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As of  April 1, 2014 PinnacleHealth facilities and employed physicians participate in the following list of health insurance plans. This list of accepted insurances is updated periodically so please check with your health plan to verify coverage.

There may be certain services provided at our facilities that are not covered by our contract with your health plan (for example, some health plans require members to use specific laboratories and may not pay for laboratory services at our facilities). Please contact your health plan's Member Services department to confirm specific details of your plan.  Also, your health insurance plan may require you to obtain a referral or authorization before the delivery of certain types of care. Please inquire with your health plan prior to scheduling an appointment.
 
In addition, please be aware that you may receive bills from other sources not employed by PinnacleHealth such as Tristan Radiology Specialists, Quantum Imaging Radiology, Riverside Anesthesia, Pediatrix Medical Group (neonatologists), Pathology Associates of Central PA, community ambulance services, etc.  

Please confirm your health plan's participation with all appropriate entities prior to having services rendered.
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Category Payor Contracted Services Excluded
Products/Services

Commercial  

Aetna
Hospital Inpatient & Outpatient, Physician & Ambulance Services HMO patients must use Quest for laboratory services
Capital Blue Cross Hospital Inpatient & Outpatient,Physician & Ambulance Services  
Cigna / Great West Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Devon Health Services PPO Network Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Geisinger Health Plan Hospital Inpatient & Outpatient, & Physician & Ambulance Services  
HealthAmerica / HealthAssurance / Coventry / First Health Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Highmark Hospital Inpatient & Outpatient, Physician & Ambulance Services  
InterGroup PPO Network Hospital Inpatient & Outpatient, & Physician Services  
Keystone Health Plan Central HMO Hospital Inpatient & Outpatient, Physician & Ambulance Services HMO patients must use Quest for laboratory services
Multiplan / Private Health Care Systems PPO Network Hospital Inpatient & Outpatient, & Physician Services  
PrimeSource PPO Network Hospital Inpatient & Outpatient, & Physician Services  
PA Preferred Health Network PPO Hospital Inpatient & Outpatient, & Physician Services  
SouthCentral Preferred PPO Network Hospital Inpatient & Outpatient Services Only  
United Healthcare / MAMSI / Oxford Health Plans / OneNet PPO Hospital Inpatient & Outpatient, & Physician Services  
UPMC Commerciall* Hospital Inpatient & Outpatient, & Physician Services Terminated as of October 1, 2014
UPMC Commercial insurance is not directly contracted with PinnacleHealth but patients may access PinnacleHealth under the above Private Healthcare System PPO contract

Behavioral Health
Mental Health Network Professional Services Only  
Magellan Behavioral Health Professional Services Only  
Quest Behavioral Health Professional Services Only  
United Behavioral Health Professional Services Only  

Government Programs
Medicare Hospital Inpatient & Outpatient, Physician & Ambulance Services  
PA Department of Public Welfare - Medicaid Hospital Inpatient & Outpatient, Physician & Ambulance Services PinnacleHealth not participating for Behavioral Health Services
Veterans Affairs All services with the exception of Primary Care as of 2/7/2014
Tricare Hospital Inpatient & Outpatient, Physician & Ambulance Services  

Medicare
Advantra
(a HealthAmerica program)
Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Aetna Gold Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Care Improvement Plus Hospital Inpatient & Outpatient, Physician & Ambulance Services Terminated on 3/16/2014
Freedom Blue Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Gateway Medicare Advantage Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Geisinger Gold Hospital Inpatient & Outpatient, & Physician & Ambulance Services  
Humana Gold Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Medicare Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Senior Blue Hospital Inpatient & Outpatient, Physician & Ambulance Services HMO patients must use Quest for laboratory services
Sterling Health Plans Hospital Inpatient & Outpatient, Physician & Ambulance Services  
United Healthcare Community Plan Medicare Hospital Inpatient & Outpatient, Physician & Ambulance Services PinnacleHealth not participating with any United Healthcare Medicare Solutions plans - only UHC Community Plan Medicare
Universal American (aka Today's Options) Hospital Inpatient & Outpatient, Physician & Ambulance Services  

Medicaid
Aetna Better Health Medicaid HMO Facility, Professional, & Ambulance services  
AmeriHealth Mercy Health Plan Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Gateway Health Plan Hospital Inpatient & Outpatient, Physician & Ambulance Services  
PA Dept of Public Welfare - Medicaid Hospital Inpatient & Outpatient, Physician & Ambulance Services  
United Healthcare Community Plan Hospital Inpatient & Outpatient, Physician & Ambulance Services  
UPMC Health Plan Hospital Inpatient & Outpatient, Physician & Ambulance Services Terminated as of October 1, 2014

Children's Health Insurance of PA (CHIP)
Aetna Better Health Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Capital Blue Cross Hospital Inpatient & Outpatient, Physician & Ambulance Services  
Geisinger Health Plan Hospital Inpatient & Outpatient, & Physician Services  
Highmark Hospital Inpatient & Outpatient, Physician & Ambulance Services  
United Healthcare Community Plan Hospital Inpatient & Outpatient, Physician & Ambulance Services  
UPMC Health Plan Hospital Inpatient & Outpatient, Physician & Ambulance Services Terminated as of October 1, 2014

Transplant
Aetna Institute of Excellence Transplant Network Hospital & Physician Transplant Services Only  

AIG Benefits Solution / Chartis Transplant Network
Hospital & Physician Transplant Services Only  
Cigna LifeSource Transplant Network Hospital & Physician Transplant Services Only  
Coventry Health Transplant Network Hospital & Physician Transplant Services Only  
Preferred Healthcare Network Hospital & Physician Transplant Services Only  
Optum Health Transplant Network Center of Excellence Hospital & Physician Transplant Services Only  
South Central Preferred/PrimeSource Health Network Hospital & Physician Transplant Services Only  

Worker's Comp
CorVel Corporation Hospital Inpatient & Outpatient Only  
First Health Hospital Inpatient & Outpatient Only  
Focus Healthcare Hospital Inpatient & Outpatient Only  
USA MCO Hospital Inpatient & Outpatient Only