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Independence Blue Cross offers a variety of individual plans for people who do not have employer-sponsored health insurance. Individual plans can include coverage for you, you and your spouse, or your entire family. This chart is an overview of the individual health plans available to you.

Benefits COBRA† Keystone HMO Conversion HIPAA Continued-Coverage Plans Keystone HMO (medically underwritten plans) Personal Choice® PPO (medically underwritten plans) Personal Choice® PPO (guaranteed enrollment plans) Blue Cross® and Blue Shield® Plans adultBasic
Prescription drug coverage †   X X X X X ‡
Vision coverage †     X        
Dental coverage †              
Mental health coverage † X       ±    
Maternity care X X X X   † X X
Preexisting medical conditions may not be covered for first 12 months       X X X X  
Preexisting exclusion period may be waived or reduced       X X X X  
Guaranteed enrollment plan X X X     X X X
Approval based on health status and medical history       X X      
Coverage period limited X              

Applicants must meet plan eligibility requirements and reside in Bucks, Chester, Delaware, Montgomery, or Philadelphia counties (except COBRA). See plan details for more information.

COBRA

  • Allows individuals to temporarily continue with the same health benefits as they had under their employer plan.
  • Available to all employees (employed by a company with 20 or more employees) whose coverage has been terminated.
  • Provisions within the federal stimulus package offer a 65 percent premium subsidy beginning February 17, 2009, for up to nine months.

For more information, visit U.S. Department of Labor’s website or contact your former employer.

Eligibility requirements

  1. You are between 18 and 64.
  2. Qualifying events include termination of employment, reduction in work hours, death of subscriber, loss of dependent status, and divorce or legal separation.
  3. Your employer provides COBRA (20 or more employees).
  4. You enroll within 60 days of losing coverage.

More about Guaranteed Enrollment Plans.

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Keystone HMO Conversion

  • Individuals switching from an employer-based Keystone Health Plan East HMO plan or COBRA plan may be able to move into one of two available KHPE Flex HMO conversion plans.
  • Members select a primary care physician from our expansive network to coordinate all care.
  • The plan covers primary and specialist care, preventive care, hospitalization, and emergency and urgent care.

Eligibility requirements

  1. You are between 18 and 64.
  2. You are converting from an employer-based KHPE HMO plan.
  3. Qualifying events for spouses and dependents include death of subscriber, divorce, or loss of dependent status.
  4. You apply within 30 days of losing group coverage.

More about Guaranteed Enrollment Plans.

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HIPAA Continued-Coverage Plans

  • Coverage is available for individuals who are no longer eligible for group coverage or have exhausted COBRA coverage.
  • There is no preexisting condition exclusion as long as the individual has had group coverage for at least 18 months and enrolls before there is a break in coverage of 63 days or more.
  • Individuals may receive care from any hospital or doctor.
  • Applicants choose the range of coverage — from hospitalization, medical/surgical, and Major Medical plans. These plans do not cover routine preventive services.

Eligibility requirements

  1. You are between 18 and 64.
  2. You are no longer eligible for employer-sponsored coverage and have exhausted all COBRA benefits.
  3. You apply within 63 days of losing group coverage.
  4. You were enrolled in a health plan for 18 months under group coverage.
  5. You no longer qualify for any other group coverage or are not enrolled in any other health insurance coverage.

Learn more about PDF icon HIPAA Continued-Coverage Plans.

More about Guaranteed Enrollment Plans.

To learn more about preexisting condition exclusions and what qualifies as a Blue-to-Blue or a non-Blue-to-Blue transfer, review the Creditable Coverage FAQ.

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Keystone Health Plan East HMO (medically underwritten plans)

  • Members select a primary care physician from our expansive network to coordinate all care.
  • Plans cover primary and specialist care, preventive care, hospitalization, emergency and urgent care, vision, and prescription drugs.
  • Because this is a medically underwritten plan, coverage is not guaranteed, so some applications may not be approved based on medical conditions. Final rates are based on age, gender, and medical history.
  • The preexisting condition exclusion can be reduced or eliminated with credit given for prior coverage under a Blue plan as long as the individual transfers directly without a break in Blue plan coverage. Applicants covered by another carrier may also be eligible to reduce or eliminate the preexisting condition exclusion. To be eligible, applicants must have had coverage for at least 18 months without a break in coverage of more than 63 days prior to their current application.

Eligibility requirements

  1. You are between 18 and 64.
  2. You are in generally good health.
  3. You are not an expectant parent, in the process of adoption, or surrogacy.
  4. You must not be eligible for Medicare.

For a free rate quote, visit www.ibx4you.com.

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Personal Choice® PPO (medically underwritten plans)

  • Individuals may receive care from any provider without a referral, in-network or out of network.
  • Plan covers primary and specialist care, preventive care, hospitalization, emergency and urgent care, and prescription drugs.
  • The preexisting condition exclusion can be reduced or eliminated with credit given for prior coverage under a Blue plan as long as the individual transfers directly without a break in Blue plan coverage. Applicants covered by another carrier may also be eligible to reduce or eliminate the preexisting condition exclusion. To be eligible, applicants must have had coverage for at least 18 months without a break in coverage of more than 63 days prior to their current application.
  • Because this is a medically underwritten plan, coverage is not guaranteed, so some applications may not be approved based on medical conditions. Final rates are based on age, gender, and medical history.

Eligibility requirements

  1. You are between 18 and 64.
  2. You are in generally good health.
  3. You are not an expectant parent, in the process of adoption, or surrogacy.
  4. You must not be eligible for Medicare.

For a free rate quote, visit www.ibx4you.com.

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Personal Choice® PPO (guaranteed enrollment plans)

  • Individuals may receive care from any provider without a referral, in-network or out of network.
  • Plan covers primary and specialist care, preventive care, hospitalization, emergency and urgent care, and prescription drugs.
  • The preexisting condition exclusion can be reduced or eliminated with credit given for prior coverage under a Blue plan as long as the individual transfers directly without a break in Blue plan coverage.

Eligibility requirements

  1. You are between 18 and 64.
  2. You must not be eligible for Medicare.

More about Guaranteed Enrollment Plans.

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Traditional Blue Cross® and Blue Shield® Plans

  • Individuals may receive care from any hospital or doctor for covered care.
  • Applicants choose the range of coverage — from hospitalization, medical/surgical, and major medical plans. These plans do not cover routine preventive services.
  • The preexisting condition exclusion can be reduced or eliminated with credit given for prior coverage under a Blue plan as long as the individual transfers directly without a break in Blue plan coverage.

To be eligible, you must be between 18 and 64.

More about Traditional Blue Cross and Blue Shield Plans.

To learn more about preexisting condition exclusions and what qualifies as a Blue-to-Blue transfer, review the Creditable Coverage FAQ.

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adultBasic

  • This is limited-benefit health insurance available for low-income, uninsured adults.
  • There is currently a waiting list for state-funded coverage, but individuals may purchase coverage at full cost.
  • The plan covers doctor’s office visits, inpatient hospitalization, surgery, emergency accident and medical care, diagnostic tests and services, maternity and newborn care, gynecological/obstetrical care, and routine mammograms.

Eligibility requirements

  1. You are between 19 and 64.
  2. You have been a Pennsylvania resident for 90 days prior to enrollment.
  3. You were uninsured for at least 90 days prior to enrollment, except if you are uninsured because you are no longer working.
  4. You are a U.S. citizen, permanent/resident alien, or refugee.
  5. You are not covered by any other health insurance plan.
  6. You are not eligible for Medical Assistance or Medicare.
  7. You meet the family size and income guidelines.

More about adultBasic.

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* As of February 17, 2009, the American Recovery and Reinvestment Act allows eligible individuals to receive a COBRA premium subsidy of 65 percent for up to nine months. For more information, visit the U.S. Department of Labor’s website.
† Because COBRA is a continuation of group coverage, this coverage is available if it is included in your group benefits program. Please contact your former employer for details.
‡ Prescriptions are not covered, except for diabetic supplies, insulin, and immunosuppressants related to transplants.
± Coverage and benefits vary based on the plan. Please see detailed plan benefits for more information.