Billing and Insurance – Tower Health Medical Group, Reading 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, Reading is contracted in-network with the following health insurance companies:

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 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:

  • Not PEBTF HMO
  • 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
  • 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)
    • UPMC Employees Advantage Network (PPO and EPO) – Tier 1
    • UPMC Employees Out of Area Network
    • Panther Gold Advantage Network (For Pitt Employees) – Tier 1
    • UPMC Inside Advantage – Tier 1
    • MyCare Advantage PPO/EPO – Tier 1
    • Tower Network

    We do not participate in the following UPMC plans:

    • Partner Network
    • Standard Network
    • Enhanced Access Network
    • Panther Gold Network (For Pitt Employees)
    • FEHB Employees
    • MyCare Advantage HMO

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
  • UHC Medicaid
  • UPMC for You HMO

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
    • 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
  • AmeriHealth Caritas VIP Care
  • Capital Blue Cross Medicare Advantage
    • Blue Journey HMO plans (ALL)
    • Blue Journey PPO plans (ALL)
    • Blue Journey Essential
    • Blue Journey Value
  • Highmark Medicare Advantage
    • Freedom Blue PPO
    • Community Blue Medicare PPO (including Signature Plan)
    • Community Blue Medicare PPO Plus – Clinton, Lycoming, Sullivan, and Tioga Counties only

    We do not participate in the following Highmark plans:

    • Community Blue Medicare HMO (Signature Plan)
  • Humana PFFS (Private Fee For Service)
  • 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

We do not participate in the following Keystone 65 plans:

    • Focus
  • 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 (ALL)
    • All Plans Tower/UPMC Berks County

Without Drug Coverage

  • Keystone 65
    • Preferred Medical Only HMO
    • Select Medical Only HMO

We do not participate in the following Keystone 65 plans:

    • Focus
  • United Healthcare AARP Medicare Complete

Special Needs Plans

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

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

  • Aetna Better Health Kids
  • Capital Cares for Kids
  • Highmark CHIP
  • IBC CHIP
  • UHC 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
    • Premium Network
    • Inside Advantage for Individuals (Tier 1 – Gold, Silver, & Bronze)
    • Tower Network

        We do not participate in the following UPMC plans:

    • Partner Network
    • Standard Network
    • Select Network

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

Payor Product Lines
Aetna (Behavioral Health) Commercial
Community Care Behavioral Health (CCBH) [through Aetna Better Health, AmeriHealth Caritas, Gateway, or UHC Community Plan] Medicaid through Berks County ONLY
Community Care Behavioral Health (CCBH) [through UPMC] Commercial, CHIP, Medicare, Medicaid
Quest Commercial

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