Each plan below has recorded coverage in Pennsylvania. The lines of business shown are the ones that plan operates in this state — a carrier can run commercial business in one state and Medicaid managed care in the next, and each line is a separate contract.
Coverage data as of July 28, 2026. Payer footprints change with contract cycles; we verify against current payer requirements at the start of any engagement.
Marketplace plans are not listed for Pennsylvania. Pennsylvania runs its own health insurance exchange rather than using healthcare.gov, and the federal dataset behind this page covers only healthcare.gov states. Carriers selling on the Pennsylvaniaexchange are therefore absent from the marketplace column — that is a gap in our source data, not an indication that none exist.
National carriers
National carriers credential centrally, so one application generally covers every state you practice in. Network participation and fee schedules are still contracted separately by state and by line of business.
| Payer | Parent company | Lines of business in Pennsylvania | Credentialing guide |
|---|---|---|---|
| Aetna | CVS Health | CommercialMedicare Advantage | Full guide |
| AmeriHealth Caritas | Independence Health Group / Blue Cross Blue Shield of Michigan (joint venture) | Medicare AdvantageMedicaid | — |
| Centene Corporation | Independent | Medicare AdvantageMedicaid | Full guide |
| Cigna Healthcare | The Cigna Group | Commercial | Full guide |
| Clover Health | Independent | Medicare Advantage | — |
| Devoted Health | Independent | Medicare Advantage | — |
| Elevance Health | Independent | Medicaid | Full guide |
| GEHA | Independent | Commercial | — |
| Humana | Independent | Medicare Advantage | Full guide |
| UnitedHealthcare | UnitedHealth Group | CommercialMedicare AdvantageMedicaid | Full guide |
| Wellcare | Centene Corporation | Medicare Advantage | Full guide |
Blue Cross Blue Shield plans
Blue Cross Blue Shield is a federation of independent licensees. Each plan credentials on its own — being in-network with one Blue plan does not make you in-network with another.
| Payer | Parent company | Lines of business in Pennsylvania | Credentialing guide |
|---|---|---|---|
| Blue Cross Blue Shield Association | Independent | Commercial | Full guide |
| Capital Blue Cross | Independent | CommercialMedicare Advantage | Full guide |
| Health Care Service Corporation | Independent | Medicare Advantage | Full guide |
| Highmark Blue Cross Blue Shield | Highmark Health | CommercialMedicare Advantage | Full guide |
| Independence Blue Cross | Independence Health Group | CommercialMedicare Advantage | Full guide |
Medicaid managed care
Medicaid managed-care organizations contract under a state Medicaid agency. Most require an active state Medicaid provider ID before they will begin credentialing, so the state enrollment has to finish first.
| Payer | Parent company | Lines of business in Pennsylvania | Credentialing guide |
|---|---|---|---|
| Behavioral Health Services of Somerset and Bedford Counties | Community Care Behavioral Health | Medicaid | — |
| Capital Area Behavioral Health Collaborative | PerformCare | Medicaid | — |
| Carbon-Monroe-Pike Joinder Board | Community Care Behavioral Health | Medicaid | — |
| Health Partners Plan | Independent | Medicaid | — |
| Highmark Wholecare | Highmark Blue Cross Blue Shield | Medicare AdvantageMedicaid | — |
| Keystone First | AmeriHealth Caritas | Medicaid | — |
| Lycoming-Clinton Joinder Board | Community Care Behavioral Health | Medicaid | — |
| Northeast Behavioral Health Care Consortium | Community Care Behavioral Health | Medicaid | — |
| Northwest Behavioral Health Partnership | Carelon Behavioral Health | Medicaid | — |
| Pennsylvania Health and Wellness | Centene Corporation | Medicaid | Full guide |
| Southwest Behavioral Health Management | Carelon Behavioral Health | Medicaid | — |
| Tuscarora Managed Care Alliance | PerformCare | Medicaid | — |
| York | Community Care Behavioral Health | Medicaid | — |
Regional & local plans
Regional plans operate in a limited footprint and more often credential in-house rather than through a delegated CVO. Turnaround varies more than it does with national carriers.
| Payer | Parent company | Lines of business in Pennsylvania | Credentialing guide |
|---|---|---|---|
| American Health Advantage of Pennsylvania | Mitchell Family Office | Medicare Advantage | — |
| Geisinger Health Plan | Risant Health | CommercialMedicare AdvantageMedicaid | — |
| Jefferson Health Plans | Thomas Jefferson University | Medicare Advantage | — |
| Peak Health | West Virginia United Health System | Medicare Advantage | — |
| Perennial Advantage | Perennial Consortium | Medicare Advantage | — |
| Provider Partners Health Plans | Rifkin Managed Care Holding | Medicare Advantage | — |
| UPMC Health Plan | UPMC | CommercialMedicare AdvantageMedicaid | — |
Networks & IPAs
Networks, IPAs, and rental networks aggregate provider panels. Joining one can reach several payers at once, but the contracting party is the network — not the payer whose members you end up seeing.
| Payer | Parent company | Lines of business in Pennsylvania | Credentialing guide |
|---|---|---|---|
| Carelon Behavioral Health | Elevance Health | Medicaid | — |
| ChoiceCare Network | Humana | Commercial | — |
| Evernorth Behavioral Health | Cigna Healthcare | Commercial | — |
| First Health Network | Aetna | Commercial | — |
| Galaxy Health Network | Independent | Commercial | — |
| HealthSmart | Independent | Commercial | — |
| Magellan Healthcare | Centene Corporation | Medicaid | Full guide |
| MultiPlan (Claritev) | Claritev Corporation | Commercial | — |
| PHCS Network | MultiPlan (Claritev) | Commercial | — |
| Prime Health Services | Independent | Commercial | — |
| Three Rivers Provider Network (TRPN) | Independent | Commercial | — |
| UMR | UnitedHealthcare | Commercial | — |
| Zelis Network | Zelis Healthcare | Commercial | — |
Government programs
Government programs enroll providers through their own systems rather than commercial credentialing. Enrollment is usually a prerequisite for participating in the managed-care plans built on top of them.
| Payer | Parent company | Lines of business in Pennsylvania | Credentialing guide |
|---|---|---|---|
| Humana Military | Humana | Government program | Full guide |
| Medicare (Original Medicare / Part A & B) | Centers for Medicare & Medicaid Services | Government program | Full guide |
| VA Community Care Network | U.S. Department of Veterans Affairs | Government program | — |
Credentialing in Pennsylvania
Read our Pennsylvania guide for how Medicare, state Medicaid, the local Blue plan, and the commercial carriers fit together: provider credentialing in Pennsylvania.
Get in-network in Pennsylvania
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