Billing and Insurance – Tower Health Medical Group, Pottstown Hospital

Tower Health Medical Group is 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 Medical Group is determined solely by your insurance. Tower Health Medical Group is contracted in-network 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.

Insurance Information

Tower Health Medical Group at Pottstown Hospital consists of:

  • Berks Family Care
  • Berks Medical Associates
  • Coventry Psychiatry
  • Collegeville Internal Medicine
  • Coventry Family Care
  • Coventry Foot and Ankle Surgery
  • Coventry Pediatrics
  • Pottstown Critical Care
  • Pottstown Pathology
  • Surgical Partners of Pottstown
  • Tri-County Neurology
  • Tri-County Physical Therapy

Commercial Plans (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 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
    • 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
    • Preferred - Open Choice PPO, Preferred Choice POS II, Preferred Select
    • Preferred Elect Choice EPO, Preferred Managed Choice
    • Premier Care - Network & Premier Care Network Plusk

    We do not participate in the following Aetna plans:

    • Aetna Signature
    • PEBTF HMO
  • Cigna
    • ChoiceFund OA Plus
    • Open Access Plus
    • OA Plus
    • ChoiceFund OA Plus with CareLink PPO
    • Choice Fund PPO Network
    • HMO
    • POS
  • First Health Network
  • First Health
  • HealthAmerica/Advatra
  • Highmark (Premier Blue)
  • Independence Blue Cross
  • 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
    • 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
    • Enhanced Access Network
    • FEHB Employees
    • MyCare Advantage PPO/EPO – Tier 2
    • Panther Gold Advantage Network (For Pitt Employees) – Tier 1
    • Panther Gold Network (For Pitt Employees)
    • Premium Network Plans (PPO and EPO)
    • Tower Network
    • UPMC Employees Advantage Network (PPO and EPO) – Tier 1
    • UPMC Employees Out of Area Network
    • UPMC Inside Advantage – Tier 1

    We do not participate in the following UPMC plans:

    • MyCare Advantage HMO
    • Partner Network
    • Standard Network

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

Plans Offering Drug Coverage

  • Aetna Coventry
    • Advantra Gold PPO
    • Advantra Northern Pennsylvania Gold HMO
    • Advantra Southeast Prime HMO
    • Advantra Silver HMO & PPO
    • Advantra Silver Plus HMO & PPO
    • Advantra One PPO
    • Advantra Basic Medical HMO
  • Aetna Medicare
    • Aetna PEBTF PPO
    • Basic HMO
    • Choice HMO
    • Gold PPO
    • Premier HMO
    • Silver HMO & PPO
    • Standard HMO

We do not participate in the following Aetna plans:

    • Not PEBTF HMO
  • Cigna Health Spring

We do not participate in the following Cigna Health Spring plans:

    • Alliance HMO
  • Health America/ Advantra
  • Highmark (Freedom Blue)
  • Humana
    • Choicecare Network HMO
    • Choicecare Network PPO
    • Choicecare Network PFFS
  • Independence Blue Cross
  • Keystone First
  • United Healthcare
    • Unitedhealthcare Dual Complete
    • Unitedhealthcare Group Medicare Advantage Plan
    • Unitedhealthcare Assisted Living Plan (PPO)
    • Unitedhealthcare Nursing Home Plan
  • United Healthcare AARP Medicare Complete
  • UPMC for Life
    • HMO & PPO (ALL)

    We do not participate in the following UPMC plans:

    • HMO Premier Rx Western PA
    • HMO Premier Rx Lycoming & Tioga
    • HMO Premier Rx Excela Health
    • All Plans Tower/UPMC Berks County

Special Needs Plan

  • Aetna Coventry
    • Advantra Cares (HMO SNP)
  • Gateway Health Medicare Assured
    • Diamond HMO
    • Ruby HMO
  • United Healthcare
    • Unitedhealthcare Dual Complete
    • Unitedhealthcare Group Medicare Advantage Plan
    • Unitedhealthcare Assisted Living Plan (PPO)
    • Unitedhealthcare Nursing Home Plan
  • UPMC for Life Dual
  • UPMC for Life Options

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

  • Aetna Better Health CHIP
  • UHC CHIP
  • UPMC for Kids

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

  • Aetna Better Health
  • Keystone First
  • UHC Medicaid
  • UPMC Community Health Choices
  • UPMC for You HMO

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

  • Independence Blue Cross (Tier 1)
    • 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
  • Highmark
  • UPMC Health Plans
    • Inside Advantage for Individuals (Tier 1 – Gold, Silver, & Bronze)
    • Premium Network
    • Tower Network

    We do not participate in the following UPMC plans:

    • Partner Network
    • Select Network
    • Standard Network