When you or a loved one need long-term support at home, understanding your benefits can feel confusing. Programs, eligibility rules, and health plan options can quickly become overwhelming—especially when you are already focused on health, safety, and daily care.

Community HealthChoices, often called CHC, was created to make that process more coordinated and supportive for eligible Pennsylvanians. At Traditional Home Care, we believe families deserve clear guidance so they can make confident decisions and access the care they need.

What Is Community HealthChoices?

Community HealthChoices is Pennsylvania’s mandatory managed care program for adults who are eligible for both Medicare and Medicaid, as well as certain individuals with physical disabilities who need long-term services and supports.

The goal of CHC is to help more people receive care in their homes and communities rather than in institutional settings. This gives individuals greater opportunity to remain independent, spend more time with family, and enjoy a better quality of life.

Who Qualifies for CHC?

You may be automatically enrolled in Community HealthChoices if you are age 21 or older and meet one of the following conditions:

• You receive both Medicare and Medicaid
• You receive long-term services and supports through the Attendant Care, Independence, COMMCARE, or Aging waivers
• You receive long-term services and supports through the OBRA waiver and clinically qualify for nursing facility level of care
• You live in a nursing home and Medicaid pays for your care

Who Does Not Qualify?

Some individuals are not eligible for CHC. This may include:

• Individuals in the OBRA waiver who do not clinically qualify for nursing facility level of care
• Individuals with intellectual or developmental disabilities receiving services through the Office of Developmental Programs
• Individuals living in a state-operated nursing facility, including state veterans’ homes

What Does CHC Cover?

Community HealthChoices combines many important benefits into one managed care plan. This includes physical health services, prescription coverage, and for eligible individuals, long-term services and supports.

CHC also includes care coordination, which helps manage services and connect members to the care they need more efficiently. For many families, this added support makes it easier to navigate healthcare and stay organized.

What Happens After Enrollment?

Once enrolled in CHC, you will choose a health plan and a primary care practitioner, also known as a PCP. Your health plan works with a network of doctors, hospitals, clinics, and other providers to help meet your healthcare needs.

Your PCP will help oversee your care and serve as a key part of your health team. If you already have both Medicare and Medicaid and are enrolled in a Medicare Advantage plan, you may not need to change your Medicare PCP.

What About the LIFE Program?

Some individuals may qualify for the Living Independence for the Elderly, or LIFE, program instead of CHC. If you are already enrolled in LIFE, you can remain there unless you choose to change.

To qualify for the LIFE program, individuals generally must:

• Be age 55 or older
• Meet the level of care needs for a skilled nursing facility or special rehabilitation facility
• Meet financial eligibility requirements or be able to private pay
• Live in an area served by a LIFE provider
• Be able to be safely served in the community

Why This Matters for Families

Programs like CHC are designed to give people more choice, more support, and more opportunity to remain safely at home. For many families, that means less disruption, more independence, and a better overall quality of life.

But understanding which program is right for your loved one can still feel complicated. That is why it is so important to have a trusted care team who can help you understand your options and guide you through the process.

Home Care Support You Can Trust

At Traditional Home Care, we understand that every family’s situation is unique. We are here to provide compassionate support, answer your questions, and help you access the services that allow your loved one to live safely and comfortably at home.

If you would like to learn more about Community HealthChoices or how home care services may fit into your care plan, our team is here to help.