Keystone Health Plan East HMO plans
With a Keystone HMO plan from Independence Blue Cross, you can see any doctor or visit any hospital in the Keystone Health Plan East network. You will pick a primary care physician (PCP), or family doctor, to coordinate your care. Your PCP will treat you for general health needs and refer you to specialists as needed.
With a Keystone HMO plan, you are only covered for care from in-network doctors and hospitals for routine care and planned procedures. Care received from out-of-network providers is only covered in the case of an emergency.
To learn more about HMOs, read the article “What is a Health Maintenance Organization (HMO)?”
Is a Keystone HMO plan right for you?
A Keystone HMO plan from Independence Blue Cross may be the best Pennsylvania health insurance option for you and your family if you:
- Live within one of these five counties
- Want to save money by selecting health care providers in the Independence Keystone Health Plan East network
- Are willing to have a primary care physician (PCP) to coordinate all of your healthcare and provide referrals for specialty care
How Keystone HMO plans work
Keystone HMO plan options
| Keystone HMO Gold | Keystone HMO Gold Classic1 | Keystone HMO Silver Classic1 | Keystone HMO Silver Basic1 | Keystone HMO Bronze | |
|---|---|---|---|---|---|
| Deductible | $0 | $500 | $3,500 | $5,500 | $8,500 |
| Primary care physician visit | $35 | $40 no deductible | $35 no deductible | $35 no deductible | $75 no deductible |
| Specialist visit | $65 | $80 no deductible | $80 no deductible | $80 no deductible | $150 no deductible |
| Inpatient hospital | $750/day2 | 20% after deductible | 30% after deductible | 50% after deductible | Subject to deductible and $700/day2 |
| Generic prescription drugs | $15 | $15 | $20 no deductible (Integrated with Medical deductible) | $20 no deductible (Integrated with Medical deductible) | $25 no deductible (Integrated with Medical deductible) |
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Resources
- Find out which health providers are available in these plans.
- Still have questions about the Keystone HMO health plans? Call a licensed agent to learn more about your health options at 1-888-475-6206 (TTY:711).
- Learn the differences between an HMO plan and a PPO plan.
- Ready to enroll? Apply now.
Additional information
Review important information to get a better understanding of our individual and family health insurance policies and guidelines and the steps Independence Blue Cross takes to help you receive appropriate covered services.
1 HMO Gold Classic, HMO Silver Classic, and HMO Silver Basic are only available for purchase through the Pennsylvania Insurance Exchange (Pennie).
2 Amount shown reflects copay per day. There is a maximum of 5 copays per admission.