Your Long-Term Services and Supports (LTSS) Benefits

Some Participants also have LTSS.* The Pennsylvania (PA) Department of Human Services (DHS) determines if Participants are eligible for LTSS. Keystone First Community HealthChoices (CHC) covers LTSS for Participants who cannot do some activities of daily living or who have chronic illnesses. LTSS include services in the community and in a nursing home. LTSS help you live where you want to, for example, at home or in another residential setting in the community, or a nursing home. LTSS also support you where you want to work.

In order to be able to get LTSS, you will have to have a "clinical eligibility determination" that shows that you need the type of services provided in a nursing home, even if you are getting or could get the services at home or in another community setting. This is called being "Nursing Facility Clinically Eligible," also called "NFCE." This means that not everyone may get LTSS.

How can I learn more about the clinical eligibility determination process?
Visit the PA Independent Enrollment Broker (IEB) website to learn more.

Watch to learn more about your benefits

As a Keystone First CHC Participant who also receives LTSS benefits, there are additional benefits and services that you may receive. Here are some of the additional benefits and services Participants may be able to receive:

Home- and Community-Based Services (HCBS)

What are HCBS?
HCBS are services and supports provided in your home and community. HCBS help older adults and persons with disabilities live independently and stay in their homes. Services include help with activities of daily living, or ADLs. These services give Participants choices. They help Participants make and reach goals.

Who’s eligible for HCBS?
Participants who have LTSS are eligible for HCBS. The PA DHS determines if Participants are eligible for LTSS benefits. Keystone First CHC helps eligible Participants with LTSS get access to home- and community-based services.

HCBS covers 32 services. You can find a complete listing of HCBS services in your Participant Handbook (PDF). You can call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976) to ask for a copy of the Participant Handbook.

Have questions?
If you get LTSS and have questions about your HCBS, talk with your Service Coordinator or call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976).

*Not all Participants get LTSS. The PA DHS determines if Participants are eligible for LTSS.