Keystone Health Plan East HMO
Keystone Health Plan East HMO provides a complete range of benefits. A member’s overall medical needs are coordinated by one doctor, the primary care physician (PCP), while most specialty care needs are referred. Thanks to our wide network of participating physicians and hospitals, this HMO is easy to use and cost effective.
Features of Keystone Health Plan East HMO
- Members choose a PCP from a wide network of more than 20,000 doctors and 100+ hospitals.
- A member’s overall medical needs are coordinated by one doctor — the PCP.
- Referrals for specialty care are coordinated by the PCP.
- There are no claim forms, no deductibles, and low out-of-pocket expenses.
- Well-being programs, including fitness reimbursement and discounts on alternative services, are available at no additional cost.
- Programs to manage chronic conditions are included.
- Direct Access OB/GYN allows women to receive care from a network OB/GYN without a PCP referral.¹
- Comprehensive benefits for students and travelers out of the area are available through our Guest MembershipSM program.
¹Non-routine care provided by reproductive endocrinologists/infertility specialists and gynecologic oncologists continues to require a referral from PCP.
For a specific information on benefits, limitations, and exclusions, please refer to the applicable benefits materials.
Additional Information
Keystone Health Plan East HMO Summary of Benefits
Select Drug Program Summary of Benefits
Davis Vision Summary of Benefits
Prescription Reimbursement Claim Form
To contact a service representative, call 1-800-ASK-BLUE (1-800-275-2583).