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Prospective Members, Enrolled Members

and Provider Inquiries: 800-405-9681 (TTY 711)

PPHP: A Special Needs Plan for the Most Vulnerable

Provider Partners Health Plans (PPHP) 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. PPHP is sponsored by a group of highly experienced leaders that work with physicians, hospitals and other providers to improve care and outcomes for our members.

PPHP replaces 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

PPHP offers our Special Needs Plans in Illinois, Maryland, Missouri, Ohio and Pennsylvania.

Individuals residing in Illinois must live in one of four Illinois counties – Cook, McHenry, Will, and Winnebago.

Individuals residing in Maryland must live in one of eleven Maryland counties – Allegany, Anne Arundel, Baltimore, Baltimore City, Carroll, Dorchester, Frederick, Garrett, Harford, Howard, and Washington.

Individuals residing in Missouri must live in one of forty Missouri counties – Audrain, Barry, Boone, Butler, Caldwell, Callaway, Chariton, Christian, Clay, Clinton, Dade, Dallas, Douglas, Greene, Henry, Hickory, Howard, Jackson, Jefferson, Laclede, Lafayette, Lawrence, Lincoln, Madison, Maries, McDonald, Miller, Moniteau, Montgomery, Ray, Reynolds, Saline, St. Charles, Stoddard, Stone, Taney, Warren, Washington, Webster, and Wright.

Individuals residing in Ohio must list in one of six Ohio counties – Cuyahoga, Fairfield, Hocking, Lake, Stark, and Summit.

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

Page Last Updated:  10/1/2020

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2021