Maximus and the PA IEB
If you are trying to get help at home in Pennsylvania, you may hear the name Maximus come up early in the process.
That is because Maximus operates the Pennsylvania Independent Enrollment Broker (PA IEB), the statewide program that helps Pennsylvanians start (and track) enrollment for long-term services and supports (LTSS) such as home and community-based services.
Families often ask:
- โIs Maximus my insurance?โ
- โDo I have to call them to get services?โ
- โWhat happens after I apply?โ
This article breaks it down in plain English, so you know what Maximus does, what the PA IEB does, and how to move through the steps with less stress.
What is Maximus in Pennsylvania home care?
Maximus is a company contracted by the Commonwealth of Pennsylvania to provide enrollment and application support for certain DHS programs. In this role, Maximus runs the PA Independent Enrollment Broker (PA IEB) services that help eligible residents apply for Medicaid-funded home and community-based services and other LTSS programs administered by Pennsylvaniaโs Office of Long Term Living (OLTL).
Think of Maximus (PA IEB) as the front door and guide for enrollment steps. They help coordinate the application flow and next steps, but they are not your home care agency.
What does the PA IEB actually do?
When you contact the PA IEB, they can help with things like:
- Starting an application for waiver services or Community HealthChoices (CHC) LTSS
- Explaining what information you need and what to expect
- Scheduling an assessment visit (location depends on your situation)
- Supporting the eligibility and enrollment process and helping you check status
The PA IEB site also includes application resources, CHC explanations, and a status check tool.
The two PA IEB phone numbers
People get tripped up here because there are different numbers depending on where you are in the process.
- If you are applying / a prospective applicant: call 1-877-550-4227
- If you are already enrolled and need beneficiary support: call 1-844-824-3655
What to expect after you apply
While every case is different, the PA IEB generally coordinates the steps that move your application forward, including assessments and documentation. Pennsylvania DHS notes that the IEB helps schedule an in-person assessment and assists with completing a Medicaid application that is sent to the County Assistance Office (CAO).
The PA IEB also states you will receive an eligibility decision within a timeframe described on their site (commonly referenced as within 90 days after the process reaches certain milestones).
Common documents families should prepare
Families are often asked for information related to identity, insurance or benefits, income, and medical need. In many cases, your physician may be involved for certification paperwork. The PA IEB provides forms and submission instructions, including fax and email contacts used for documents.
If you are sending anything that includes health information, follow PA IEB instructions for secure submission.
Where LightSpring Care fits in
Maximus and the PA IEB help with enrollment and eligibility steps. LightSpring Care helps with what families care about most once services are approved: dependable, day-to-day support at home.
Here is how we typically help clients alongside the PA IEB process (without pretending to โbeโ the PA IEB):
- Help you understand the difference between CHC, waivers, and home care options
- Help you organize questions and paperwork before calls or visits
- Plan for care at home while the enrollment process is moving forward
- Coordinate start of care once authorizations and coverage are in place
If you are in the middle of enrollment and you are unsure what step you are on, the PA IEB โCheck Statusโ tool may help when you have your case details.
Quick FAQ
Is Maximus the same as my health plan?
No. Maximus runs the PA IEB enrollment support function under contract with Pennsylvania DHS. Your CHC health plan is separate.
Do I have to use the PA IEB?
If you are applying for CHC LTSS or certain OLTL-administered LTSS pathways, Pennsylvania directs applicants to start with the Independent Enrollment Broker.
What if I already have services and need help now?
If you are already enrolled, use the beneficiary support number: 1-844-824-3655.
Next step
If you are trying to start services and you want a clear plan call LightSpring Care to talk through your home care needs and what support would look like once services begin.
