Dear TMC clients,
As a reminder, starting September 1, 2022, United Healthcare Community Plan and Aetna Better Health will no longer be providing Medicaid options (known as managed care organizations, or MCOs) in Pennsylvania’s Southwest and Northwest Zones. All clients should have received notice of this from TMC in June.
If you currently have coverage through United Healthcare Community Plan or Aetna Better Health and live in one of the counties listed below, and will be receiving care at TMC from September 1st onward, you will need to change your MCO no later than August 16th in order for your care with TMC to be covered. You should soon be receiving information in the mail from the Department of Human Services with instructions on making this change.
The Southwest Zone includes clients living in the following counties: Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Washington, and Westmoreland. The two remaining MCO options for this area will be UPMC For You and Highmark Wholecare (formerly Gateway).
The Northwest Zone includes clients living in the following counties: Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venengo, and Warren. The one remaining MCO option for this area will be UPMC For You.
***Please note: although you may be informed that you can also choose Geisinger, AmeriHealth, and HealthPartners as an MCO, TMC is not contracted or in-network with these MCOs; therefore, your care would not be covered by those plans.***
The PA Health Law Project has released detailed information on this restructuring of PA’s Medicaid options, which you can view here. We advise you to contact your case manager directly for any questions you might have or assistance you might need.
Once you have changed MCOs and receive your new plan information, please be sure to promptly share it with Dana Kauffman, TMC’s Intake Coordinator, at d.kaufman@midwifecenter.org so that we can update our billing system accordingly.
Thanks in advance for your timely action,
TMC Staff