Pennsylvania
Community HealthChoices in Pennsylvania: A Family Guide
Community HealthChoices (CHC) is Pennsylvania's managed-care program for most adults who need long-term services and supports, combining physical health, behavioral health, and home and community-based services under Medicaid managed-care organizations. This guide explains how CHC works, who may qualify, what it may cover, how enrollment works, and how a service coordinator — including one from Alenta, where approved — fits into the picture.
What Community HealthChoices is
Community HealthChoices is Pennsylvania's managed-care long-term services and supports (LTSS) program, administered by the Department of Human Services' Office of Long-Term Living. It replaced several older fee-for-service waiver arrangements and now delivers most physical health, behavioral health, and long-term services and supports for eligible adults through contracted managed-care organizations (MCOs). For where CHC fits among Pennsylvania's broader waiver options, see our PA waiver program guide.
Who may be eligible
CHC generally serves adults age 21 and older who need a nursing-facility level of care, and adults who are eligible for both Medicare and Medicaid (dual eligible), regardless of whether they need long-term services. Actual eligibility is determined by the Pennsylvania Department of Human Services and the Independent Enrollment Broker, never by Alenta. Many older adults exploring CHC arrive from our PA waiver program for seniors page.
Dual Medicare and Medicaid eligibility
A significant share of CHC participants are "dual eligible" — enrolled in both Medicare and Medicaid. For these participants, CHC coordinates their Medicaid-funded long-term services and supports alongside their existing Medicare coverage for medical care, rather than replacing Medicare. Understanding how the two programs work together is one of the more confusing parts of CHC for many families, and it's a common topic a service coordinator can help explain.
Long-term services and supports
Long-term services and supports (LTSS) refers to the ongoing help a person needs with daily activities — bathing, dressing, meal preparation, mobility, and household tasks — whether delivered at home, in the community, or in a facility. CHC's central purpose is organizing and paying for LTSS for eligible participants who want to remain in their homes and communities when possible.
Nursing-facility clinical eligibility
Many CHC participants qualify because they meet the state's clinical criteria for a nursing-facility level of care — meaning their functional needs are significant enough that they could appropriately be cared for in a nursing facility, but they are choosing to receive services in the community instead. This determination is made through a functional eligibility screening conducted by the state or its contractor, not by Alenta.
Former Aging, Attendant Care, Independence, and CommCare populations
Community HealthChoices consolidated several older Pennsylvania waivers — known as Aging, Attendant Care, Independence, and CommCare — into a single managed-care structure, in stages starting in 2018. Those program names are no longer active; most of what they covered is now part of CHC. If you encounter these older names in past paperwork or conversations, they refer to services that generally now fall under CHC.
CHC managed-care organizations
Under CHC, a participant enrolls in one of Pennsylvania's contracted CHC managed-care organizations. That MCO is responsible for authorizing and paying for covered services, including physical health care, behavioral health referrals, and long-term services and supports such as personal assistance, home modifications, and service coordination. The MCO — not Alenta — makes coverage and authorization decisions.
Plan choice and changes
Participants generally choose among the CHC-MCOs available in their region during enrollment and may have opportunities to change plans during designated periods or under certain circumstances. The Independent Enrollment Broker can explain current plan options and enrollment periods for a specific county.
Screening and needs assessments
Before and during CHC enrollment, participants typically go through a functional eligibility screening (often called the Level of Care Determination) and periodic needs reassessments. These evaluate mobility, activities of daily living, cognitive status, and safety at home, and they inform how much support the service plan authorizes.
The role of a service coordinator
A CHC service coordinator is the participant's main point of contact for organizing long-term services and supports. The coordinator conducts assessments, helps build a person-centered service plan, connects the participant with approved providers, monitors how services are working, and helps resolve problems as they come up — all within the framework set by the participant's MCO. Community HealthChoices service coordination is one specific part of the broader CHC program described on this page.
Person-centered planning
Person-centered planning means the participant's own goals, preferences, and daily routine drive the service plan — not a one-size-fits-all template. A good service coordinator asks what a good day looks like for the participant, what supports would make that possible, and builds the plan around those answers, revisiting it as circumstances change.
IEB enrollment process
The Pennsylvania Independent Enrollment Broker (IEB) conducts the initial screening and enrollment counseling for CHC. The IEB explains program options, helps a person understand plan choices, and routes an approved applicant toward enrollment in a CHC-MCO, though it does not provide ongoing service coordination itself.
What CHC may cover
Depending on the participant's approved service plan, CHC may cover physical health services, behavioral health referrals, personal assistance services, home-delivered meals, home accessibility modifications, assistive technology, non-medical transportation, and service coordination itself. Coverage always depends on individual assessment and the participant's chosen MCO's authorization.
What Alenta may help explain
Alenta offers complimentary initial navigation to help families understand how CHC works, what dual eligibility means for their situation, what to expect from screening and enrollment, and what questions to bring to the IEB or their chosen MCO. This is general orientation, not a determination of eligibility or coverage.
Where Alenta may provide formal coordination
Where approved as a CHC service coordination provider, Alenta works within a participant's chosen MCO network to deliver the assessment, planning, provider connection, and monitoring functions described above. Alenta's formal Community HealthChoices service-coordination area currently includes 14 Pennsylvania counties: Berks, Bucks, Carbon, Chester, Delaware, Lancaster, Lebanon, Lehigh, Luzerne, Montgomery, Northampton, Philadelphia, Schuylkill, York. Availability also depends on the participant's chosen MCO, program authorization, and participant choice. See Pennsylvania waiver service coordination for our broader waiver work.
Frequently asked questions
- What is Community HealthChoices?
- Community HealthChoices (CHC) is Pennsylvania's mandatory managed-care program for most adults who need long-term services and supports, combining physical health, behavioral health, and home and community-based services under Medicaid managed-care organizations (MCOs).
- Who may be eligible for Community HealthChoices?
- CHC generally serves adults age 21 and older who need a nursing-facility level of care, and adults who are eligible for both Medicare and Medicaid (dual eligible), regardless of whether they need long-term services. Actual eligibility is determined by the Pennsylvania Department of Human Services and the Independent Enrollment Broker, never by Alenta.
- Is Alenta a Community HealthChoices managed-care organization?
- No. Alenta is not a Community HealthChoices MCO, is not the Pennsylvania Department of Human Services, and does not determine eligibility. Where approved, Alenta may serve as a participant's service coordination entity working alongside their chosen CHC-MCO.
- Can I choose or change my CHC service coordinator?
- Participants generally have some ability to choose or request a change of service coordination entity within their CHC-MCO's network, subject to that MCO's process and availability. Contact your MCO or Alenta to ask about options.
- Which counties does Alenta serve for CHC service coordination?
- Alenta's formal CHC service-coordination area currently includes 14 Pennsylvania counties: Berks, Bucks, Carbon, Chester, Delaware, Lancaster, Lebanon, Lehigh, Luzerne, Montgomery, Northampton, Philadelphia, Schuylkill, and York.
Referral process
If you are already enrolled in Community HealthChoices and want to ask about Alenta as your service coordination provider, comparing CHC with waiver options for seniors, or a professional referring a participant, the fastest path is to submit a waiver referral or contact Alenta. We'll confirm whether Alenta serves your county and MCO and walk through next steps.
Ready to hand this to someone who does it for a living?
One free, no-obligation 20-minute phone consultation with a care manager — not a salesperson. We return every call within one business day.