Skip to main content
English | Spanish

Prospective & Enrolled Members: 800-405-9681 (TTY 711)

Provider Inquiries: 1-855-969-5907 (TTY 711)

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, Pennsylvania, and Texas.

Individuals residing in Illinois must live in one of 6 Illinois counties – Cook, DuPage, Kane, McHenry, Will, and Winnebago.

Individuals residing in Maryland must live in one of 13 Maryland counties – Allegany, Anne Arundel, Baltimore, Baltimore City, Carroll, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Queen Anne’s, and Washington.

Individuals residing in Missouri must live in one of 55 Missouri counties – Audrain, Barry, Boone, Butler, Caldwell, Callaway, Camden, Carroll, Chariton, Christian, Clay, Clinton, Cole, Crawford, Dade, Dallas, DeKalb, Douglas, Greene, Henry, Hickory, Howard, Jackson, Jasper, Jefferson, Laclede, Lafayette, Lawrence, Lincoln, Livingston, McDonald, Madison, Maries, Miller, Mississippi, Moniteau, Montgomery, New Madrid, Pulaski, Ray, Reynolds, Ripley, St. Charles, 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 16 Pennsylvania counties – Allegheny, Armstrong, Beaver, Bucks, Butler, Chester, Delaware, Fayette, Greene, Lancaster, Lawrence, Mercer, Montgomery, Philadelphia, Washington, and Westmoreland.

Individuals residing in Texas must live in one of 41 Texas counties – Anderson, Angelina, Bandera, Bexar, Cherokee, Concho, Delta, Denton, Ector, El Paso, Falls, Fannin, Freestone, Goliad, Gregg, Grimes, Guadalupe, Hardin, Hood, Hopkins, Howard, Jefferson, Jim Wells, Karnes, Limestone, Madison, Medina, Navarro, Orange, Palo Pinto, Refugio, Robertson, Runnels, Smith, Somervell, Titus, Trinity, Tyler, Upshur, Wise, and Young.

Page Last Updated:  10/15/2021

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2022