Plan types

We offer plans in 21 counties with various network options depending on where you live.

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Plan types available by county of residence

Health maintenance organization (HMO)

Available in all 21 counties.

An HMO plan requires you to select a Primary Care Physician (PCP) to coordinate routine care like checkups or sick appointments. Your PCP will refer you to a specialist or for diagnostic services in your plan’s network, if needed. Services provided by out-of-network providers are generally not covered unless otherwise included in your contract (e.g., emergency services).

Find in-network providers easily at MyCare Finder

Preferred provider organization (PPO)

Available in all counties except Lancaster.

A PPO plan offers you the flexibility to choose any doctor you’d like, but you’ll pay less out of pocket when you use an in-network provider. If you visit an out-of-network provider, your out-of-pocket costs could be much higher, or your care might not be covered.

Find in-network providers easily at MyCare Finder

PPO Tiered Plan Options

Preferred provider organization (Advance PPO) plans

Available in Lancaster county.

Advance PPO gives you peace of mind with the power to save and the power to choose. These plans offer you extra savings when you get care from certain providers.

For greater savings and lower out-of-pocket costs, visit Choice 1 providers when you need medical services. Choice 2 providers offer you more access to care, giving you the flexibility and convenience to choose doctors and hospitals without referrals.

Choice 1 providers: Geisinger, Lancaster General, Lehigh Valley Health Network, St. Luke's, UPMC Central Pa.

Choice 2 providers: All remaining providers in the Capital Blue Cross PPO network and out-of-area BlueCard providers.

Find in-network providers easily at MyCare Finder

Preferred provider organization (Capital Advantage PPO) plans

Available in Cumberland, Dauphin, and Perry counties.

Capital Advantage PPO gives you peace of mind with the power to save and the power to choose. These plans offer you extra savings when you get care from certain providers.

For greater savings and lower out-of-pocket costs, visit Choice 1 providers when you need medical services. Choice 2 providers offer you more access to care, giving you the flexibility and convenience to choose doctors and hospitals without referrals.

Choice 1 providers: UPMC Central Pa.'s robust provider network is the anchor of your Choice 1 option. For the lowest cost-share, you can select providers from among UPMC Central Pa.'s many settings and specialties.

Choice 2 providers: All remaining providers in the Capital Blue Cross PPO network and out-of-area BlueCard providers.

Find in-network providers easily at MyCare Finder

Preferred Provider Organization (Convenience PPO) plans

Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York counties only.

Convenience PPO gives you peace of mind with the power to save and the power to choose. For greater savings and lower out-of-pocket costs, visit Choice 1 providers when you need medical services. Choice 2 providers offer you more access to care, giving you the flexibility and convenience to choose doctors and hospitals without referrals.

Choice 1 providers: Penn Medicine Lancaster General Health, St. Luke's University Health Network, and WellSpan Health.

Choice 2 providers: All remaining providers in the Capital Blue Cross PPO network and out-of-area BlueCard providers

Find in-network providers easily at MyCare Finder

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