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  • 17,803 complaints received
  • 5,003 Field Investigations
  • $16,348,986 saved
  • October 1, 2013 - September 30, 2014

    HealthChoices General Information

    The HealthChoices Program is the name of one of Pennsylvania's mandatory managed care programs for Medical Assistance recipients.

    Through Physical Health Managed Care Organizations, recipients receive quality medical care and timely access to all appropriate physical health services, whether the services are delivered on an inpatient or outpatient basis. The Department of Public Welfare's Office of Medical Assistance Programs oversees the Physical Health component of the HealthChoices Program.

    Through Behavioral Health Managed Care Organizations, recipients receive quality medical care and timely access to appropriate mental health and/or drug and alcohol services. This component is overseen by the Department of Public Welfare's Office of Mental Health and Substance Abuse Services.

    HealthChoices currently serves approximately 900,000 recipients in the following zones:

    • Southeast Zone - Bucks, Chester, Delaware, Montgomery and Philadelphia counties
    • Southwest Zone - Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Green, Indiana, Lawrence, Somerset, Washington and Westmoreland counties
    • Lehigh/Capital Zone - Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry and York counties
    • New West Zone - Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango and Warren counties
    • New East Zone - Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne and Wyoming counties

    The HealthChoices Program has three goals that guide the Department of Public Welfare in its implementation efforts. These goals are:

    • To improve access to health care services for Medical Assistance recipients;
    • To improve the quality of health care available to Medical Assistance recipients; and
    • To stabilize Pennsylvania's Medical Assistance spending.

    The HealthChoices Enrollment Program's Web site provides information on health plans, doctors, health care services, enrollment and more.

    Click below to be directed to the HealthChoices Enrollment Program Website: