Health Plans for Individuals and Families

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Keystone Health Plan East HMO

Basic Eligibility Requirements*

  • Primary applicant must be the oldest person to be covered and between 18 and 64.
  • You are generally in good health.
  • You are not an expectant parent or in the process of adoption or surrogacy.
  • You must be a resident of Bucks, Chester, Delaware, Montgomery, or Philadelphia counties in Pennsylvania.
  • You are not eligible for Medicare.

Note: Any spouse applying for coverage must be present to provide an electronic signature at the end of the application.

Application Process

  1. Complete the online application.
  2. We will review your application and medical history.
  3. You will be notified if additional information is needed or if you are approved for coverage.

Apply Online

Your application is subject to medical underwriting and you may be contacted to provide additional information. We will try to ensure that this process moves quickly, but it’s important that you do not cancel your existing health care coverage until we notify you if your application is approved. The effective date of approved coverage is either the 1st or the 15th of the month following underwriting approval.

*Important notice regarding Individual HMO

These are medically underwritten programs, so coverage is not guaranteed, and some applications may not be approved based on medical conditions. As a medically underwritten product, acceptance and rates are based on your health status. There is no automatic transfer from any existing Keystone, Personal Choice, or other Independence Blue Cross Plan, into the individual medically underwritten plans.

In addition, the HMO plans are subject to a preexisting condition exclusion. Coverage for any preexisting condition, illness, or injury for which medical advice or treatment was recommended or received within the 90-day period that precedes the effective date of coverage is excluded for the first 12 months.

There is no waiver of the preexisting exclusion provision. Certificates of Creditable Coverage from a group plan are not applicable for these products. Even if you have been continuously insured under another plan prior to applying with us, the preexisting exclusion provision will apply to any approved application.

Note: Applications take time to process, so you should maintain your current coverage until we notify you that your application has been approved.