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.

For more information, view a summary of benefits for this plan: [2016-2017 plan year]. Find in-network providers using the PennCare Provider Directory or the Personal Choice Provider Directory.