AmeriHealth Caritas Pennsylvania is a Medical Assistance (Medicaid) managed care health plan serving more than 114,000 Medical Assistance recipients across two regions of Pennsylvania: Lehigh/Capital, comprising Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry, and York counties; and New West, comprising Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, Mercer, McKean, Potter, Venango and Warren counties.
Headquartered in Harrisburg, AmeriHealth Caritas Pennsylvania offers all of the benefits and services of regular Medical Assistance, plus special programs and benefits that are only available to AmeriHealth Caritas Pennsylvania members. AmeriHealth Caritas Pennsylvania provides extensive programs to help members prevent illness and injury so they can live fuller lives, and aims to provide a medical home that helps members access the services they need.
AmeriHealth Northeast offers all of the benefits and services of regular Medical Assistance, plus special programs and benefits that are only available to AmeriHealth Northeast members. We focus on connecting members with the care they need to stay well. And, through our extensive wellness programs, we can help our members prevent illness and injury so they can live fuller lives. AmeriHealth Northeast serves about 58,000 members in Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Shuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne and Wyoming counties.
Click here to read an October, 2018 Governing Magazine article by Paul A. Tufano, Chairman and CEO of AmeriHealth Caritas, about the influence of the state Health and Human Services Committee.
Highmark Wholecare has been caring for the most vulnerable Pennsylvanians for the past 30 years. We believe in caring for the whole person in all communities where the need is greatest. We see a future in which everyone has equal opportunity to achieve their best health. Through our leading Medicaid and Medicare programs, we are coordinating healthcare that goes beyond doctors and medicine that helps our nearly 370,000 members achieve not just physical health, but also delivers whole person care. Our team members are helping to drive this new kind of healthcare in collaboration with a network of 29,000 primary care physicians, specialists, hospitals, and other ancillary providers. We are also committed to supporting our neighbors through our many community outreach and engagement programs. www.highmarkwholecare.com
Geisinger Health Plan (GHP) is part of Geisinger, an integrated health system that provides our members and patients with exceptional healthcare. Since 1985, GHP, headquartered in Danville, Pennsylvania, has provided high quality, affordable healthcare benefits, and now serves more than 600,000 members. Coverage is available for businesses of all sizes, individuals and families, Medicare beneficiaries, Children’s Health Insurance Program (CHIP) and Medical Assistance recipients. GHP recently expanded its footprint and now offers GHP Kids (CHIP) and GHP Family (Medical Assistance) plans statewide, throughout all 67 counties in Pennsylvania. GHP has a robust network of over 180 hospitals and over 19,000 providers available to serve its members. GHP has received national recognition for our innovation, and for uniquely and effectively managing medical costs and improving outcomes. In 2022, the National Committee for Quality Assurance (NCQA) awarded GHP with Health Equity Accreditation, and GHP was one of only 9 organizations in the nation to also earn Health Equity Accreditation Plus.
Nationally recognized for its innovations in managed care, Health Partners is among the top fifteen Medicaid plans in the country, one of the highest-rated in Pennsylvania and receives strong ratings for member and provider satisfaction according to the National Committee for Quality Assurance’s (NCQA) Medicaid Health Insurance Plan Ratings 2016–2017. Health Partners is a not-for-profit managed health care organization serving nearly 280,000 members in Southeastern Pennsylvania. It provides a broad range of health coverage options through Health Partners Medicare, Health Partners (Medicaid) and KidzPartners (Children’s Health Insurance Program). Founded more than 30 years ago, Health Partners is one of the few hospital-owned health plans in the country. Learn more about how Health Partners is doing it right at HealthPartnersPlans.com, twitter.com/HPPlans and facebook.com/
Keystone First is Pennsylvania’s largest Medical Assistance (Medicaid) managed care health plan, serving nearly 300,000 Medical Assistance recipients in the Southeastern Pennsylvania counties of Bucks, Chester, Delaware, Montgomery and Philadelphia counties.
Keystone First offers all of the benefits and services of regular Medical Assistance, plus special programs and benefits that are only available to Keystone First members. Keystone First provides extensive programs to help members prevent illness and injury so they can live fuller lives, and aims to provide a medical home that helps members access the services they need.
UnitedHealthcare Community Plan is UnitedHealth Group’s government programs business segment, which has contracts in 24 states and the District of Columbia and serves more than 3.2 million members, making us the country’s largest Medicaid organization. UnitedHealthcare Community Plan is the result of the integration of the AmeriChoice and Unison health plans in Pennsylvania. We leverage the best practices learned nationwide by UnitedHealthcare to offer a comprehensive, high quality product to Pennsylvania members. Currently, throughout the Commonwealth, we administer health care benefits to over 270,000 Medical Assistance, CHIP and Medicare members in 50 counties.
UPMC for You is uniquely positioned to offer an extensive set of leading-practice healthcare strategies comprising both programs and interventions that address the medical needs of Medical Assistance recipients in a high-quality, cost-effective manner. UPMC for You’s current provider network consists of 87 hospitals, 3,501 primary care practitioners (PCPs), and 8,905 specialists. In addition, UPMC for You has a full array of ancillary providers, including but not limited to durable medical equipment (DME), home health (HH) and skilled nursing facilities (SNF). In 2015, UPMC for You earned a 4 (out of 5) from the National Committee for Quality Assurance (NCQA). Of the 149 Medicaid plans in the nation that were rated by NCQA, only 11 had a rating higher than 4.
UPMC for You is an integrated partner company of the UPMC Insurance Services Division, which also includes UPMC Health Plan, UPMC for Life, UPMC WorkPartners, UPMC for Kids, LifeSolutions, Askēsis Development Group, eBenefits, and Community Care Behavioral Health. The UPMC Insurance Services Division offers a full range of group health insurance, Medicare, Children’s Health Insurance Program, Special Needs Plans, Medical Assistance, Commercial, behavioral health, employee assistance, benefits administration solutions, and workers’ compensation products and services to over 2.9 million members.