How to apply for Pennsylvania Community HealthChoices (CHC)

Who it's for

Community HealthChoices (CHC) is Pennsylvania's mandatory Medicaid managed-care program for long-term services and supports (LTSS). It serves residents age 21 and older who are enrolled in both Medicare and Medicaid (dual eligible) or who qualify for Medicaid because they need the level of care a nursing facility provides. CHC covers nursing-facility care plus a wide range of home- and community-based services that help people stay in their own homes — personal assistance, home health aide visits, adult day services, home-delivered meals, home and vehicle modifications, personal emergency response systems, and service coordination — all managed by a CHC health plan the participant chooses. To qualify for the LTSS portion, a person must be determined nursing-facility clinically eligible (NFCE) through an in-home assessment and must meet Medicaid's long-term-care financial limits: for 2026 that is monthly income at or below $2,982 (300% of the SSI Federal Benefit Rate) and countable resources at or below $8,000 for an individual ($2,000 SSI limit plus Pennsylvania's $6,000 resource disregard), with spousal-impoverishment protections for married couples. The Independent Enrollment Broker schedules the assessment and helps with plan choice: call 1-877-550-4227, or the CHC participant line at 1-844-824-3655.

What you'll need

• Proof of age (65+) or Social Security disability determination
• Proof of Pennsylvania residency
• Social Security card
• Medicare card (if enrolled)
• Proof of all monthly income (Social Security award letter, pension statements)
• Bank statements and documentation of countable resources for both spouses if married
• Nursing-facility clinically eligible (NFCE) determination from the in-home assessment

Where to apply

What to say when you call

"Hello, I'm calling to ask about Pennsylvania Community HealthChoices (CHC). I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need proof of age (65+) or Social Security disability determination, proof of Pennsylvania residency, social Security card — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Gather your required documents before starting. You will need: proof of age or Social Security disability determination; proof of Pennsylvania residency; your Social Security card; your Medicare card if you have one; proof of all monthly income such as a Social Security award letter or pension statements; bank statements and documentation of countable resources (both spouses' documents if married); and the nursing-facility clinically eligible (NFCE) determination from your in-home assessment.
2. Contact the Independent Enrollment Broker to start the process. Call 1-877-550-4227 to apply by phone or to get help applying online. You can also reach the CHC participant line at 1-844-824-3655 with questions.
3. Schedule and complete the in-home assessment. The Independent Enrollment Broker will arrange this visit. A clinician comes to your home to determine whether you meet the nursing-facility clinically eligible (NFCE) standard. This step is required — clinical eligibility cannot be decided from intake answers alone.
4. Review your financial eligibility. Pennsylvania's long-term-care Medicaid limits apply. Confirm the current income and resource limits with the Independent Enrollment Broker, especially if you are married, since spousal-impoverishment protections allow the at-home spouse to keep substantially more income and assets than the single-applicant limits show.
5. Submit your application with all required documents. Apply online or by phone at 1-877-550-4227. Make sure every document on the list is included to avoid delays.
6. Choose a CHC managed-care health plan. Once eligibility is confirmed, you will select a CHC plan from the options available in your area. The Independent Enrollment Broker can walk you through the choices and help you decide.
7. Keep your contact information current with the Independent Enrollment Broker and your chosen CHC plan so you receive notices about your coverage and any next steps.

What to expect: After submitting, the Pennsylvania Department of Human Services and the Independent Enrollment Broker will review your application, your in-home assessment results, and your financial documents. Processing times vary, so ask the Independent Enrollment Broker at 1-877-550-4227 for an estimate of how long your review may take. If approved, you will be enrolled in the CHC managed-care plan you selected and can begin accessing covered services, which may include personal assistance, home health aide visits, adult day services, home-delivered meals, home modifications, and more. To keep your coverage, you must complete an annual financial recertification and a periodic reassessment of your level of care — watch for notices from DHS and your CHC plan so you do not miss these deadlines.

Renewals

annual financial recertification plus periodic reassessment of level of care