The Pennsylvania Coalition of Medical Assistance MCOs is an organization of Medical Assistance Managed Care Organizations (MCOs), which provide health care to coverage to more than one million Medicaid recipients across the Commonwealth. PAMCO and its member MCOs share a common goal of ensuring access to high-quality healthcare to our Medicaid members. Many are among the State’s most vulnerable citizens.
Today, PAMCO member MCOs serve Medicaid members in 25 counties included in three HealthChoices zones, the Southeast, the Southwest and the Lehigh/Capital Zones. MCOs also provide coverage in 25 additional counties under a Voluntary managed model, in which members can choose an MCO option.
Learn more about Medicaid Managed Care in Pennsylvania
A number of PAMCO’s member plans also provide Child Health Insurance Program and Medicare managed care to the Commonwealth’s citizens.
A brief overview of each of PAMCO’s member plans:
www.amerihealthmercy.com
AmeriHealth Mercy Health Plan, a member of the AmeriHealth Mercy Family of Companies, is a Medical Assistance (Medicaid) managed care health plan serving more than 108,000 Medical Assistance recipients in Adams, Berks, Carbon, Cumberland, Dauphin, Lackawanna, Lancaster, Lebanon, Lehigh, Luzerne, Monroe, Northampton, Perry, Pike and York counties in Pennsylvania.
www.keystonemercy.com
Keystone Mercy Health Plan, a member of the AmeriHealth Mercy Family of Companies, is a Medical Assistance (Medicaid) managed care health plan serving more than 300,000 Medical Assistance recipients in Philadelphia and Bucks, Chester, Delaware, and Montgomery counties in Pennsylvania.
www.mycoventrycares.com
CoventryCares™ from HealthAmerica is a Pennsylvania Medicaid Managed Care Organization serving Delaware, Bucks, Chester, Montgomery and Philadelphia counties. With over 35 years of providing health care benefits, HealthAmerica has earned a reputation as one of the most trusted and experienced health insurers in Pennsylvania. The company ranks 14th in the nation for HMO and POS plans by the National Committee for Quality Assurance, and its Medicare plan ranks 28th nationally. It has ranked among the top health plans by NCQA for six consecutive years. HealthAmerica provides a range of traditional and consumer-directed health insurance products, including self-funded, Medicare, Medicaid, indemnity, nongroup, and pharmacy plans. It currently has "Excellent" accreditation by the NCQA for its commercial HMO, POS, and Medicare plans.
www.uhccommunityplan.com
UnitedHealthcare Community Plan is UnitedHealth Group's government programs business segment, which has contracts in 24 states and the
District of Columbia and serves more than 3.2 million members, making us the country's largest Medicaid organization. UnitedHealthcare Community
Plan is the result of the integration of the AmeriChoice and Unison health plans in Pennsylvania. We leverage the best practices learned
nationwide by UnitedHealthcare to offer a comprehensive, high quality product to Pennsylvania members. Currently, throughout the
Commonwealth, we administer health care benefits to over 270,000 Medical Assistance, CHIP and Medicare members in 50 counties.
www.GatewayHealthPlan.com
Gateway Health Plan® is a top-ranked managed care organization that provides service to more than 263,000 members eligible for Medical Assistance. Established in 1992 as an alternative to Pennsylvania’s Department of Public Welfare's Medical Assistance Program, Gateway Health Plan operates in select counties throughout Pennsylvania. Gateway Health Plan Medicare Assured® HMO SNP, a Special Needs Plan for those eligible for both Medicare and Medical Assistance, is one of the nation’s largest Medicare programs for the dual-eligible population with more than 27,000 members in 27 Pennsylvania counties. Gateway’s mission is to provide accessible, quality healthcare services to its members.
www.healthpart.com
Health Partners is a not-for-profit health plan serving more than 170,000 members in the Greater Philadelphia region. Its HealthChoices Medicaid plan consistently ranks number one in member satisfaction in the area in an annual consumer survey and is rated as “Excellent,” the highest level possible, by the National Committee for Quality Assurance (NCQA). In 2009, the company launched KidzPartners, which provides free or low-cost health insurance to uninsured children and teens through CHIP, Pennsylvania's Children's Health Insurance Program. Founded more than 25 years ago, Health Partners is one of the few hospital-owned health plans in the country and has received national recognition for its innovations in managed care.
www.upmchealthplan.com
UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC, one of the nation's top-ranked health systems. The integrated partner companies of the UPMC Insurance Services Division – which includes UPMC Health Plan, UPMC Work Partners, LifeSolutions (EAP), UPMC for You (Medical Assistance), and Community Care Behavioral Health – offer a full range of group health insurance, Medicare, Special Needs Plan (SNP), CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services to nearly 1.6 million members. UPMC Health Plan’s local provider network includes UPMC as well as community providers, totaling more than 125 hospitals, and more than 11,500 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland.
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