Background

A Special Needs Plan for the Most Vulnerable

Provider Partners Health Plans is a Medicare Advantage plan designed to improve care for Medicare beneficiaries who reside in long-term care facilities or who live at home and need the type of care that is provided in a nursing home.  We are sponsored by a group of highly experienced leaders that work with physicians, hospitals, and other providers to improve care and outcomes for our members.

Provider Partners Health Plans replaces original Medicare coverage with an all-in-one plan that covers:

• Inpatient care (Part A)
• Outpatient and primary care (Part B)
• Prescription drugs (Part D)
• Other specialized, coordinated wellness services

Coordinated Long-Term Care Special Needs Plans are offered in Illinois, Indiana, Kentucky, Maryland, Missouri, North Carolina, Pennsylvania, and Texas.

Individuals residing in Illinois must live in one of 8 Illinois counties – Cook, DuPage, Kane, Lake, McHenry, Ogle, Will, and Winnebago.

Individuals residing in Indiana must live in one of the 49 Indiana counties – Allen, Boone, Brown, Cass, Clark, Daviess, Decatur, DeKalb, Delaware, Dubois, Elkhart, Fayette, Floyd, Gibson, Hamilton, Hancock, Hendricks, Henry, Howard, Jackson, Jefferson, Johnson, Kosciusko, LaPorte, Lawrence, Madison, Marion, Marshall, Miami, Monroe, Montgomery, Morgan, Noble, Orange, Pike, Porter, Putnam, Randolph, Scott, Shelby, St. Joseph, Tippecanoe, Vanderburgh, Wabash, Warrick, Washington, Wells, White, and Whitley.

Individuals residing in Kentucky must live in one of 11 Kentucky counties – Breckinridge, Bullitt, Henry, Jefferson, Nelson, Oldham, Robertson, Shelby, Spencer, Trimble, and Washington.

Individuals residing in Maryland must live in one of 18 Maryland counties – Allegany, Anne Arundel, Baltimore, Baltimore City, Caroline, Carroll, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Queen Anne’s, Somerset, Talbot, Washington, Wicomico, and Worcester.

Individuals residing in Missouri must live in one of 65 Missouri counties – Audrain, Barry, Boone, Butler, Caldwell, Callaway, Camden, Cape Girardeau, Carroll, Cedar, Chariton, Christian, Clay, Clinton, Cole, Crawford, Dade, Dallas, DeKalb, Dent, Douglas, Franklin, Greene, Henry, Hickory, Howard, Iron, Jackson, Jasper, Jefferson, Laclede, Lafayette, Lawrence, Lincoln, Livingston, Madison, Maries, McDonald, Miller, Mississippi, Moniteau, Montgomery, New Madrid, Phelps, Platte, Polk, Pulaski, Ray, Reynolds, Ripley, Saline, Scott, St. Charles, St. Francois, St. Louis, St. Louis City, Stoddard, Stone, Taney, Texas, Vernon, Warren, Washington, Webster, and Wright.

Individuals residing in North Carolina must live in one of 14 North Carolina counties – Cabarrus, Catawba, Davidson, Davie, Forsyth, Gaston, Guilford, Lincoln, Mecklenburg, Mitchell, New Hanover, Pender, Union, and Wilkes.

Individuals residing in Pennsylvania must live in one of 18 Pennsylvania counties – Allegheny, Armstrong, Beaver, Bucks, Butler, Cambria, Chester, Crawford, Delaware, Fayette, Greene, Lancaster, Lawrence, Mercer, Montgomery, Philadelphia, Somerset, and Westmoreland.

Individuals residing in Texas must live in one of 83 Texas counties – Anderson, Angelina, Bandera, Bexar, Brazos, Brown, Burleson, Burnet, Caldwell, Cass, Chambers, Cherokee, Collin, Comanche, Concho, Cooke, Crane, Dallas, Delta, Denton, Ector, El Paso, Falls, Fannin, Fort Bend, Freestone, Garza, Goliad, Gregg, Grimes, Guadalupe, Hamilton, Harris, Harrison, Henderson, Hood, Hopkins, Howard, Hutchinson, Jasper, Jefferson, Jim Wells, Karnes, Kaufman, Lavaca, Limestone, Lubbock, Madison, Maverick, McLennan, Medina, Midland, Milam, Moore, Nacogdoches, Navarro, Orange, Palo Pinto, Parker, Potter, Randall, Red River, Refugio, Robertson, Rockwall, Runnels, San Saba, Shelby, Smith, Somervell, Tarrant, Titus, Tom Green, Tyler, Upshur, Uvalde, Van Zandt, Victoria, Waller, Washington, Williamson, Wise, and Young.