Who Covers Your Physical Health Services?

Physical health services are available through your HealthChoices Physical Health Managed Care Organization (PH-MCO) or your Community HealthChoices Managed Care Organization (CHC-MCO). If you have questions about physical health services, you will need to contact the Managed Care Organization (MCO) that provides these services. If you are unsure if you are enrolled in a PH-MCO or a CHC-MCO, contact your local County Assistance Office (CAO).

PH-MCOs have Special Needs Units that help coordinate members’ physical health services with their behavioral health needs. If a CHC-MCO participant is eligible for long-term services and supports, the participant’s service coordinator will work with the participant to create a care plan that addresses the participant’s physical and behavioral health needs. If a CHC-MCO participant is not eligible for long-term services and supports and needs additional assistance with services, the participant can receive assistance from a service coordinator.

No matter which MCO plan covers your physical health services, you will be a member of CBH, as long as you are enrolled in a HealthChoices program and live in Philadelphia County.

Your Physical Health Services

If you need any of the following services, the services will be provided by your PH-MCO or CHC-MCO:

  • Check-ups.
  • Services for a physical health condition or illness.
  • Most medications (not including Medication-Assisted Treatment [LINK TO MAT SECTION]) covered by CBH
  • An ambulance.

Coordinating Physical Health and Behavioral Health Care

Your overall health can be improved greatly when your providers consider both your physical health and behavioral health needs at the same time and coordinate your care. Actions you can take to help your providers better coordinate your health needs include:

  • Signing release forms that will allow your providers to share information with each other about the treatment you are getting.
  • Telling your physical health provider
    • about all of the medications you take for your behavioral health diagnosis.
    • about any changes in your behavioral health diagnosis or treatment.
  • Telling your behavioral health provider
    • about all of the medications you take for your physical health diagnosis.
    • about any changes in your physical health diagnosis or treatment.

HealthChoices Physical Health

Selecting Your PH-MCO

If you are new to HealthChoices and have not yet selected a PH-MCO, you may contact PA Enrollment Services to help you choose a health plan that best meets your needs. If you do not choose a PH-MCO, a PH-MCO will be chosen for you. If you want to change your PH-MCO, you may also contact PA Enrollment Services.

Philadelphia County has the following PH-MCOs:

Community HealthChoices

Community HealthChoices (CHC) is Pennsylvania’s Medical Assistance managed care program that includes physical health benefits and Long-Term Services and Supports (LTSS). The Office of Long-Term Living (OLTL) in the Department of Human Services oversees the physical health benefits and LTSS of Community HealthChoices. Those services are provided through the Community HealthChoices Managed Care Organizations (MCOs).

CHC serves individuals who also have Medicare coverage, and disabled adults age 21 and over.

CHC members have the choice of the following three MCOs to coordinate physical health care and LTSS:

Selecting Your CHC-MCO

If you are new to HealthChoices and need help choosing your CHC-MCO, you may visit enrollchc.com or call 844-824-3655. If you do not choose a CHC-MCO, a CHC-MCO will be chosen for you.