How to Enroll
Enroll by Mail
Completing your enrollment application
Each enrollee will need to complete an application.
Indicate the group number of the desired product on the completed enrollment application from the chart below:
|Keystone 65 HMO — without drug coverage||434853|
|Keystone 65 HMO — with drug coverage||434854|
|Personal Choice 65 PPO — without drug coverage||434855|
|Personal Choice 65 PPO — with drug coverage||434856|
|Select Option PDP||452714|
- Indicate the desired effective date on the completed application. This will always be the first of a month.
- Send completed applications within a full month of the desired effective date.
Send your completed enrollment applications to:
Independence Blue Cross
1901 Market Street
Government Programs – 28th floor
Attn: Kathy Burton
Philadelphia, PA 19103
How to pay your monthly premium
No premium payment is required at the time you apply. A monthly premium invoice will be sent to you. You have three options for remitting payment:
- Pay by mail.
- Use ZipCheck. This is an Electronic debit from your checking or savings account (not available with MedigapSecurity or Select Option PDP).
- Use eBilling. Visit ibxpress.com to set up online premium payment.