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Prospective & Enrolled Members: 800-405-9681 (TTY 711) | Provider Inquiries: 1-855-969-5907 (TTY 711)

Provider Partners Health Plans is a Medicare Advantage plan designed to improve care for Medicare’s 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 replace traditional 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, Maryland, Missouri, Pennsylvania, and Texas.

Individuals residing in Illinois must live in one of 7 Illinois counties – Cook, DuPage, Kane, Lake, McHenry, Will, and Winnebago.

Individuals residing in Maryland must live in one of 16 Maryland counties – Allegany, Anne Arundel, Baltimore, Baltimore City, Caroline, Carroll, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Queen Anne’s, Talbot, Washington, and Worcester.

Individuals residing in Missouri must live in one of 62 Missouri counties – Audrain, Barry, Boone, Butler, Caldwell, Callaway, Camden, Cape Girardeau, Carroll, Chariton, Christian, Clay, Clinton, Cole, Crawford, Dade, Dallas, DeKalb, Douglas, Franklin, Greene, Henry, Hickory, Howard, Jackson, Jasper, Jefferson, Laclede, Lafayette, Lawrence, Lincoln, Livingston, McDonald, Madison, Maries, Miller, Mississippi, Moniteau, Montgomery, New Madrid, Phelps, Platte, Polk, Pulaski, Ray, Reynolds, Ripley, St. Charles, St. Francois, St. Louis, St. Louis City, Saline, Scott, Stoddard, Stone, Taney, Vernon, Warren, Washington, Webster and Wright.

Individuals residing in Pennsylvania must live in one of 20 Pennsylvania counties – Allegheny, Armstrong, Beaver, Bucks, Butler, Chester, Crawford, Delaware, Erie, Fayette, Greene, Lancaster, Lawrence, Mercer, Montgomery, Philadelphia, Somerset, Venango, Washington, and Westmoreland.

Individuals residing in Texas must live in one of 67 Texas counties – Anderson, Angelina, Bandera, Bexar, Brazos, Brown, Burnet, Cherokee, Collingsworth, Comanche, Concho, Dallas, Delta, Denton, Ector, El Paso, Falls, Fannin, Freestone, Goliad, Gray, Gregg, Grimes, Guadalupe, Hall, Hardin, Harris, Hood, Hopkins, Howard, Hutchinson, Jefferson, Jim Wells, Karnes, Kaufman, Limestone, Lubbock, Madison, Matagorda, Maverick, McLennan, Medina, Moore, Nacogdoches, Navarro, Orange, Palo Pinto, Potter, Randall, Refugio, Robertson, Runnels, Sabine, San Saba, Smith, Somervell, Tarrant, Titus, Trinity, Tyler, Upshur, Uvalde, Val Verde, Victoria, Wichita, Wise, and Young.

Page Last Updated:  10/15/2022

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2023