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
  • Northeast
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.