Tower Health Hospital-Based Clinics

Tower Health Hospital-Based Clinics consist of:

  • Reading Hospital Center for Public Health
  • Reading Hospital Children's Health Center
  • Reading Hospital Family Health Care Center (primary care and obstetrical services)
  • Reading Hospital Internal Medicine Practice
  • Reading Hospital Occupational Health Services
  • Reading Hospital Women's Health Clinic

Tower Health Hospital-Based Clinics are committed to providing affordable, quality healthcare to all patients. We understand that 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 Hospital-Based Clinics is determined solely by your insurance. Tower Health Hospital-Based Clinics are contracted with many health plans. A list of those plans can be found below. You can also call our Patient Financial Services office at 484-628-5683 for a complete list.

Please note: our list is not meant to be all-inclusive and is subject to change. Please check with your health plan to verify coverage.

Commercial Plans (Insurance through your employer)

  • Aetna
    • Aetna HMO
    • Aetna HMO (Open Access)
    • Aetna HMO / Health Network Only
    • 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:

  • AmeriHealth Administrators
  • Capital Blue Cross
    • CareConnect – PinnacleHealth ACA Network
    • Comprehensive
    • POS
    • PPO
    • PPO Choice
    • Traditional
    • HMO

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

  • Valley Advantage EPO
  • Cigna
    • ChoiceFund OA Plus
    • Open Access Plus
    • OA Plus
    • ChoiceFund OA Plus with CareLink PPO
    • Choice Fund PPO Network
    • HMO
    • POS
  • Coventry
  • EHP Significa Network
  • First Health Network
  • Great West
  • 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
  • Keystone Health Plan Central
  • Keystone Health Plan East
  • Lehigh Valley Health Network Plan
  • Tower Health PPO
  • TriCare
  • 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 Plans
    • UPMC Employees Out of Area PPO Plan
    • UPMC Out of Area Gold
    • UPMC Out of Area Silver
    • UPMC Total Advantage PPO
    • MyCare Advantage PPO Level 2 Providers

    We do not participate in the following UPMC plans:

    • Partner Network Plans (HMO and EPO Plans)
    • Standard Network Plans (HMO Plans)
    • Partner Network Plans (HMO and EPO Plans)
    • UPMC Business Advantage HMO (Referral Required)
    • UPMC Business Advantage HMO (No Referral)
    • Enhanced Access (HMO and POS Plans)
    • UPMC Employees Advantage (EPO Plans)
    • Panther Gold Advantage HMO (For Pitt Employees)
    • Panther Gold HMO (For Pitt Employees)
    • FEHB Plans
    • UPMC Inside Advantage Level 1 Providers
    • MyCare Advantage HMO Level 1 Providers
    • MyCare Advantage HMO Level 2 Providers
    • MyCare Advantage PPO Level 1 Providers
    • Prime Care
  • VA CCN (VA Community Care Network) administered by Optum/United Healthcare

Medicaid HMO (Insurance program through the state for those requiring financial assistance)

  • Aetna Better Health
  • AmeriHealth Caritas
    • Pennsylvania
    • Northeast
  • Highmark Blue Shield Special Care
  • Gateway Health Plan
  • Keystone Family Health Plan
  • UHC Medicaid
  • UPMC for You
    • Health Choices
    • Community Health Choices

Medicare Advantage (Insurance for people over 65 years of age or with disabilities)

Plans Offering Drug Coverage

  • AARP Medicare
    • Complete HMO
    • Complete Choice PPO
  • Aetna Coventry
    • Advantra Gold PPO (1/1/20 new name - Aetna Medicare Advantra Premier Plus PPO)
    • Advantra Northern Pennsylvania Gold HMO (1/1/20 new name - Aetna Medicare Advantra Gold HMO)
    • Advantra Southeast Prime HMO (1/1/20 new name - Aetna Medicare Advantra Value HMO)
    • Advantra Silver HMO & PPO (1/1/20 new name - Aetna Medicare Advantra Silver HMO & PPO)
    • Advantra Silver Plus HMO & PPO (1/1/20 new name - Aetna Medicare Advanta Silver Plus HMO & PPO)
    • Advantra One PPO (1/1/20 new name - Aetna Medicare Advantra Credit Value PPO)
    • Advantra Basic Medical HMO (1/1/20 new name - Aetna Medicare Advantra Core HMO)
  • Aetna Medicare
    • Choice HMO
    • Silver HMO
    • Gold PPO
    • Premier HMO
    • Standard HMO
  • AmeriHealth Caritas VIP Care
  • Capital Blue Cross Medicare Advantage
    • Blue Journey HMO
  • Coventry Advantra
    • Gold PPO
    • Silver HMO
    • One PPO
  • Humana (Choicecare)
    • Humana Gold Plus HMO
    • Humana Choice PPO
    • Humana Gold Choice PFFS
  • Humana Gold Plus (HMO D-SNP)
  • Highmark Medicare Advantage
    • Freedom Blue PPO
    • Community Blue Medicare PPO
    • Community Blue Medicare PPO Plus – Clinton, Lycoming, Sullivan, and Tioga Counties only
  • Independence Blue Cross
    • IBC HMO Medicare Basic/Select
    • IBC HMO Medicare
    • IBC PPO Medicare
    • Amerihealth HMO Medicare
  • Keystone 65
    • Basic Rx HMO
    • Preferred Rx HMO
    • Select Rx HMO
  • Personal Choice 65 Rx PPO
  • United Healthcare
    • Unitedhealthcare Dual Complete
    • Unitedhealthcare Group Medicare Advantage Plan
    • Unitedhealthcare Assisted Living Plan (PPO)
    • Unitedhealthcare Nursing Home Plan
  • UPMC for Life
    • HMO
    • PPO

Plans without Drug Coverage

  • Keystone 65
    • Preferred Medical Only HMO
    • Select Medical Only HMO
  • United Healthcare AARP Medicare Complete

Special Needs Plans

  • Aetna Coventry
    • Advantra Cares (HMO SNP) -(1/1/20 new name - Aetna Medicare Advantra Cares HMO D-SNP)
  • Gateway Health Medicare Assured
    • Diamond HMO
    • Ruby HMO
  • Keystone First VIP Choice HMO
  • United Healthcare
    • AARP Medicare Complete
    • UHC Dual complete
    • UHC Group Medicare Advantage Plans
    • UHC Assisted Living Plan (PPO)
    • UHC Nursing Home Plan

CHIP (Children's Health Insurance Program through the state)

  • Aetna Better Health Kids
  • Capital Cares for Kids
  • Highmark CHIP
  • UPMC for Kids

Marketplace/ACA Plans (Independent insurance plans through the Affordable Care Act)

  • Capital Blue Cross
    • Bronze PPO 7350-0-60
    • Silver PPO 5000/10/30
    • Gold PPO 2000/10/20
  • Independence Blue Cross (Tier 3)
    • Keystone HMO Platinum
    • Keystone HMO Gold
    • Keystone HMO Gold Proactive (tiered network plan)
    • Keystone HMO Silver
    • Keystone HMO Silver Proactive (tiered network plan)
    • Keystone HMO Bronze
    • Personal Choice® PPO Platinum
    • Personal Choice PPO Gold
    • Personal Choice PPO Silver
    • Personal Choice PPO Silver Reserve
    • Personal Choice PPO Bronze
    • Personal Choice PPO Bronze Reserve
    • Personal Choice PPO Catastrophic
  • UPMC Health Plans
    • Tower UPMC Advantage Bronze
    • Tower UPMC Advantage Silver
    • Tower UPMC Advantage Gold

Behavior Health Organization (Administrator/Payor of behavioral health benefits)

Payor Product Lines
Community Care Behavioral Health (CCBH) [through Aetna Better Health, AmeriHealth Caritas, Gateway, or UHC Community Plan] Medicaid through Berks, Chester, York, and Adams Counties ONLY
Community Care Behavioral Health (CCBH) [through UPMC] Commercial, CHIP, Medicare, Medicaid
Magellan Commercial
MH Net Commercial, Medicare
Quest Commercial

Please call Customer Service (at the number on the back of your insurance card) to determine your Behavioral Health insurance vendor.