Creating Healthier Communities Toolkit
Help Us Create Healthier Communities
As a valued provider, stakeholder, and/or partner, you play a vital role in helping Medicaid members maintain their health and well-being. One of the most important ways we can support our communities right now is by ensuring individuals and families keep their health insurance coverage.
CBH has developed a set of resources to help Medicaid-eligible residents stay informed and connected to coverage. These materials are designed for distribution by providers and stakeholders like you to patients and clients who may be at risk of losing their insurance.
Together, we can ensure continued access to care and help build healthier communities across Philadelphia.
Please note: This page and its contents are for informational purposes only. Information may have changed since publication. For the most current and accurate guidance about Medicaid coverage, individuals should contact their local County Assistance Office or visit the Pennsylvania Department of Human Services.
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Medicaid Frequently Asked Questions
Am I covered by Medicaid?
Call the Pennsylvania Department of Human Services (PA DHS) customer service center to find out if you are actively enrolled in Medicaid.
Be prepared to be placed on hold when calling. Remember, access to reliable, quality health care is worth the wait.
- Statewide Customer Service Center – 1-877-395-8930
- Philadelphia Customer Service Center – 1-215-560-7226
- You can also visit dhs.pa.gov to view your coverage information online.
How will I know if I’ve been denied coverage or if my coverage was terminated?
- You will receive a notice from PA DHS at the last address on record, stating that you were denied Medicaid or that your coverage was terminated.
- If you don’t know if you received a notice, or if your address may have changed recently, call the PA DHS Customer Service Centers or visit dhs.pa.gov to find out if you have active Medicaid coverage.
- Your health care provider may tell you that your Medicaid coverage is inactive when you schedule an appointment.
- Visit your local County Assistance Office (CAO) and ask a representative.
What can I do if I was denied Medicaid coverage or if my coverage was recently terminated?
You can appeal the decision by requesting a fair hearing. A fair hearing allows is a formal process where individuals can appeal decisions made by the Pennsylvania Department of Human Services (DHS) related to their Medicaid benefits. For more information about fair hearings and appeals visit http://www.pa.gov/services/dhs/hearings-and-appeals-dhs
- The notice you received in the mail from PA DHS stating that you were denied Medicaid or that your coverage was terminated will include information about how to file an appeal or fair hearing.
- You can request a fair hearing by calling the PA DHS Customer Service Center (877-395-8930) You have a limited amount of time to do so. Request a fair hearing and ask for an explanation of why you were denied or terminated from Medicaid coverage. Be prepared to be placed on hold when calling.
- Visit your local County Assistance Office to request a fair hearing or appeal.
- Call the Pennsylvania Health Law Project Helpline at 1-800-274-3258 for additional assistance.
What can I do if the deadline has passed for me to request an appeal or fair hearing for my Medicaid coverage termination or denial?
You can reapply to renew your benefits.
How do I apply or reapply for Medicaid?
- Online via COMPASS: compass.state.pa.us
- Phone: 1-866-550-4355 for the Customer Service Center for Health Care Coverage
- Be prepared to experience wait times when making calls or visiting your CAO. Remember, access to reliable, quality health care is worth the wait.
- In Person: Visit your local CAO
- Mail: Download application form PA 600 HC and mail it to your local CAO.
*myCOMPASS PA is a service of the Pennsylvania Department of Human Services. Community Behavioral Health does not operate the DHS website and COMPASS app.
