- Associated Press - Monday, December 1, 2014

HARRISBURG, Pa. (AP) — Hundreds of thousands of Pennsylvanians frozen out of the first year of coverage under the 2010 federal health care law’s Medicaid expansion could begin applying for the coverage Monday.

Under the broadening of Medicaid’s income guidelines, childless adults under 65 and earning up to $15,600 this year - or 133 percent of the federal poverty level - are eligible. More parents under 65 also are eligible, depending on their income and the number of children they have.

Coverage begins Jan. 1, and enrollment is year-round in the program nicknamed Healthy Pennsylvania by outgoing Republican Gov. Tom Corbett.

State officials say they do not know how many people will seek the coverage, and a Department of Human Services spokeswoman could not immediately gauge enrollment interest Monday morning.

Some 600,000 adults are newly eligible, although some of those people might already be insured through other programs, officials say. Previously, able-bodied adults under 65 were not eligible for Medicaid, unless they had practically no income.

People who enroll can choose from Medicaid-funded insurance plans offered by eight insurers across nine geographic regions. The plans carry various co-payments, and not every hospital will accept each insurance plan offered in the region. Sicker people will be moved into a new high-risk plan being offered under in the existing Medicaid program beginning Jan. 1.

Healthy Pennsylvania plans will cover visits to the physician, emergency room and specialists, and prescription drugs. However, the state will not reimburse insurers under Healthy Pennsylvania for dental coverage or renal dialysis, but insurers may offer it anyway.

People can enroll through the state Department of Human Services by going online, calling 866-550-4355 or going into a county assistance office.

The Medicaid expansion could get particularly complicated for some people.

People who earned about $11,500 to $15,300 last year were eligible to buy subsidized coverage through the federally run marketplace that opened last Jan. 1 as part of the 2010 federal law, but they must switch into Pennsylvania’s Medicaid system now that its income guidelines are expanding, officials say.

Federal and state officials were unable to say how many people that might affect.

The expanded federal Medicaid subsidy became available to states in 2014, but it was delayed a year in Pennsylvania because Corbett had sought federal approval to make changes to it. In broad terms, though, there is little difference between Healthy Pennsylvania and Medicaid.




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