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Community Health Choices (CHC) Waiver

Community Health Choices (CHC Waiver)

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Pennsylvania’s long-term services and supports LTSS managed care program for people eligible for both medicaid and medicare, as well as individuals 21 or older with physical disabilities to maintain independence in their homes
 

  1. Age: 21 or older

  2. Residency: Must be PA resident

  3. Income/Assets: As of 2024, a single individual generally cannot exceed $2, 829/month, asset limit $8,000

  4. Functional need requirement (nursing facility level of care)

 

Application Process

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  1. Determine eligibility: apply for Home and Community-Based Services (HCBS) eligibility through county assistance office COMPASS Intake  this website has link to see if you qualify and application completion -

  2. Initiate application: Contact the PA Independent Enrollment Broker (IEB) telephonically 1-877-550-4227, online https://paieb.com/en/waiver-application, mail application PA Independent Enrollment Broker - Web Referral Form 

  3. Functional Assessment: An assessment agency will schedule face to face visit to determine functionality, completed by local Area Agency on Aging (AAA)

  4. Complete physician certification form: verify need for nursing level facility level of care MA 570 Physician Certification Form

  5. Submit documentation: proof of income, assets, and medical needs PA 1968 - Long-Term Services and Supports Pending Documentation Form

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Special Process for CHC and OBRA Waiver Applicants

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If you're applying for Community HealthChoices (CHC) or OBRA waivers, you have two pathways:

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Option 1: Start with the Independent Enrollment Broker (IEB)

  • Contact the IEB directly to schedule your at-home clinical assessment

  • The IEB also continues to guide applicants on how to complete the financial application for long term care services.

  • This has been the traditional pathway and remains available
     

Option 2: Start with the Customer Service Center

  • Call the Center at 1-866-550-4355 to begin with the financial application

  • They will connect you with the IEB, who will conduct the required clinical assessment

  • The IEB also continues to advise applicants on how to complete the financial application for long term care services.
     

Importantly, the clinical assessment component remains unchanged regardless of which application option you choose. The IEB still serves as the point of contact for clinical assessments and continues to provide guidance on the overall waiver application process. Since this process is so now, we don't yet have data on whether processing times or efficiency differs between these two starting points. We will continue to monitor this process and provide updates.

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Individuals who experience problems with the new phone application process or whose application for waiver or nursing facility services is denied can contact PHLP’s Helpline for assistance: 1-800-274-3258 or staff@phlp.org.

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