Keystone HMO plans have changed quite a bit since the passage of Obamacare. Instant federal tax credits now help pay premiums and acceptance is guaranteed, regardless of any medical treatment you are receiving or contemplating.
Of course, the article below was written in 2010, so all described plans are now unavailable for new purchase. However, if you purchased these policies in April 2010 (or before), you can keep that existing coverage, even though it does not meet current mandated requirements. However, you can read about current Pa Keystone Health Plan East coverage and compare rates and benefits.
Here is the article:
Policies are offered by Independence Blue Cross. We help you understand the benefits of each plan and easily apply for private coverage. The policy offers comprehensive medical benefits through a selected Network of doctors and hospitals. We will advise you which plan provides the help that is most important to you and at the lowest possible premium.
Both catastrophic and comprehensive options are available. Also offered are options to supplement Medicare and guaranteed issue contracts for applicants that may not be able to qualify medically for coverage. Medicaid may be available (low-cost or no-cost) to you and/or members of your family if you meet income requirements.
Compare Individual Keystone HMO Plans
There are seven different individual Keystone HMO plans, including four copay and three deductible plans. The HMO deductible plans feature premiums as low as $76 per month since there is a deductible to meet for major medical claims. The HMO Copay plans also offer premiums as low as $111 per month with no deductible for catastrophic claims.
Rates will vary, depending on your age and existing medical conditions. To keep premiums affordable, you can consider a higher deductible on the catastrophic portion of your policy. However, that does raise your potential out of pocket risk. So if your available liquid assets are low, paying a higher rate for a lower deductible may be a temporary solution.
Opening Of Marketplace
When the Pa Health Exchange is available (Open Enrollment starts in October 2014), you may become eligible for a federal tax subsidy. Also, you will not have to provide any medical information. Prices will reduce for some applicants, but not everyone. Our quote engine will automatically calculate your premium. And remember…Keystone is NCQA accredited and no referrals are needed for an OBGYN maternity or regular visit.
All seven plans include preventive benefits that are 100% covered without a waiting period. Some of the specific HMO preventive coverages are mammograms, pediatric immunizations, nutrition counseling and outpatient lab/pathology. Birth control pills, annual OB/GYN exams and coverage for routine eye exams and eyeglasses or contacts are also included. Dental benefits are optional. We have made it easy for you to view rates on this page by using the form at the top of the page. Within minutes, you can compare the most recommended choices.
Additional coverages include doctor’s office visits, hospital care, newborn and maternity care, emergency coverage, outpatient services, prescription medications and skilled nursing facility care. Some of these benefits may be subject to a deductible or copay. You can also view our Pennsylvania Keystone Benefit Summary. We’ll be happy to review any portion of the benefits with you. If maternity coverage is not needed, a PPO plan will save you money. However, after 2014, maternity must be included on all policies.
Healthy Lifestyles Discounts
The “Healthy Lifestyles” program provides a 35% discount on selected alternative health services such as massage therapy and acupuncture. This program includes reimbursements and incentives that can help to assist you in leading a healthier life. Up to $150 of your fitness center fees are eligible for reimbursement. And you can use this feature every year. Since it’s a bit like “free money, we highly encourage you to take advantage of the offers.
More than 50,000 doctors and 100 hospitals ensure that you’ll always have a wide selection of providers to choose from. Whether you need a family physician, a specialist or a prenatal doctor, you won’t have to go far for the best treatment in the area. Claims are handled very quickly and efficiently and most doctors and hospitals enjoy working with the company. If you’re a student and you need to travel, you will retain some benefits.
Policies Are Not Guaranteed To Be Approved
IBX policies are medically underwritten, so it is possible that some applications may not be approved based on current or past conditions. Rates and approval are based on health status. Pre-existing conditions, illness or injury where medical advice or treatment was recommended or treated within the 90-day period prior to the effective date are excluded for the first 12 months. However, if a policy is approved, a pre-existing condition clause (if applicable) would not impact other unrelated treatment.
Naturally, not every condition is covered. For example, unnecessary medical procedures, acupuncture, contraceptive devices (this changes in 2014), cosmetic supplies and hearing aids are not expenses that will be reimbursed. A complete list is available from the policy contract. There are no surprises when you examine the list.