What type of insurance is keystone health plan east

Keystone Health Plan East HMO Proactive plans with a tiered network

Our most popular plan, Keystone HMO Proactive, works just like a typical Health Maintenance Organization (HMO) in that you can visit any doctor or hospital in the Keystone Health Plan East network, and you select a primary care physician to refer you to specialists. These HMO plans also let you save on your out-of-pocket costs when you visit certain health care providers.

How a tiered network provides choice and savings

All HMO providers are grouped into one of three tiers based on cost and, in some cases, quality measures. While all of the doctors and hospitals in the Keystone Health Plan East network must meet high quality standards, some are able to offer the same services at a lower cost. The good news is that more than 50 percent of doctors and hospitals in our network are in the most affordable tier, Tier 1 – Preferred, so you have plenty of choices.

A tiered network is different from a limited network. Other health insurers may offer plans with a limited network, which does not give you access to the full network of doctors and hospitals. But our tiered network gives you access to the entire Keystone Health Plan East network. And the choice to save is yours — you can choose providers in Tier 1 for some covered services and providers from Tier 2 or 3 for other covered services.

Is a Keystone HMO Proactive plan right for you?

One of our Keystone HMO Proactive plans may be the best health insurance option for you and your family if you live within one of these five counties and are looking for an affordable coverage option that still gives you access to a wide variety of providers within the Independence Keystone Health Plan East network.

To learn more about HMOs in general, read the article “What is an HMO?”

Keystone HMO Proactive plan options and benefits

Options

Some of our most affordable health insurance plans for individuals and families, the Proactive family of products can help save you money while giving you the freedom to choose each time you receive care.

• Keystone HMO Gold Proactive
• Keystone HMO Silver Proactive
• Keystone HMO Silver Proactive Lite1
• Keystone HMO Silver Proactive Select2
• Keystone HMO Silver Proactive Basic1
• Keystone HMO Silver Proactive Value2

Benefits

• Save money on monthly premiums. When you choose a Keystone HMO Proactive plan, you save money because your monthly premiums are lower than our regular HMO plans.
• Save money on out-of-pocket costs. When you choose Tier 1 – Preferred providers, you’ll save on out-of-pocket costs every time you receive care.
• Choose quality providers that offer the best value. High quality doesn’t have to mean high cost. While all of the doctors and hospitals in our network must meet high quality standards, many offer the same health care services at a lower cost. If they cost less, you pay less.
• Choose providers from any tier. You have the freedom to choose from any tier every time you receive care. So you can choose providers in Tier 1 – Preferred for some covered services, and providers from the other two tiers for other covered services.
• Pay the same cost for select services, no matter where you go. Even though you can save money by choosing providers in Tier 1 – Preferred, there are some covered services that cost the same across all tiers, such as:
  • Preventive care
  • Emergency room
  • Emergency ambulance
  • Urgent care
  • Prescription drugs
  • Physical and occupational therapy
  • Pediatric dental and vision
  • Mental health
  • Outpatient lab/pathology
  • Routine radiology

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 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 (except for emergency services).

To learn more about HMOs, read the article “What is a Health Maintenance Organization (HMO)?”

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Is a Keystone HMO plan right for you?

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
• You have or are willing to designate a primary care physician to coordinate all of your healthcare and provide referrals for specialty care

How Keystone HMO plans work

Keystone HMO plan options

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