The PennCare Network is the top-tier benefit level for all health plans offered to employees of the University of Pennsylvania and the University of Pennsylvania Health System.
Why Use PennCare Providers?
For employees using the PennCare Network, out-of-pocket expenses are significantly reduced or eliminated. The vast majority of services are available at the top-tier level, however, if a service is not available within the PennCare Network, employees may access the full network available through the health plan they have selected at a middle-tier benefit level. Please note that for some selected services, PennCare Network providers have limited capacity in their practices.
While employees' covered benefits will not change during the plan year, PennCare Network providers/services may change. The provider search on this web site is continually updated throughout the year. For questions or clarification about available providers or services, call toll free 1-877-354-4999 or your benefits office.
Which Providers Participate in PennCare?
The PennCare Network includes all providers employed by the University of Pennsylvania Health System, the Children's Hospital of Philadelphia, and Good Shepherd Penn Partners.
Beginning October 1, 2016, Lancaster General Health facilities and employed providers are top-tier providers in the PennCare Network. Please note that not all physicians groups at Lancaster General Health are in the PennCare Network at this time. A list of participating Lancaster General Health providers can be found here. If you need to verify whether a Lancaster General Health provider is participating in the PennCare Network, please contact the UPHS benefits office at 215-615-2675, option #4 or email any questions to BenefitsQuestions@uphs.upenn.edu.
The PennCare Network also includes additional physicians or facilities that have a contract with the University of Pennsylvania Health System to provide services at the top-tier benefits level for University of Pennsylvania and University of Pennsylvania Health System employees. It does not include all providers affiliated with UPHS.
PennCare providers may refer to non-participating facilities, whereby members would be responsible for co-payments/co-insurance amounts. Members are required to check with providers prior to services rendered to ensure they are aware of benefits and financial obligations.
Always confirm facility and provider levels of coverage before seeking services since not every provider is covered at the top tier.
Behavioral Health Benefits
To access behavioral health benefits, contact Penn Behavioral Health at 1-888-321-4433 or visit www.pennbehavioralhealth.org. The Penn Behavioral Health provider network is a staff-and-affiliate model consisting of more than 500 licensed practitioners credentialed to standards set by the National Committee on Quality Assurance. This model combines the significant resources of Penn Medicine with community-based providers in the delivery of accessible and quality behavioral health care.
PennCare Network Facilities
All hospitals and locations owned by Penn Medicine and the Children's Hospital of Philadelphia (CHOP) are part of the PennCare Network. In addition, effective October 1, 2016, Lancaster General Health facilities are top-tier in the PennCare Network.
Some in-network physicians and providers also see patients in stand-alone practice locations around the Philadelphia region. In this case, the professional services they provide are still considered in-network. However, please note that if in the course of treatment, you are referred to a hospital-based service at a hospital or facility that is not part of the PennCare Network, those services will be billed at middle-tier or out-of-network rates.