PennCare/Personal Choice PPO

Administered by Independence Blue Cross, the PennCare/Personal Choice Preferred Provider Organization (PPO) plan doesn’t require a Primary Care Provider (PCP) or referrals. You can go to any provider, but your out-of-pocket costs are based on the type of provider you use:

PennCare Network Providers

When you use health care providers who are part of, or affiliated with, the UPHS network:

• Preventive care services are covered at 100%.
• Most other services are covered at 90% after a deductible; you pay only 10% of the covered charges.

Personal Choice Preferred Providers

When you use health care providers who are part of the Personal Choice network:

• Preventive care services are covered at 100%.
• Provider office visits are covered at 100% after copays.
• Most other services are covered at 80% after a deductible; you pay 20% of the covered charges.

Non-Preferred Providers

When you use health care providers who aren’t part of the PennCare or Personal Choice networks:

• Most services are covered at 60% after a deductible; you pay 40% of the covered charges.