Planes de salud de Medicaid en Southeast Zone, PA

Servicios para miembros: 1-855-227-1302

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• Enhanced Member Supports Unit

  Nurse case managers who help schedule or get to medical appointments, manage multiple prescriptions, support children with special needs, and connect members to behavioral health and community agencies.

• Geisinger Health Plan Obtenido el 2026-07-17

enrollment.portal_name and enrollment.portal_url (Pennsylvania Enrollment Services, https://www.enrollnow.net/en) are quote-gated against a captured snapshot of the Department of Human Services' own Physical HealthChoices home page (pa.gov/agencies/dhs/resources/medicaid/hc), which names Pennsylvania Enrollment Services as the official website for plan and doctor information and links directly to enrollnow.net; the literal domain text does not appear in the captured page body (it lives in a link href, not visible text), so this is the same evidentiary shape as WV.json's mountainhealthtrust.com binding. enrollment.phone is quote-gated against a captured snapshot of DHS's own Physical HealthChoices contact page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-contact-us), which lists PA Enrollment Services (Maximus) MCO at 1-800-440-3989. enrollment.choice_window_days ships as an honest not_found fact: every DHS and PA Enrollment Services source found describes plan changes as available any time with the new plan taking effect a future month later, never as a fixed number of days before auto-assignment, so choice_window_note describes that instead of inventing a day count. All 5 zone rosters (areas.southeast.plans through areas.northwest.plans) and all 5 zone county lists (service_areas.*.county_names) are quote-gated against a single captured snapshot of DHS's own Managed Care Organizations (MCO) - Physical HealthChoices page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-mco), which lists each zone's counties and health plans directly. I manually cross-checked that page against DHS's separate Statewide MCO Map page (pa.gov/agencies/dhs/resources/medicaid/statewide-mco-map) and both list identical zones, counties, and plans, but only hc-mco was captured as a snapshot to keep the source list lean. DHS's own page lists AmeriHealth Caritas Northeast as a distinct roster entry from AmeriHealth Caritas Pennsylvania (Northeast zone only, versus Lehigh/Capital, Northwest, and Southwest for the Pennsylvania entry) even though public reporting elsewhere describes AmeriHealth Caritas Northeast as having merged into AmeriHealth Caritas Pennsylvania's corporate structure years ago; this file follows DHS's own current page literally rather than resolving that discrepancy, and both plan records point at the same live amerihealthcaritaspa.com member site since no separate AmeriHealth Caritas Northeast PA site could be found, which a human should double check. This is the Physical HealthChoices (mandatory Medicaid managed care) roster only; Community HealthChoices (the separate dual-eligible/LTSS program) and Behavioral Health HealthChoices (the county based behavioral health carve out) are out of scope for this file. Every plan record's member_phone, provider_directory_url, and formulary_url is prototype data read directly off each plan's own site, not independently fact-cited beyond what is listed here, so the state as a whole stays unverified, matching the TX/CA/FL/NY precedent. Extra benefits are limited to items each plan's own site describes in enough detail to state plainly; where a plan's site only gestures at unspecified 'special programs' with no verifiable detail (AmeriHealth Caritas Pennsylvania, AmeriHealth Caritas Northeast, UPMC for You), extra_benefits ships empty rather than guessed.

Servicios para miembros: 1-800-553-0784

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• JeffConnect 24/7 telehealth

  Free access to Jefferson providers around the clock through JeffConnect, plus free Teladoc phone and video consults.

• Diabetes prevention program

  A lifestyle change program to help members with prediabetes make healthy lifestyle choices and work toward weight loss.

• Jefferson Health Plans Obtenido el 2026-07-17

enrollment.portal_name and enrollment.portal_url (Pennsylvania Enrollment Services, https://www.enrollnow.net/en) are quote-gated against a captured snapshot of the Department of Human Services' own Physical HealthChoices home page (pa.gov/agencies/dhs/resources/medicaid/hc), which names Pennsylvania Enrollment Services as the official website for plan and doctor information and links directly to enrollnow.net; the literal domain text does not appear in the captured page body (it lives in a link href, not visible text), so this is the same evidentiary shape as WV.json's mountainhealthtrust.com binding. enrollment.phone is quote-gated against a captured snapshot of DHS's own Physical HealthChoices contact page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-contact-us), which lists PA Enrollment Services (Maximus) MCO at 1-800-440-3989. enrollment.choice_window_days ships as an honest not_found fact: every DHS and PA Enrollment Services source found describes plan changes as available any time with the new plan taking effect a future month later, never as a fixed number of days before auto-assignment, so choice_window_note describes that instead of inventing a day count. All 5 zone rosters (areas.southeast.plans through areas.northwest.plans) and all 5 zone county lists (service_areas.*.county_names) are quote-gated against a single captured snapshot of DHS's own Managed Care Organizations (MCO) - Physical HealthChoices page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-mco), which lists each zone's counties and health plans directly. I manually cross-checked that page against DHS's separate Statewide MCO Map page (pa.gov/agencies/dhs/resources/medicaid/statewide-mco-map) and both list identical zones, counties, and plans, but only hc-mco was captured as a snapshot to keep the source list lean. DHS's own page lists AmeriHealth Caritas Northeast as a distinct roster entry from AmeriHealth Caritas Pennsylvania (Northeast zone only, versus Lehigh/Capital, Northwest, and Southwest for the Pennsylvania entry) even though public reporting elsewhere describes AmeriHealth Caritas Northeast as having merged into AmeriHealth Caritas Pennsylvania's corporate structure years ago; this file follows DHS's own current page literally rather than resolving that discrepancy, and both plan records point at the same live amerihealthcaritaspa.com member site since no separate AmeriHealth Caritas Northeast PA site could be found, which a human should double check. This is the Physical HealthChoices (mandatory Medicaid managed care) roster only; Community HealthChoices (the separate dual-eligible/LTSS program) and Behavioral Health HealthChoices (the county based behavioral health carve out) are out of scope for this file. Every plan record's member_phone, provider_directory_url, and formulary_url is prototype data read directly off each plan's own site, not independently fact-cited beyond what is listed here, so the state as a whole stays unverified, matching the TX/CA/FL/NY precedent. Extra benefits are limited to items each plan's own site describes in enough detail to state plainly; where a plan's site only gestures at unspecified 'special programs' with no verifiable detail (AmeriHealth Caritas Pennsylvania, AmeriHealth Caritas Northeast, UPMC for You), extra_benefits ships empty rather than guessed.

Servicios para miembros: 1-800-521-6860

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• Bright Start maternity program

  A maternity and pregnancy support program for members who are pregnant or recently gave birth.

• Focus on Fitness

  A fitness and exercise support program for members.

• Keystone First Obtenido el 2026-07-17

enrollment.portal_name and enrollment.portal_url (Pennsylvania Enrollment Services, https://www.enrollnow.net/en) are quote-gated against a captured snapshot of the Department of Human Services' own Physical HealthChoices home page (pa.gov/agencies/dhs/resources/medicaid/hc), which names Pennsylvania Enrollment Services as the official website for plan and doctor information and links directly to enrollnow.net; the literal domain text does not appear in the captured page body (it lives in a link href, not visible text), so this is the same evidentiary shape as WV.json's mountainhealthtrust.com binding. enrollment.phone is quote-gated against a captured snapshot of DHS's own Physical HealthChoices contact page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-contact-us), which lists PA Enrollment Services (Maximus) MCO at 1-800-440-3989. enrollment.choice_window_days ships as an honest not_found fact: every DHS and PA Enrollment Services source found describes plan changes as available any time with the new plan taking effect a future month later, never as a fixed number of days before auto-assignment, so choice_window_note describes that instead of inventing a day count. All 5 zone rosters (areas.southeast.plans through areas.northwest.plans) and all 5 zone county lists (service_areas.*.county_names) are quote-gated against a single captured snapshot of DHS's own Managed Care Organizations (MCO) - Physical HealthChoices page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-mco), which lists each zone's counties and health plans directly. I manually cross-checked that page against DHS's separate Statewide MCO Map page (pa.gov/agencies/dhs/resources/medicaid/statewide-mco-map) and both list identical zones, counties, and plans, but only hc-mco was captured as a snapshot to keep the source list lean. DHS's own page lists AmeriHealth Caritas Northeast as a distinct roster entry from AmeriHealth Caritas Pennsylvania (Northeast zone only, versus Lehigh/Capital, Northwest, and Southwest for the Pennsylvania entry) even though public reporting elsewhere describes AmeriHealth Caritas Northeast as having merged into AmeriHealth Caritas Pennsylvania's corporate structure years ago; this file follows DHS's own current page literally rather than resolving that discrepancy, and both plan records point at the same live amerihealthcaritaspa.com member site since no separate AmeriHealth Caritas Northeast PA site could be found, which a human should double check. This is the Physical HealthChoices (mandatory Medicaid managed care) roster only; Community HealthChoices (the separate dual-eligible/LTSS program) and Behavioral Health HealthChoices (the county based behavioral health carve out) are out of scope for this file. Every plan record's member_phone, provider_directory_url, and formulary_url is prototype data read directly off each plan's own site, not independently fact-cited beyond what is listed here, so the state as a whole stays unverified, matching the TX/CA/FL/NY precedent. Extra benefits are limited to items each plan's own site describes in enough detail to state plainly; where a plan's site only gestures at unspecified 'special programs' with no verifiable detail (AmeriHealth Caritas Pennsylvania, AmeriHealth Caritas Northeast, UPMC for You), extra_benefits ships empty rather than guessed.

Servicios para miembros: 1-800-414-9025

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• All-in-one fitness benefit

  A fitness benefit for members age 18 and older, described on the plan's own site as an extra some other plans don't offer.

• UnitedHealthcare of Pennsylvania, Inc. Obtenido el 2026-07-17

enrollment.portal_name and enrollment.portal_url (Pennsylvania Enrollment Services, https://www.enrollnow.net/en) are quote-gated against a captured snapshot of the Department of Human Services' own Physical HealthChoices home page (pa.gov/agencies/dhs/resources/medicaid/hc), which names Pennsylvania Enrollment Services as the official website for plan and doctor information and links directly to enrollnow.net; the literal domain text does not appear in the captured page body (it lives in a link href, not visible text), so this is the same evidentiary shape as WV.json's mountainhealthtrust.com binding. enrollment.phone is quote-gated against a captured snapshot of DHS's own Physical HealthChoices contact page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-contact-us), which lists PA Enrollment Services (Maximus) MCO at 1-800-440-3989. enrollment.choice_window_days ships as an honest not_found fact: every DHS and PA Enrollment Services source found describes plan changes as available any time with the new plan taking effect a future month later, never as a fixed number of days before auto-assignment, so choice_window_note describes that instead of inventing a day count. All 5 zone rosters (areas.southeast.plans through areas.northwest.plans) and all 5 zone county lists (service_areas.*.county_names) are quote-gated against a single captured snapshot of DHS's own Managed Care Organizations (MCO) - Physical HealthChoices page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-mco), which lists each zone's counties and health plans directly. I manually cross-checked that page against DHS's separate Statewide MCO Map page (pa.gov/agencies/dhs/resources/medicaid/statewide-mco-map) and both list identical zones, counties, and plans, but only hc-mco was captured as a snapshot to keep the source list lean. DHS's own page lists AmeriHealth Caritas Northeast as a distinct roster entry from AmeriHealth Caritas Pennsylvania (Northeast zone only, versus Lehigh/Capital, Northwest, and Southwest for the Pennsylvania entry) even though public reporting elsewhere describes AmeriHealth Caritas Northeast as having merged into AmeriHealth Caritas Pennsylvania's corporate structure years ago; this file follows DHS's own current page literally rather than resolving that discrepancy, and both plan records point at the same live amerihealthcaritaspa.com member site since no separate AmeriHealth Caritas Northeast PA site could be found, which a human should double check. This is the Physical HealthChoices (mandatory Medicaid managed care) roster only; Community HealthChoices (the separate dual-eligible/LTSS program) and Behavioral Health HealthChoices (the county based behavioral health carve out) are out of scope for this file. Every plan record's member_phone, provider_directory_url, and formulary_url is prototype data read directly off each plan's own site, not independently fact-cited beyond what is listed here, so the state as a whole stays unverified, matching the TX/CA/FL/NY precedent. Extra benefits are limited to items each plan's own site describes in enough detail to state plainly; where a plan's site only gestures at unspecified 'special programs' with no verifiable detail (AmeriHealth Caritas Pennsylvania, AmeriHealth Caritas Northeast, UPMC for You), extra_benefits ships empty rather than guessed.

Servicios para miembros: 1-800-286-4242

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Aún no hay beneficios extra en la lista.

• UPMC for You, Inc. Obtenido el 2026-07-17

enrollment.portal_name and enrollment.portal_url (Pennsylvania Enrollment Services, https://www.enrollnow.net/en) are quote-gated against a captured snapshot of the Department of Human Services' own Physical HealthChoices home page (pa.gov/agencies/dhs/resources/medicaid/hc), which names Pennsylvania Enrollment Services as the official website for plan and doctor information and links directly to enrollnow.net; the literal domain text does not appear in the captured page body (it lives in a link href, not visible text), so this is the same evidentiary shape as WV.json's mountainhealthtrust.com binding. enrollment.phone is quote-gated against a captured snapshot of DHS's own Physical HealthChoices contact page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-contact-us), which lists PA Enrollment Services (Maximus) MCO at 1-800-440-3989. enrollment.choice_window_days ships as an honest not_found fact: every DHS and PA Enrollment Services source found describes plan changes as available any time with the new plan taking effect a future month later, never as a fixed number of days before auto-assignment, so choice_window_note describes that instead of inventing a day count. All 5 zone rosters (areas.southeast.plans through areas.northwest.plans) and all 5 zone county lists (service_areas.*.county_names) are quote-gated against a single captured snapshot of DHS's own Managed Care Organizations (MCO) - Physical HealthChoices page (pa.gov/agencies/dhs/resources/medicaid/hc/hc-mco), which lists each zone's counties and health plans directly. I manually cross-checked that page against DHS's separate Statewide MCO Map page (pa.gov/agencies/dhs/resources/medicaid/statewide-mco-map) and both list identical zones, counties, and plans, but only hc-mco was captured as a snapshot to keep the source list lean. DHS's own page lists AmeriHealth Caritas Northeast as a distinct roster entry from AmeriHealth Caritas Pennsylvania (Northeast zone only, versus Lehigh/Capital, Northwest, and Southwest for the Pennsylvania entry) even though public reporting elsewhere describes AmeriHealth Caritas Northeast as having merged into AmeriHealth Caritas Pennsylvania's corporate structure years ago; this file follows DHS's own current page literally rather than resolving that discrepancy, and both plan records point at the same live amerihealthcaritaspa.com member site since no separate AmeriHealth Caritas Northeast PA site could be found, which a human should double check. This is the Physical HealthChoices (mandatory Medicaid managed care) roster only; Community HealthChoices (the separate dual-eligible/LTSS program) and Behavioral Health HealthChoices (the county based behavioral health carve out) are out of scope for this file. Every plan record's member_phone, provider_directory_url, and formulary_url is prototype data read directly off each plan's own site, not independently fact-cited beyond what is listed here, so the state as a whole stays unverified, matching the TX/CA/FL/NY precedent. Extra benefits are limited to items each plan's own site describes in enough detail to state plainly; where a plan's site only gestures at unspecified 'special programs' with no verifiable detail (AmeriHealth Caritas Pennsylvania, AmeriHealth Caritas Northeast, UPMC for You), extra_benefits ships empty rather than guessed.