Commercial Health Plans Community Health Choices (CHC) Dual

Commercial Health Plans

UPMC Hanover

(Hospital Only)

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

Aetna (Health America, Coventry and First Health)

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Aetna PinnacleHealth Whole Health (Narrow Network)

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Aetna PEBTF Choice PPO

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Aenta PEBTF/REHP Custom HMO (Updated participation effective 1/1/2022)

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Blue Cross/Blue Shield of Maryland/CareFirst (excludes HMO)

✔

Capital Blue Cross / Keystone Health Plan Central

✔

✔ ✔

✔ ✔ ✔ ✔ ✔ ✔

Capital Blue Cross - Capital Advantage EPO

✔

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Capital Blue Cross - Care Connect (Narrow Network)

✔

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Cigna

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Devon Health Services

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Geisinger Health Plan

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Geisinger Health Plan (PEBTF)

Highmark Blue Shield

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Prime Health Services

` ` ✔

Preferred Healthcare (PHC- Lancaster Only)

✔ ✔

Private HealthCare System (PHCS) PPO& MultiPlan

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Significa Benefit Services, Inc.

✔

United Healthcare

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

UPMC Health Plan 

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

WellSpan Population Health Services (AKA PrimeSource (PPO)/ South Central Preferred

✔

✔ ✔

✔

✔ ✔ ✔

Community Health Choices (CHC)

UPMC Hanover

(Hospital Only)

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

AmeriHealth Caritas CHC

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

PA Health and Wellness CHC

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

UPMC CHC

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Dual-Eligible (Medicare+Medicaid): D-SNP

UPMC Hanover

(Hospital Only)

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

Aetna Medicare Advantra Cares

✔ ✔ ✔ ✔ ✔ ✔

✔ ✔ ✔

Albright Life*

✔

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

AmeriHealth Caritas VIP Care - HMO D-SNP

✔

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Senior Life*

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

SpiriTrust Lutheran LIFE*

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

United Healthcare Dual Complete

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Wellcare by Allwell/PA Health and Wellness

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Marketplace/Pennie/Exchange/ACA/Healthcare.gov

UPMC Hanover

(Hospital Only)

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

Capital Blue Cross

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Geisinger Marketplace (PPO and HMO)

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Geisinger Marketplace Premier (PPO and HMO)

Highmark - my Blue Access PPO

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Highmark - my Direct Blue EPO

✔

UPMC Health Plan

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Medicare/Medicare Advantage Health Plans

UPMC Hanover

(Hospital Only)

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

Medicare - Traditional

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Aetna Medicare Advantage / Advantra

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Aetna Pinnacle Prime (narrow network)

✔ ✔

✔ ✔ ✔ ✔ ✔ ✔ ✔

Capital Blue Cross / Keystone Health Plan Central - Blue Journey

✔ ✔ ✔ ✔

✔ ✔ ✔ ✔ ✔

Cigna Medicare PPO/HMO - effective 07/01/2022

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Geisinger Gold

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Highmark - Community Blue Medicare HMO

✔ ✔

Highmark - Community Blue Medicare Plus PPO / Community Blue Medicare PPO North Central

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Highmark Freedom Blue

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Highmark Wholecare Assured - previously Gateway Assured

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Humana - HMO

✔ ✔ ✔

Humana - PPO & PFFS

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

United HealthCare Group Medicare Advantage

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

UPMC forLife

✔ ✔

✔ ✔ ✔ ✔ ✔ ✔ ✔

Wellcare by Allwell - PPO

✔ ✔

✔ ✔ ✔ ✔ ✔ ✔

✔

Wellcare by Allwell - HMO

✔ ✔

✔ ✔ ✔ ✔ ✔ ✔ ✔

Medicaid Health Plans

UPMC Hanover

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

PA State Medical Assistance

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

AmeriHealth Caritas

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Geisinger Family Plan

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Health Partners Plan

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Highmark Wholecare - previously Gateway

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

UnitedHealthcare Community Plan - Out of Area

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

UPMC for You

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

CHIP

UPMC Hanover

(Hospital Only)

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

Aetna Better Health Kids

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Capital Blue Cross

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Geisinger Health Plan Kids

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Highmark Healthy Kids

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

KidzPartners

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

UnitedHealthcare Community Plan for Kids

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

UPMC For Kids

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Other Governmental Programs

UPMC Hanover

Facility Only

Facility

PHMS Professional

(Including Hanover

Professionals)

Facility

PHRP Professional

Facility

PHRP Professional

Facility

PHRP

Professional

Facility

Humana Military (Tricare)

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

VA CCN

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

Veterans Affairs

✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

*= PACE program

✔ = participating or in network

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Carlisle and Pinnacle Health

Regional Physicians (PHRP)

UPMC Lititz and Pinnacle Health

Regional Physicians (PHRP)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

UPMC Carlisle and Pinnacle Health

Regional Physicians (PHRP)

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Lititz and Pinnacle Health

Regional Physicians (PHRP)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

UPMC Carlisle and Pinnacle Health

Regional Physicians (PHRP)

UPMC Lititz and Pinnacle Health

Regional Physicians (PHRP)

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Carlisle and Pinnacle Health

Regional Physicians (PHRP)

UPMC Lititz and Pinnacle Health

Regional Physicians (PHRP)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Carlisle and Pinnacle Health

Regional Physicians (PHRP)

UPMC Lititz and Pinnacle Health

Regional Physicians (PHRP)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

UPMC Lititz and Pinnacle Health

Regional Physicians (PHRP)

UPMC Carlisle and Pinnacle Health

Regional Physicians (PHRP)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

UPMC LititzUPMC Carlisle

UPMC Pinnacle (Harrisburg, West

Shore, Community Osteopathic) and

Pinnacle Health Medical Services

(PHMS)

UPMC Carlisle and Pinnacle Health

Regional Physicians (PHRP)

UPMC Lititz and Pinnacle Health

Regional Physicians (PHRP)

UPMC Memorial and Pinnacle Health

Regional Physicians (PHRP)

Effective 9/1/2022