Reading Medical Group

Tower Health Medical Group is committed to providing affordable, quality healthcare to all patients. We understand the billing and payment for healthcare services can be confusing. Knowing your insurance policy is important for you to receive the maximum benefits for your healthcare services. Your benefit coverage level for care provided by Tower Health Medical Group is determined solely by your insurance. Tower Health Medical Group is contracted with many health plans. A list of those plans can be found below.

Reading Physician Groups

Tower Health Medical Group:

The groups listed above have contracts with the following health insurance companies: 

Commercial

Insurance through your employer

• Aetna
  • Aetna HMO
  • Aetna HMO (Open Access)
  • Aetna HMO / Health Network Only
  • Aetna PEBTF PPO
  • 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

• First Health Network
• AmeriHealth Administrators
• Cigna
  • ChoiceFund OA Plus
  • Open Access Plus
  • OA Plus
  • ChoiceFund OA Plus with CareLink PPO
  • Choice Fund PPO Network
  • HMO
  • POS
• Capital Blue Cross
  • CareConnect – PinnacleHealth ACA Network
  • Comprehensive
  • POS
  • PPO
  • Traditional
  • HMO

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

- PPO Choice
- Valley Advantage EPO
- 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
• 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)
  • UPMC Employees Advantage Network (PPO and EPO) – Tier 1
  • UPMC Employees Out of Area Network
  • Panther Gold Advantage Network (For Pitt Employees) – Tier 1
  • UPMC Inside Advantage – Tier 1
  • MyCare Advantage PPO/EPO – Tier 1
  • Tower Network

We do not participate in the following UPMC plans:
- Partner Network
- Standard Network
- Enhanced Access Network
- Panther Gold Network (For Pitt Employees)
- FEHB Employees
- MyCare Advantage HMO

Medicare Advantage

Insurance for people over 65 years of age or with disabilities.

• Aetna Coventry
  • Advantra Gold PPO
  • Advantra Northern Pennsylvania Gold HMO
  • Advantra Southeast Prime HMO
  • Advantra Silver HMO & PPO
  • Advantra Silver Plus HMO & PPO
  • Advantra One PPO
  • Advantra Basic Medical HMO
• Aetna Medicare
  • Aetna PEBTF PPO
  • Basic HMO
  • Choice HMO
  • Gold PPO
  • Premier HMO
  • Silver HMO & PPO
  • Standard HMO
• AmeriHealth Administrators
• AmeriHealth Caritas VIP Care
• Capital Blue Cross Medicare Advantage
  • Blue Journey HMO plans (ALL)
  • Blue Journey PPO plans (ALL)
  • Blue Journey Essential
  • Blue Journey Value
• Medicare (Advantra)
• Health Partners
• Highmark Medicare Advantage
  • Freedom Blue PPO
  • Community Blue Medicare PPO (including Signature Plan)
  • Community Blue Medicare PPO Plus – Clinton, Lycoming, Sullivan, and Tioga Counties only
• Humana (Choicecare Network)
  • Humana Gold Plus HMO
  • Humana Choice PPO
  • Humana Gold Choice PFFS

We do not participate in the following Highmark plans:
- Community Blue Medicare HMO (Signature Plan)

• Medicare Advantage
• PA Health and Wellness (Allwell to Wellcare)
  • HMO DSNP - Active in Berks, Chester, Montgomery and Philadelphia Counties.
  • HMO MAPD - Active in Berks, Chester, Montgomery and Philadelphia Counties.
  • PPO MAPD - Active in Berks, Chester, Montgomery and Philadelphia Counties.
  • PPO DSNP – Not active until 1/1/2023 at which time it will be active in Berks, Chester, Montgomery and Philadelphia Counties.
• United Healthcare
  • Unitedhealthcare Dual Complete
  • Unitedhealthcare Group Medicare Advantage Plan
  • Unitedhealthcare Assisted Living Plan (PPO)
  • Unitedhealthcare Nursing Home Plan
• UPMC for Life
  • HMO & PPO (ALL)
  • All Plans Tower/UPMC Berks County
• Vibra
  • Enhanced Complete Coverage PPO
  • Essential Coverage PPO

CHIP

Children's Health Insurance Program through the state

• Aetna Better Health Kids
• Capital Cares for Kids
• Highmark CHIP
• HPP KidzPartners
• IBC CHIP
• UHC CHIP
• UPMC for Kids

Medicaid HMO

Insurance program through the state for those requiring financial assistance

• Aetna Better Health
• AmeriHealth Administrators
• AmeriHealth Caritas
  • Pennsylvania
  • Community Health Choices
• Gateway Health Plan
• Health Partners
• PA Health and Wellness
  • PA Health and Wellness Community Health Choices (CHC): Active in Berks, Chester, Montgomery and Philadelphia Counties.
• UHC Medicaid
• UPMC (Community Health Choices)
• UPMC for You HMO

Marketplace/ACA Plans

Independent insurance plans through the Affordable Care Act

PA Health and Wellness (Ambetter) : Going live in Berks 1/1/2023. It is currently active in Chester, Montgomery and Philadelphia counties.

• UPMC Health Plans
  • Premium Network
  • Inside Advantage for Individuals (Tier 1 – Gold, Silver, & Bronze)
  • Tower Network

We do not participate in the following UPMC plans:

- Partner Network
- Standard Network
- Select Network