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MedicaidAdministrativeHigh impact

Pennsylvania: No copays for Medicaid members starting July 1

UnitedHealthcare·PA·State news
Effective date
Jul 1, 2025
We identified it
Jan 12, 2026
Days to comply

Summary

Starting July 1, 2025, UnitedHealthcare Community Plan of Pennsylvania Medicaid members no longer pay copays for any services, including pharmacy. Billing teams must stop collecting copays at point of care for these members.

Action Required

Action needed
Immediately: Stop collecting copays from UnitedHealthcare Community Plan of Pennsylvania Medicaid members for all services and pharmacy. Front desk staff must verify member eligibility through UnitedHealthcare Provider Portal before services to confirm Medicaid status. Update billing workflows to exclude copay collection for this specific plan.