Changes in Managed Care Plans – August 16 Deadline for Medicaid Recipients to Select Coverage

Pennsylvania is quickly approaching the August 16th deadline for those insured through Medicaid to (re)select a physical health managed care plan. A result of the state's new physical health managed care agreement, around 500,000 Medicaid, or MA, recipients will need to shift plans.

Though all 2.3 million Pennsylvanians on Medicaid will have the option to shift plans, only the ~500,000 insured through plans excluded from that state's new agreement, outlined below, need to select a new plan; if they do not do so before August 16, they will be automatically assigned a plan. To ensure Medicaid recipients don’t lose their MA insurance plan, PA ACP urges members to notify their Medicaid patients of this upcoming deadline, directing them here.

The following plans will no longer be offered(in various places in PA:

  • Aetna will no longer operate a Medicaid plan anywhere in PA.
  • United will no longer operate in the Southwest and Lehigh/Capital zones.
  • Highmark will no longer operate in the Northwest zone.

New plans will be available in every zone in the state. Learn more about the new plans and their availability according to state zones here.

To learn more about this agreement, which goes into effect on September 1, 2022, register here for the information session with the PA Dept. of Human Services, PA Health Law Project and PA Health Access Network, scheduled for Wednesday, August 10 at 2:00pm.

No Medicaid recipient will lose coverage as a result of this new agreement; however, we must lend a hand in educating Pennsylvanians insured through Medicaid that the end of the Public Health Emergency, be it in October 2022 or January 2023, could result in mass loss of coverage.

PA-ACP has urged the state to extend its MA redetermination timeline from 6 to 12 months, initiate a public awareness campaign to ensure Medicaid enrollees update their contact information in their health plan database and inform enrollees who will no longer qualify for MA, of their other coverage options.