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 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 has contracts with the following health insurance companies:

Commercial Plans

  • 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:

  • 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 Plans
    • UPMC Employees Out of Area PPO Plan
    • UPMC Out of Area Gold
    • UPMC Out of Area Silver
    • 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

Medicaid HMO

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

Medicare Advantage

Plans Offering Drug Coverage

  • AARP Medicare
    • Complete HMO
    • Complete Choice PPO
  • Aetna Medicare
    • Choice HMO
    • Silver HMO
    • Gold PPO
    • Premier HMO
    • Standard 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
  • Coventry Advantra
    • Gold PPO
    • Silver HMO
    • One PPO
  • 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
  • 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

  • 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

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

Marketplace/ACA Plans

  • 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