Reading Hospital Center for Public Health

Insurance Information

Commercial Plans

Insurance through your employer

Aetna

• Aetna HMO
• Aetna HMO (Open Access)
• Aetna HMO / Health Network Only
• Aetna QPOS
• Aetna Savings Plus
• Aetna Select
• Aetna Signature
• Aetna Value Performance Network
• Aetna Voluntary Plans
• Aetna Whole Health
• Choice POS, Choice - POS (Aetna HealthFund), Choice POS II, Choice POS II (Aetna HealthFund)
• Elect Choice EPO
• Health Network Only & Health Network Option
• International Medical
• Managed Choice, Managed Choice - Open Access, Managed Choice POS
• Mercy Preferred Choice POSII, Mercy Preferred Choice Select, Mercy Preferred Elect Choice EPO
• Mercy Preferred Managed Choice & Mercy Preferred Open Choice (PPO)
• Open Access - Elect Choice, Open Access EPO
• Open Access POS, Open Access EPO Plus (Broad) & Open Access POS II (Broad)
• Open Choice PPO & Open Choice PPO - Aetna HealthFund
• Peak Preference Select HNOnly on the Altius Network and Peak Preference Select HNOption on the Altius Network
• Preferred - Open Choice PPO, Preferred Choice POS II, Preferred Select
• Preferred Elect Choice EPO, Preferred Managed Choice
• Premier Care - Network & Premier Care Network Plus

We do not participate in the following Aetna plans:

 - Not PEBTF HMO

AmeriHealth Administrators

Capital Blue Cross

• CareConnect – PinnacleHealth ACA Network
• Comprehensive
• POS
• PPO
• PPO Choice
• Traditional
• HMO

We do not participate in the following Capital Blue Cross plans:

 - Valley Advantage EPO

Cigna

• ChoiceFund OA Plus
• Open Access Plus
• OA Plus
• ChoiceFund OA Plus with CareLink PPO
• Choice Fund PPO Network
• HMO
• POS

Coventry

EHP Significa Network

First Health Network

Great West

HealthAmerica/Health Assurance

Highmark Blue Shield (NOTE: standard tier)

We do not participate in the following Highmark plans:

- Community Blue Medicare HMO
- My Direct Blue EPO

Independence Blue Cross

• Keystone HMO Proactive (Tier 3)
• Keystone HMO/POS/Direct POS
• Personal Choice PPO
• Personal Choice EPO
• Personal Choice Tiered  (Tier 2)
• National BlueCard PPO
• IBC HMO Commercial tier 3 Standard
• IBC PPO Commercial
• AmeriHealth PPO & HMO Commercial
• AmeriHealth Comprehensive Major Medical

Keystone Health Plan Central

Keystone Health Plan East

Lehigh Valley Health Network Plan

Tower Health PPO

TriCare

United Healthcare

• Unitedhealthcare Navigate
• All Savers
• Unitedhealthcare Catalyst
• Unitedhealthcare Choice and Choice Plus
• Unitedhealthcare Choice Advance and Choice Plus Advance
• Unitedhealthcare Options PPO plans
• Unitedhealthcare Tiered Benefit Plans
• Unitedhealthcare MD-IPA Plan
• Unitedhealthcare Student Resources
• UHC Compass Rose PPO Plan

We do not participate in the following United Healthcare plans: 

 - Oxford (unless the member has access to choice plus)
 - Heritage (unless the member has access to choice plus)
 - Erikson Advantage

UPMC Health Plans

• Premium Network Plans PPO and EPO Plans
• UPMC Employees Out of Area PPO Plan
• UPMC Out of Area Gold
• UPMC Out of Area Silver
• MyCare Advantage PPO Level 2 Providers

We do not participate in the following UPMC plans:

 - Partner Network Plans (HMO and EPO Plans)
 - Standard Network Plans (HMO Plans)
 - Partner Network Plans (HMO and EPO Plans)
 - UPMC Business Advantage HMO (Referral Required)
 - UPMC Business Advantage HMO (No Referral)
 - Enhanced Access (HMO and POS Plans)
 - UPMC Employees Advantage (EPO Plans)
 - Panther Gold Advantage HMO (For Pitt Employees)
 - Panther Gold HMO (For Pitt Employees)
 - FEHB Plans
 - UPMC Inside Advantage Level 1 Providers
 - MyCare Advantage HMO Level 1 Providers
 - MyCare Advantage HMO Level 2 Providers
 - MyCare Advantage PPO Level 1 Providers
 - Prime Care

Medicaid HMO

Insurance program through the state for those requiring financial assistance

Aetna Better Health

AmeriHealth Caritas

• Pennsylvania
• Community Health Choices

Highmark Blue Shield Special Care

Gateway Health Plan

Keystone Family Health Plan

UHC Medicaid

UPMC for You

• Health Choices
• Community Health Choices

Medicare Advantage 

Insurance for people over 65 years of age or with disabilities

Plans Offering Drug Coverage

AARP Medicare

• Complete HMO
• Complete Choice PPO

Aetna Coventry

• Advantra Gold PPO (1/1/20 new name - Aetna Medicare Advantra Premier Plus PPO)
• Advantra Northern Pennsylvania Gold HMO (1/1/20 new name - Aetna Medicare Advantra Gold HMO)
• Advantra Southeast Prime HMO (1/1/20 new name - Aetna Medicare Advantra Value HMO)
• Advantra Silver HMO & PPO (1/1/20 new name - Aetna Medicare Advantra Silver HMO & PPO)
• Advantra Silver Plus HMO & PPO (1/1/20 new name - Aetna Medicare Advanta Silver Plus HMO & PPO)
• Advantra One PPO (1/1/20 new name - Aetna Medicare Advantra Credit Value PPO)
• Advantra Basic Medical HMO (1/1/20 new name - Aetna Medicare Advantra Core HMO)

Aetna Medicare

• Choice HMO
• Silver HMO
• Gold PPO
• Premier HMO
• Standard HMO

AmeriHealth Caritas VIP Care

Capital Blue Cross Medicare Advantage

• Blue Journey HMO

Coventry Advantra

• Gold PPO
• Silver HMO
• One PPO

Humana (Choicecare)

• Humana Gold Plus HMO
• Humana Choice PPO
• Humana Gold Choice PFFS

Highmark Medicare Advantage

• Freedom Blue PPO
• Community Blue Medicare PPO
• Community Blue Medicare PPO Plus – Clinton, Lycoming, Sullivan, and Tioga Counties only

Independence Blue Cross

• IBC HMO Medicare Basic/Select
• IBC HMO Medicare
• IBC PPO Medicare
• Amerihealth HMO Medicare

Keystone 65

• Basic Rx HMO
• Preferred Rx HMO
• Select Rx HMO

Personal Choice 65 Rx PPO

United Healthcare

• Unitedhealthcare Dual Complete
• Unitedhealthcare Group Medicare Advantage Plan
• Unitedhealthcare Assisted Living Plan (PPO)
• Unitedhealthcare Nursing Home Plan

UPMC for Life

• HMO
• PPO

Plans without Drug Coverage

Keystone 65

• Preferred Medical Only HMO
• Select Medical Only HMO

United Healthcare AARP Medicare Complete

Special Needs Plans

Aetna Coventry

• Advantra Cares (HMO SNP) -(1/1/20 new name - Aetna Medicare Advantra Cares HMO D-SNP)

Gateway Health Medicare Assured

• Diamond HMO
• Ruby HMO

Keystone First VIP Choice HMO

United Healthcare

• AARP Medicare Complete
• UHC Dual complete
• UHC Group Medicare Advantage Plans
• UHC Assisted Living Plan (PPO)
• UHC Nursing Home Plan

CHIP

Children's Health Insurance Program through the state

Aetna Better Health Kids

Capital Cares for Kids

Highmark CHIP

IBC CHIP

UHC CHIP

UPMC for Kids

Marketplace/ACA Plans

Independent insurance plans through the Affordable Care Act

Capital Blue Cross

• Bronze PPO 7350-0-60
• Silver PPO 5000/10/30
• Gold PPO 2000/10/20

Independence Blue Cross (Tier 3)

• Keystone HMO Platinum
• Keystone HMO Gold
• Keystone HMO Gold Proactive (tiered network plan)
• Keystone HMO Silver
• Keystone HMO Silver Proactive (tiered network plan)
• Keystone HMO Bronze
• Personal Choice® PPO Platinum
• Personal Choice PPO Gold
• Personal Choice PPO Silver
• Personal Choice PPO Silver Reserve
• Personal Choice PPO Bronze
• Personal Choice PPO Bronze Reserve
• Personal Choice PPO Catastrophic

UPMC Health Plans

• Tower UPMC Advantage Bronze
• Tower UPMC Advantage Silver
• Tower UPMC Advantage Gold

Behavior Health Organization 

Administrator/Payor of behavioral health benefits

Payor	Product Lines
Community Care Behavioral Health (CCBH) [through Aetna Better Health, AmeriHealth Caritas, Gateway, or UHC Community Plan]	Medicaid through Berks, Chester, York, and Adams Counties ONLY
Community Care Behavioral Health (CCBH) [through UPMC]	Commercial, CHIP, Medicare, Medicaid
Magellan	Commercial
MH Net	Commercial, Medicare
Quest	Commercial

Please call Customer Service (at the number on the back of your insurance card) to determine your Behavioral Health insurance vendor.