Independence Blue Cross (IBX) has offered affordable high-quality health insurance plans to Pennsylvania residents for almost 80 years. They is the region’s biggest medical coverage provider and serves the Philadelphia area and Southeastern Pennsylvania. We help you compare Keystone and Personal Choice health insurance quotes so you can enroll at the lowest possible cost. IBX participates in the Pa Health Exchange and Open Enrollment. However, you can also purchase plans without a federal subsidy. To qualify for coverage, you must reside in Bucks, Montgomery, Chester, Delaware, or Philadelphia County.
We proudly represent individual and family medical options, and offer coverage at the best available pricing. We spend time to review each policy, and determine which option best provides the coverage you need, with the lowest out-of-pocket cost. You can easily apply for a policy online from this website. We are also happy to send or email specific benefit and coverage details. Free quotes can be obtained from the top portion of this page.
Applying For 2017 Coverage
Applications submitted for 2017 effective dates do not require answering any medical questions or providing any details of medical history. For the Pa Marketplace, some of the popular plan options IBX is offering include Personal Choice catastrophic, Personal Choice PPO, Keystone HMO, and PPO Multi-State and Keystone HMO Proactive (Silver, Gold and Platinum Metal plans). Of course, federal tax subsidies could drastically reduce rates for these plans.
Personal Choice Catastrophic - $50 copay for first three pcp office visits. Substance abuse and mental health outpatient visits are also included. Additional visits and all specialist visits must meet deductible. Policy deductible is $7,150 with maximum out-of-pocket expenses of $7,150 and 0% coinsurance.
Personal Choice PPO Bronze - $50 copay for pcp office visits and $40 for telemedicine calls. Deductible is $5,500 with maximum out-of-pocket expenses of $7,150 and coinsurance. All drugs are subject to deductible.
Keystone HMO Bronze - $50 and $100 office visit copays with $40 copay for telemedicine calls. Deductible is $6,850 with maximum out-of-pocket expenses of $7,150 and 50% coinsurance. Drugs must meet deductible.
Personal Choice PPO Bronze Reserve - $6,500 deductible with maximum out-of-pocket expenses of $6,500 and 0% coinsurance.
Personal Choice Bronze Basic- - $40 pcp office visit copay for first three office visits. $7,150 deductible with maximum out-of-pocket expenses of $7,150 and 0% coinsurance.
Personal Choice PPO Silver - $30 and $70 office visit copays with $40 for telemedicine calls. $2,500 deductible with $6,500 maximum out-of-pocket expenses and 30% coinsurance. Generic drugs receive $15 copay.
The descriptions of plans below refer to various "grandfathered" policies that are no longer made available for purchase. They are not ACA-compliant and do not include the 10 required "Essential Health Benefits." Also, maximum out-of-pocket expenses are sometimes higher than allowed under Obamacare. However, if these policies were issued before March 23 2010, and have not been terminated, they may be kept in-force.
Since these types of policies are exempt from current reforms, they may not be materially altered or you risk losing its favored status. For example, by substantially raising or lowering the deductible, the policy may not be renewed. If you do receive written notification that your policy is being canceled, you have 60 days to enroll in an Exchange plan with federal subsidies available (Special SEP).
The two available types of Keystone HMO policies are “deductible” and “copay." The Blue Cross “deductible” contracts are the HMO $8,000 (introduced in 2012), HMO $5,000, HMO $2,500 and HMO $1,500 plans. “Deductible” plans are the most affordable type of coverage, since the policy-owner incurs a higher out-of-pocket expense on expensive claims. After the deductible, the insured is responsible for 30% of medical expenses, subject to maximum limits. Office visits are covered with a low $30 copay. Outpatient lab tests are covered at 100% and maternity benefits are also included once the deductible has been met.
The Blue Cross “copay” plans are the HMO $20, HMO $15 and HMO $10. “Copay” policies are more expensive since there is no major deductible to meet. Instead of a deductible, a small ($100-$400) copay per day is charged. However, to reduce your expenses, there is a maximum of five copays per admission. This plan is one of the most popular policies in the state and also mirrors many more expensive corporate plans.
Preventative Services Covered At 100%
Both types of Keystone contracts feature preventative services that are not subject to a deductible. Some of the covered services include mammograms (no referral required), pediatric immunizations, outpatient lab/pathology and routine gyn exams. Routine eye exams are also included (one every two years and subject to a copay). And since there is no waiting period, once the policy is effective, you can begin to use benefits. Prior to 2014, often there was a 30-90 day waiting period to use these free services.
The number and scope of free benefits gradually expands each year. Now, many diagnostic tests and procedures are considered preventative, along with the standard physical every year.
Symptomatic Medical Expenses
Routine primary care and specialist office visits are covered with copays ranging from $10-$50. The “HMO Copay” plans will feature slightly lower copays than the “HMO Deductible” plans. Spinal manipulations and physical/occupational therapy are also covered expenses with copays starting as low as $20. Both HMO options allow one routine eye care exam every two years.
These plans also offer very comprehensive prescription coverage. However the “HMO deductible” plans do not require that you meet a deductible before using RX benefits. Copays range from $10 to $50. However, “HMO Copay” plans have deductibles ranging from $100 to $250 on each of their policies. Out-of-pocket expenses tend to be slightly less on non-generic prescriptions. Both types have a yearly RX maximum of $2,500 per person and $5,000 per family.
Keystone HMO exclusions are typical for standard Pennsylvania health insurance plans and include services not medically necessary, treatment of substance abuse or mental illness, acupuncture, dental care, cosmetic services and private duty nursing. A complete list can be found in the "summary of benefits."
Keystone PPO Individual And Family Plans That Are No Longer Offered
There are also five different individual PPO (Personal Choice) policies. Two of the options are Health Savings Account (HSA) plans that offer either a $5,000 or $3,000 deductible option. The coinsurance is a low 0% and 20% respectively, and these are ideal for persons that are self-employed and/or looking for options to pay for health care with tax-free dollars. Small business owners should always consider this type of policy. Or if you are on a limited budget, but want to protect against unforeseen large events, it is a good choice.
Three additional PPO plans (PPO $5000 Deductible, PPO $2,500 Deductible & PPO $30 Copay) are also available. Each of the policies features a $30 copay for office visits and a $50 copay for specialist visits. Preventive benefits, prescription coverage and major medical coverage are all included.
For the international traveler, GeoBlue Travel Medical And International Health coverage is a new coverage that is now available. Previously, this plan was offered on a group basis, but now it can be purchased on a private basis. It will cover policyholders who relocates to another country and also if they travel to a completely different country.
Almost 200 countries would be included in benefits and there would be a listing of participating doctors and related facilities that would be furnished. If only temporary benefits are needed, a special policy is available if you have existing coverage here in the US.
UPDATE: 10-9-2013 IBX features two HMO "Proactive" options on the Pa Health Insurance Exchange that give Philadelphia-area consumers a low-cost choice. If they choose provider treatment in the least of three available tiers, they pay much less for treatment. Outpatient surgery, for example, could cost as much as 50%-80% less. About half of Blue Cross' physicians and hospitals participate in this specific tier.
The out-of-pocket maximums required by the ACA will still be met. Abington Memorial Hospital is one of the hospitals participating in Tier 1. Area residents can change back to their original plans every year during Open Enrollment.
February 2014 - The IBC Center for Health Care Innovation is now open. Located on Market Street in Philadelphia, this facility hopes to become the hub of medical initiatives, new ideas, and of course, innovation. Research with other local facilities along with New York University Langone Medical Center have already begun. The University of Pennsylvania has also begun collaboration involving a mobile technology project.
February 2015 - plan rates and descriptions have changed. When you request a current quote, you can easily review the specific differences in benefits and costs from previous years. The Silver-tier policies are very popular, especially if you qualify for financial aid.
March 2015 - Pennsylvania now recognizes same-sex marriages as being legal. Also, HHS has adopted the same stance. Therefore, on IBX plans, when enrolling, same-sex spouses should be entered on applications as either "spouse" or domestic partner." Specific instructions will be sent to employers within the next seven days.
April 2015 - Annual net income for 2014 reduced for the third consecutive year for non-profit IBX. However, total revenue increased almost 20% and 2 million additional consumers were added. Much of the lost revenue is due to the Obamacare legislation, which hit many carrier hard beginning in 2014 when state and federal Exchanges began offering plans. However, other corporate investments and new ventures also impacted key financial data.
Many new members and first-time enrollments were Medicare-related or affiliated with government employee plans. 2016 numbers are expected to improve, as many "preparation" expenses for Marketplace products will decline.