Medicare Advantage plan types Independence offers three types of Medicare Advantage plans: Personal Choice 65 SM PPO plans, Keystone 65 HMO plans, and the Keystone 65 Focus Rx HMO-POS plan. See below for more details.
Why choose Keystone 65 Medicare (HMO)?
· Keystone 65 Select Rx HMO. $57.50 monthly plan premium in Bucks and Philadelphia counties; $83.50 in Chester, Delaware, Montgomery. $0 primary care physician copays. $40 specialist visit copay. $0 copay medical and behavior health telemedicine visits through MDLIVE. Dental, hearing, vision included in plan!
Why should I use independence Medicare basics?
· Independence offers three types of Medicare Advantage plans: HMO, PPO, and HMO-POS. With an HMO (health maintenance organization) plan your costs are usually lower, but you are required to use only in-network health care providers. Browse our Keystone 65 HMO plans.
How do I become eligible for the Keystone 65 focus network?
Inpatient hospital. $750/day 2. 30% after deductible. 50% after deductible. Subject to deductible and $700/day 1. Generic prescription drugs. $15. $20 no deductible (integrated with medical deductible) $20 no deductible (integrated with medical deductible)
What is a Medicare Advantage plan?
Keystone 65 Focus Rx HMO. Keystone 65 Focus Rx HMO (Keystone 65 Focus) is an Independence Blue Cross (Independence) Medicare Advantage HMO benefit product. Independence offers Medicare Advantage Plans in PA to those who reside in Philadelphia, Delaware, Montgomery, Bucks, and Chester counties (i.e., the Independence five-county service …
Is Keystone 65 a Medicare supplement plan?
Keystone 65 Basic Rx (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Independence Health Group, Inc.. Plan ID: H3952-055.
Is independence a personal choice for Medicare?
Medicare awarded our Personal Choice 65SM PPO plans 4.5 out of 5 stars! Enjoy the freedom of being able to see any doctor, in or out of network, with one of the highest-quality Medicare Advantage plans available in our area.
Does Keystone 65 basic HMO require referrals?
Note: As of January 1, 2018, Independence members in our Medicare Advantage HMO plans (i.e., Keystone 65 Focus HMO, Keystone 65 Preferred HMO, Keystone 65 Select HMO, and Keystone 65 Basic HMO) no longer need referrals to see a specialist.
Who is Medicare for?
Medicare is the federal health insurance program for: People who are 65 or older. Certain younger people with disabilities. People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
Is Independence Blue Cross the same as Keystone Health Plan East?
One of the Keystone HMO plans 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. You want to save money by selecting health care providers in the Independence Keystone Health Plan East network.
Is Independence Blue Cross the same as Keystone first?
In 2012, backed by parent companies Independence Blue Cross and Blue Cross Blue Shield of Michigan, Keystone Mercy became Keystone First. Today, Keystone First serves more than 300,000 Medical Assistance recipients in the five-county Greater Philadelphia area.
Is Keystone 65 the same as Medicare?
Keystone 65 Focus Rx HMO (Keystone 65 Focus) is an Independence Blue Cross (Independence) Medicare Advantage HMO benefit product. Independence offers Medicare Advantage Plans in PA to those who reside in Philadelphia, Delaware, Montgomery, Bucks, and Chester counties (i.e., the Independence five-county service area).
What are the 4 types of Medicare?
There are four parts of Medicare: Part A, Part B, Part C, and Part D.Part A provides inpatient/hospital coverage.Part B provides outpatient/medical coverage.Part C offers an alternate way to receive your Medicare benefits (see below for more information).Part D provides prescription drug coverage.
Why do doctors not like Medicare Advantage plans?
If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because the private insurance companies make it difficult for them to get paid for the services they provide.
Does Medicare coverage start the month you turn 65?
The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month. If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.
Medicare Advantage plan types
Independence offers three types of Medicare Advantage plans: Personal Choice 65 SM PPO plans, Keystone 65 HMO plans, and the Keystone 65 Focus Rx HMO-POS plan. See below for more details.
What are Medicare Advantage plans?
Medicare Advantage plans, also known as “Medicare Part C,” were created to complement the benefits of Original Medicare (Parts A and B). These plans are offered by Medicare-approved private insurance companies (like Independence) and must follow rules set by Medicare.
What do Medicare Advantage plans cover?
Medicare Advantage plans include all the benefits of Medicare Parts A and B plans. They may also include extras like vision, dental, and hearing coverage.
Do Medicare Advantage plans cover prescription drugs?
Most Medicare Advantage plans do cover prescription drugs, but some do not. Generally, people need to get their Part D drug coverage as part of their Medicare Advantage plan.
Comparing Medicare Advantage plans
Independence offers three types of Medicare Advantage plans: HMO, PPO, and HMO-POS.
How much do Medicare Advantage plans cost in Pennsylvania?
The cost of Medicare Advantage plans varies widely based on a number of factors. When deciding on a Medicare Advantage plan, there are a few things to weigh:
What is the difference between a Medicare Advantage plan and a Medicare Supplement plan?
A Medicare Advantage plan includes Original Medicare (Parts A and B) plus additional benefits.
How many copays are there for Keystone HMO?
There is a maximum of 5 copays per admission. 2 Keystone HMO Silver and Keystone HMO Bronze are not available for purchase through the Pennsylvania Insurance Exchange (Pennie) and must be purchased through Independence directly.
What is a PCP in a keystone plan?
You 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 will not be covered for care that you receive from doctors or hospitals outside the Keystone Health Plan East network ...
What does it mean to designate a primary care physician?
You have or are willing to designate a primary care physician to coordinate all of your healthcare and provide referrals for specialty care
How to contact Medicare about Keystone 65?
If you have Medicare patients who are interested in learning more about Keystone 65 Focus, please have them contact Customer Service toll-free at 1-800-645-3965 (TTY/TDD: 711), 8 a.m. to 8 p.m., seven days a week.
How to get coverage agreement for Keystone 65?
Obtain a coverage agreement with another physician in your same or similar specialty who is participating in the Keystone 65 Focus network and has admitting privileges at a hospital that is participating in the Keystone 65 Focus network. Once complete, notify your network coordinator.
What is admitting privileges in Keystone 65?
Admitting privileges were based on the hospital affiliation information that was provided to Independence as part of the credentialing process. To be eligible for the Keystone 65 Focus network, at least one practitioner within a practice is required to have admitting privileges (if applicable to your specialty) to a participating hospital in the Keystone 65 Focus network. If you feel the information used to determine your eligibility was incorrect, please contact your network coordinator.
What is Keystone 65?
Keystone 65 Focus Rx HMO (Keystone 65 Focus) is an Independence Blue Cross (Independence) Medicare Advantage HMO benefit product available to eligible members who reside in Philadelphia, Delaware, Montgomery, Bucks, and Chester counties (i.e., the Independence five-county service area). One of the distinguishing characteristics of Keystone 65 Focus is the size and scope of its provider network, which allows Independence to offer a value-based alternative to our other Medicare Advantage HMO benefit product offerings. Members who choose Keystone 65 Focus can enjoy the same benefits as with broader-network Medicare Advantage HMO benefit products, while taking advantage of lower premiums and out-of-pocket costs due to the defined network.
How to find Keystone 65 focus?
Providers who are participating in the Keystone 65 Focus network can be found using the online provider directory. The online provider directory can be accessed using the Find a Doctor tool. Be sure to select Keystone 65 Focus from the Plans drop-down menu when entering your search criteria.
How many hospitals are in Keystone 65?
Instead, the Keystone 65 Focus network is a subset of this existing network, consisting of more than 23,000 participating providers and approximately two dozen acute care hospitals primarily located in Philadelphia, Delaware, Montgomery, Bucks, and Chester counties.
Can an ancillary provider be employed by a hospital?
An ancillary provider cannot be employed by or owned by a hospital that is non-participating in the Keystone 65 Focus network. A professional provider must currently be participating in our Medicare Advantage HMO network. A professional provider must either have (1) admitting privileges at a hospital that is participating in ...
Peg Cassidy, West Chester, PA
I found www.mymedicareadvisor.com through the internet. I was expecting a clerk to answer the phone, from some far away land, who would give me the run-around for 10 minutes. What I got instead completely floored me. I was transferred right away to Allen Heffler in a matter of five seconds. He was the complete opposite of what I expected.
Peg Cassidy, West Chester, PA
I found www.mymedicareadvisor.com through the internet. I was expecting a clerk to answer the phone, from some far away land, who would give me the run-around for 10 minutes. What I got instead completely floored me. I was transferred right away to Allen Heffler in a matter of five seconds. He was the complete opposite of what I expected.
How to contact the TDD?
If you have any questions, you can call and speak to a Member Help Team representative at 1-800-645-3965 ( T T Y/ TDD: 711).
How much is the maximum copayment per day for mental health?
$250 copayment per day for days 1 through 7 per admissionYou pay nothing for day 8 and beyond per admission$1,750 maximum copayment per admission190-day lifetime maximum in a mental health facility
How much does Medicare cover for eye exams?
$40 copayment for Medicare-covered eye exams to diagnose and treat diseases of the eye; $0 copayment for diabetic retinal exam; $0 copayment for glaucoma screening; and $0 copayment for Medicare-covered eyeglasses or contact lenses after cataract surgery.
What is evidence of coverage for Keystone 65?
The Evidence of Coverage is the legal, detailed description of your plan benefits. It explains your rights and the rules you need to follow to get covered services and prescription drugs. A copy of the Evidence of Coverage is located on our website at https://www.ibxmedicare.com/EOC. You may also call our Member Help Team to ask us to mail you an Evidence of Coverage.
When does Medicare change to a different plan?
If you want to change to a different plan or to Original Medicare for next year, you can do it from October 15 until December 7. The change will take effect on January 1, 2020.
Is Keystone 65 Select Medical Only?
You are currently enrolled as a member of Keystone 65 Select Medical-Only. Next year, there will be some changes to the plan’s costs and benefits. This booklet tells about the changes.
What is Medicare Advantage Plan?
A Medicare Advantage plan is a type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide beneficiaries with all of the Part A and Part B benefits. The Centers for Medicare and Medicaid Services (CMS) pay the insurance company to administer these benefits.
How much does Medicare Advantage cost in 2021?
How much does a Medicare Advantage Plan cost? In addition to your monthly part B premium (usually $148.50) you must pay a monthly premium for the services included in the plan.The standard Part B premium amount in 2021 is $148.50.
Is Medicare Advantage lower than Original?
The total cost of the premiums, co-payments and deductibles you pay under a Medicare Advantage plan is often lower than the total costs for coinsurance, co-payments and deductibles in Original Medicare.
