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Pennsylvania’s New Adult Medicaid Benefits Package Offers Simplified, Streamlined Coverage

Public Benefits

Pennsylvania’s New Adult Medicaid Benefits Package Offers Simplified, Streamlined Coverage

Date Posted: 
03/27/2015

On March 27, 2015, Pennsylvania’s Department of Human Services (DHS) published the Adult Medicaid benefits package for all adult recipients. Children’s Medicaid coverage will not change.

Many adult Medicaid recipients will receive the Adult benefits package beginning on April 27, 2015.  All recipients will receive the package by September 1, 2015. 

The Adult benefits package is similar to the “Interim Healthy” benefits package that most Medicaid recipients received in 2014 and some recipients receive now. It is also similar to the “Healthy Plus” package for seniors, individuals with disabilities, and pregnant women that took effect on January 1, 2015. It includes dental coverage and non-emergency transportation to medical appointments.

The Adult benefits package reinstates some behavioral health coverage limits that were eliminated for Healthy Plus. However, many of those behavioral health limits were not enforced by Medicaid behavioral health managed care organizations, and may not be enforced in the future.

DHS is accepting written comments on the Adult benefits package through April 26, 2015. Comments may be submitted to: Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120.


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