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Benefits Summary

Keystone Health Plan East HMO

Overview | Benefits Summary | FAQ | Apply

There are six different Individual HMO options, including three copay and three deductible plans. For more details on a single plan, click the plan name.

Medical Plan Benefit
Plan	Office Visit	Specialist Visit	Hospitalization
HMO $5000 Deductible	$30	$50	30%, after deductible
HMO $2500 Deductible	$30	$50	30%, after deductible
HMO $1500 Deductible	$30	$50	30%, after deductible
HMO $20 Copay	$20	$30	$400 copay per day; max. 5 copays/admission ($2,000)
HMO $15 Copay	$15	$25	$200 copay per day; max. 5 copays/admission ($1,000)
HMO $10 Copay	$10	$20	$100 copay per day; max. 5 copays/admission ($500)

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