistance. The letter tells each adult recipient which of three benefit packages they will receive starting January 1, 2015.

Adults assigned to the “Healthy” or “Healthy PA Private Coverage Option” benefit package may need to take action. Individuals placed in these two groups who fail to request “Healthy Plus” may end up with a benefit package that does not meet their needs.

 To help people understand these notices, here is an overview of the new benefit packages. Examples of the particular letter being sent for each benefit package are linked below (by benefit package title):

  •  Healthy Plus – Also referred to as “high risk,” Healthy Plus is the benefit package assigned to all adults in a disability-related MA category (i.e., Healthy Horizons, Medical Assistance for Workers with Disabilities, Home and Community Based Services Waivers, those on Medicare, and those in an institutional setting), and any adult found to be “medically frail.” This will become the most comprehensive MA benefit package. Adults assigned to this package do not need to do anything.

 

  • Healthy – Also referred to as “low risk,” Healthy is a benefit package that will have limits on a number of services. For example, radiology will be limited to six tests per year and lab work will be limited to $350 per year. This package is assigned to adults in the low-income parent and caretaker category who have not been found to be “medically frail.”

 Any adult assigned this benefit package who has health problems should ask for Healthy Plus by completing a health screen questionnaire before November 26th. Do this either:

(i) Online through My COMPASS account (www.compass.state.pa.us), or

(ii) By phone at (844) 290-3448.

  • Healthy PA Private Coverage Option (PCO) – The Healthy PA PCO benefit package will have service limits. It will be given to adults in the General Assistance-related MA category who are not “medically frail.” These individuals will also be moved out of their current HealthChoices managed care plan and into the new Private Coverage Option. To pick a PCO plan for coverage starting January 1, 2015, these recipients should call enrollment services at (844) 465-8137.

Any adult assigned this benefit package who has health problems should ask for Healthy Plus by completing a health screen questionnaire before November 26th. Do this either:

(i) Online through My COMPASS account (www.compass.state.pa.us), or

(ii) By phone at (844) 290-3448.

Individuals assigned to the Healthy or Healthy PA PCO benefit package who miss the November 26th deadline for completing the health screen can still ask for the Healthy Plus package by completing an Employability Assessment Form (EAF). They should ask their doctor to check box 1 or box 2 on this form, and then submit the completed form to their local County Assistance Office. We encourage individuals to include a note with the EAF asking that their eligibility be reviewed using this new information.

Please note: the MA benefit package for children under age 21 is not being changed.

Each letter includes a general listing of services expected to be covered under each benefit package, but no details are given about the amount of services or limitations on services. All adults on MA will receive a notice in December confirming which benefit package they will receive in 2015. If they disagree with the assignment, they can file an appeal at that time. PHLP may be able to help with those appeals.

For a printable version of this alert, CLICK HERE.

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game flyer (2)

PPD and the Keystone Coyotes

will be battling it out to raise money for Vision for Equality, Inc., an organization Empowering People with Autism & Intellectual Disabilities

Date:           Sunday, November 16, 2014

Time:          4:30 pm

Place:          NE Flyers Skate Zone

                      10990 Decatur Road

                      Philadelphia, PA  19154

 

Ticket Price:  $10.00 per person (Kids Under 5 FREE)

Raffles, 50/50 and Door Prizes

CLICK HEREfor printable flyer

To purchase tickets: 

Contact:  Colleen Rissling by email:  Crissling@visionforequality.org  or call (267) 773-5282

or  Liz Brown by email:Lbrown@visionforequality.org or call (267) 765-0300

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Recent Events

 

14th Annual Points of Transformation Awards – September 30, 2014

 

CLICK HERE to enjoy a video slideshow of the 14th Annual Points of Transformation Awards!

A Celebration of Direct Service Professionals & Supports Coordinators who exemplify our motto: “It’s all about community!”

Vision for EQuality Night at the Phillies

PhilliesGame09262014

The Philadelphia Phillies put their best foot forward on Friday night September 26th when Vision for Equality hosted their first Phillies Fundraising event at Citizens Bank Park where the Phillies won over Atlanta 5 to 1. The weather was perfect and a good time was had by all in attendance.

Pictures of the Field from up above show a delightful evening Marisol Ramos, Joel Pacheco and Ana Pacheco had along with Troy and Ryan Fillers in the Phanatic hats make us laugh. The smiles on all of their faces tell the story. We look forward to hosting another Phillies event again next Season!

Marisol-Joel-AnaTroy & Ryan 2

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IDS Lifesharing Family Fun Day – July 18, 2014

 

The Annual IDS Lifesharing Family Fun Day was held on Friday July 18, 2014 at Mermaid Lake in Blue Bell, PA. Fun in the sun was had by all. This fun-filled event provided everyone with an opportunity to meet lifesharing providers, lifesharing provider agencies and people who are seeking to reside in a lifesharing setting.

 

Everyone was able to connect, exchange information, ask questions all while enjoying activities such as music, dancing, singing,. They had raffle giveaways, basketball, tennis, swimming, ping pong, word search challenges and line dancing. Good times were had by all while everyone had time to hear stories of those in lifesharing settings.

 

The Lifeshraing Family Fun Day is all about people we love and  we live with.  Promoting Lifesharing while celebrating the success of Lifesharing families and service providers.  

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 Disability Pride 2014

 
On Saturday, June 21, 2014, hundreds of people attended the Disability Pride  Philadelphia Event. It was truly a memorable day with lively musical and artistic  performances, notable speakers and of course, the March/Parade to the National Constitution Center.  This year’s event celebrated the launch of the Community Integration Act.

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