AETNA BETTER HEALTH® OF PENNSYLVANIA
Aetna brings 30 years of experience managing and serving the full range of Medical Assistance and CHIP beneficiaries. Our organization has served Pennsylvania members since 1993, with the start of the Children’s Health Insurance Program. Since 2010, Aetna Better Health of Pennsylvania has operated as a HealthChoices contractor, currently serving over 208,000 members enrolled in the HealthChoices (Medical Assistance) program throughout the Commonwealth of Pennsylvania. We received full health plan accreditation by NCQA for our Medical Assistance and CHIP lines of business.
Our purpose is to empower people to live healthier lives. We achieve this by embedding our company values of Integrity, Excellence, Caring and Inspiration into all that we do. We are focused on delivering member-centric, fully integrated care and targeted interventions through a collaborative approach with health care providers, the community, and most importantly, members.
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.
Gateway Health is a nationally ranked managed care organization that was started in 1992 as an alternative to the Pennsylvania Department of Public Welfare’s Medical Assistance Program. Gateway is celebrating its 25th anniversary of delivering high quality healthcare coverage and wellness programs to Medical Assistance (Medicaid) eligible individuals across the Commonwealth of Pennsylvania. Gateway’s more than 310,000 members across 40 counties have the benefit of a tailored health management approach and services such as disease management, health and wellness programs, specialty care and preventive care through a wide and accessible network of primary, specialty and ancillary providers. Gateway is committed to the health of both members and their communities and looks at each member holistically with programs and outreach that meets the behavioral, emotional, economic, medical, social and spiritual needs that may present barriers to care. Gateway’s innovative care models, quality clinical outcomes and responsive and consultative customer service is the mission that drives members, providers and communities to be “Good with Gateway.” www.gatewayhealthplan.com
Geisinger Health Plan (GHP), begun in 1985, is headquartered in Danville, Pennsylvania. The plan serves approximately 551,000 members in Pennsylvania, Delaware and Maine. Geisinger Health Plan’s HMO, PPO and Geisinger Gold’s HMO are among the highest-rated private and Medicare health plans in the nation.* Coverage is available for businesses of all sizes, individuals and families, Medicare beneficiaries, Children’s Health Insurance Program (CHIP) and Medical Assistance recipients. GHP began offering CHIP through GHP Kids in November 2009. In March 2013, GHP launched Geisinger Health Plan Family, a Medical Assistance plan for residents in Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne and Wyoming counties. Beginning in June 2017, GHP will extend their Medical Assistance coverage to Medical Assistance recipients in Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry and York counties.
*NCQA’s Private and Medicare Health Insurance Plan Ratings 2016-2017. Geisinger Health Plan’s PPO is listed in NCQA Health Insurance Plan Ratings under Geisinger Quality Options. Geisinger Gold HMO is listed in NCQA Health Insurance Plan Ratings under Geisinger Health Plan.
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.
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/
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.