Overview

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How the Plan Works

Flex Copay Programs

FIVE STEPS TO BUILDING YOUR FLEX COPAY PLAN

1. Choose a health plan

Our most popular and newest health plans are available: Keystone Health Plan East HMO, Keystone Point-of-Service, Keystone Direct POS, or Personal Choice^® PPO.

2. Select a copay for office/outpatient care

Choose copayments for office visits, therapy, and diagnostic care. For example you may select the $15/$30 option — $15 for primary care/$30 for specialist care. View copay options.

3. Select cost-sharing schedule for facility/ancillary care

This applies to hospital services, outpatient surgery, and emergency room care. Cost-sharing for inpatient hospital care ranges from $0 – $250 per day. View cost-sharing options.

4. Select out-of-network benefits

Keystone Point-of-Service, Keystone Direct POS, and Personal Choice PPO plans allow members to access care out-of-network. If you select one of these plans, you can choose from two benefit levels to cover out-of-network services. View out-of-network options.

5. Select prescription drug, dental, vision, and life benefits

These optional benefits round off your benefits package. Seven prescription drug formulary options are offered through our Select Drug Program^®. View Select Drug Program options.