PennCare/Personal Choice Preferred Provider Organization

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 ProvidersWhen 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.