Individual and Family Health Plans

We make it our mission

Everyone deserves access to affordable, high-quality health care. In 2010, the Patient Protection and Affordable Care Act paved the way for the Exchange, a service to help Americans find a quality health plan that works for their family and budget.

At AmeriHealth Caritas, this is also our mission: to help people get care, stay well, and build healthy communities. We don’t stop at helping our members connect with health care providers and navigate the health care system — we also address the social and economic barriers that stand between the people in our communities and their best health and quality of life. Through AmeriHealth Caritas Next^℠, we offer a robust selection of individual and family health plans to meet the personal needs of people looking for coverage, either on or off the Exchange.

Health insurance for now, and whatever is next

AmeriHealth Caritas Next health plans work to get members and their families the care they need for their greatest wellness, without asking them to choose between financial security and good health care. We help support their life needs — today, tomorrow, and for whatever is next.

Like all Exchange plans, AmeriHealth Caritas Next health plans cover 10 essential health benefits:

• Ambulatory care (care from health care providers in outpatient settings, like medical offices)
• Emergency care
• Hospitalization
• Laboratory services
• Mental health and substance use services
• Pediatric services, including oral and vision care for children
• Pregnancy and newborn care
• Preventive care
• Prescription drugs
• Rehabilitative and habilitative services and devices (to help people recover from injuries, disabilities, or chronic conditions)

We also know that each individual’s quality of life depends on the health of their whole person — and that means access to health care that meets their mental, emotional, and medical needs. Our integrated model of care takes this approach to serve all our members.

Accordingly, we offer these additional benefits to best promote wellness for our members:

• Automatic rewards for specific preventive health behaviors through our CARE Card rewards program
• In-person vouchers to participate in WW^® (also known as Weight Watchers)
• Easy access to virtual care: $0 copay for acute, select specialty, and behavioral health care delivered remotely via MDLIVE^®
• Prescription drugs conveniently available by mail order

Coverage you can count on

AmeriHealth Caritas Next offers affordable health insurance plans to help meet the needs of our individual members and their families. Our individual and family health plans offer three levels of coverage: gold, silver, and bronze.

People seeking health care coverage can compare plans based on pricing and the features important to them before they enroll. All of our plans offer the same high quality of care and services.