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
• TriCare
• We do not participate in the following Aetna plans:
  • PEBTF HMO

First Health Network

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 

• Advantra
  • Premier Plus PPO, Gold HMO, Value HMO, Silver HMO & PPO, Silver Plus HMO & PPO, Credit Value PPO, and Core HMO
• Aetna PEBTF PPO
• Choice HMO
• Silver HMO & PPO
• Gold PPO
• Premier HMO
• Standard HMO
• Basic HMO
• We do not participate in the following Aetna plans:
  • PEBTF 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
• We do not participate in the following Highmark plans:
  • Community Blue Medicare HMO (Signature Plan)

Humana (Choicecare Network)

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

Medicare Advantage

PA Health and Wellness (Allwell to Wellcare)

• HMO DSNP
• HMO MAPD
• PPO MAPD 
• PPO DSNP

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

AmeriHealth Administrators

AmeriHealth Caritas

• Pennsylvania
• Community Health Choices

Health Partners

PA Health and Wellness

UHC Medicaid

UPMC (Community Health Choices)

UPMC for You HMO

Marketplace/ACA Plans

Independent insurance plans through the Affordable Care Act

Capital Blue Cross

• Bronze PPO
• Silver PPO
• Gold PPO

PA Health and Wellness (Ambetter)

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