Plan types
Easily browse and compare plans to find the coverage that’s right for you.
Plan types available by county of residence
| County of residence | HMO | Valley Advantage EPO | PPO Choice | PPO Choice Select | Performance PPO | PPO |
|---|---|---|---|---|---|---|
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Cumberland, Dauphin, and Perry |
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Lehigh and Northampton |
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Adams, Franklin, Lebanon, and York |
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Lancaster |
Only Catastrophic PPO available |
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Berks, Centre, Columbia, Fulton, Juniata, Mifflin, Montour, Northumerland, Schuylkill, Snyder, or Union |
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).
Valley Advantage exclusive provider organization (EPO)
Available in Lehigh and Northampton counties.
The Valley Advantage EPO plan provides high-quality care using the renowned doctors and hospitals of St. Luke’s University Health Network and other independent practices throughout the Lehigh Valley. If you visit a provider outside this network, your care in most cases will not be covered.
Preferred provider organization (PPO) Choice
Available in Lancaster county.
PPO Choice 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: Ephrata Hospital, Geisinger, Lancaster General, Lehigh Valley Health Network, Penn State Health, St. Luke's, UPMC Central Pa.
Choice 2 providers: You have the freedom to select any provider in our PPO network. Many providers from local health systems are available with Choice 2.
Preferred provider organization (PPO) choice select
Available in Cumberland, Dauphin, and Perry counties.
PPO Choice Select 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: You have the freedom to select any provider in our PPO network. Many providers from local health systems are available with Choice 2.
Performance preferred provider organization (PPO)
Available in Adams, Franklin, Lebanon, and York counties.
Performance 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. Using clinical data to identify high-performing providers, Performance PPO places those doctors and hospitals in a lower-cost Performance Plus tier.
The Performance Plus tier offers the lowest cost, high-performing providers, and a wide range of specialty care throughout our region. You’ll enjoy lower out-of-pocket cost when you receive care from these health systems: WellSpan, St. Luke's, Lancaster General, and Penn State Health. In addition to lower costs, you have the freedom to receive your care from renowned health systems throughout central Pennsylvania and the Lehigh Valley by using the Performance Select tier.
Preferred provider organization (PPO)
Available in all counties except Lancaster.
Catastrophic PPO is available in all 21 counties.
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.