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Affordable Pennsylvania Health Insurance Quotes

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Independence Blue Cross (IBX) has offered affordable high-quality private and Medicare health insurance plans to Pennsylvania residents for almost 80 years. They are 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. Senior Medicare coverage is also available.

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. Upon request, we can send or email specific benefit and coverage details. Free quotes can be obtained from the top portion of this page for all HMO, PPO, and EPO plans. Out-of-network coverage is offered on PPO plans. Tiered networks and HSA options help lower your premium.

PPO and EPO plans utilize the national BlueCard network. Coverage is available throughout the United States with most physicians and hospitals accepting the ID card. More than 95% of all doctors and large medical facilities can be used. More than 50,000 pharmacies are available in the standard and preferred networks. The largest network of physicians and hospitals in the region provides flexible provider options for all applicants.

Changes in plans include the addition of Rite Aid in the preferred pharmacy network. Walgreens is no longer a member. Weight-loss drugs are covered for obesity treatment. Also, shingles, pneumonia, and influenza vaccines are covered. Last year, IBX collaborated with Penn Medicine and the Philadelphia Eagles to provide hands-only CPR training. Penn Medicine’s Mobile CPR project travels throughout the area teaching the correct CPR techniques.

Applying For IBX Under 65 Coverage

Applications submitted for 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. Philadelphia health insurance rates have remained fairly steady in recent years. 2024 rate change requests are Personal Choice Exchange PPO (2.56% decrease), Personal Choice OFFX EPO (2.66% decrease), Personal Choice Exchange EPO (3.03% decrease),  Personal Choice OFFX PPO (2.49% decrease), Keystone IND HMO QHP (0.79% decrease), Keystone HMO Exchange (3.44% decrease), and KHPE OFFX Individual (3.52% decrease).  On and off-Exchange plans are shown below.

Catastrophic Plans

Personal Choice EPO Catastrophic – $50 copay for first three pcp office visits. Substance abuse, behavioral health, and mental health outpatient visits are also included. Additional visits and all specialist visits must meet deductible. Policy deductible is $9,450 with maximum out-of-pocket expenses of $9,450 and 0% coinsurance.

 

Bronze Plans

Personal Choice EPO Bronze Reserve – $7,450 deductible with maximum out-of-pocket expenses of $7,450 and 0% coinsurance. All drugs and non-preventative office visits are subject to deductible.

Personal Choice PPO Bronze – $50 copay for pcp office visits. Specialist visits are subject to deductible and coinsurance. Deductible is $6,000 with maximum out-of-pocket expenses of $9,450 and 50% coinsurance. All drugs are subject to deductible and coinsurance. The generic drug copay is $35 and not subject to a deductible. Out-of-network benefits are provided, although the deductible increases to $15,000. Urgent care visits are subject to the deductible.

Personal Choice EPO Bronze Classic – $65 copay for pcp office visits.  Deductible is $4,200 with maximum out-of-pocket expenses of $9,450 and 50% coinsurance. All drugs are subject to deductible and coinsurance. Urgent care visit copay is $65.

Personal Choice EPO Bronze Basic – $20 copay for first three pcp office visits. Specialist visits are subject to deductible and coinsurance. Deductible is $9,450 with maximum out-of-pocket expenses of $9,450 and 0% coinsurance. All non-generic drugs are subject to deductible. The generic drug copay is $25..

Keystone HMO Bronze – $75 and $150 office visit copays. Deductible is $8,500 with maximum out-of-pocket expenses of $9,450 and 50% coinsurance. Routine diagnostic tests are subject to $0 and $150 copays (blood work and x-rays), and MRIs and PET and CT scans are subject to $250 copay. Rehab services are subject to $150 copay. Generic drug copay is $25. Other drugs are subject to deductible and coinsurance.

Silver Plans

Personal Choice PPO Silver Classic – $30 and $75 office visit copays. Physical and occupational therapy office visits also receive $75 copay at freestanding facilities. Speech therapy office visits also receive a $75 copay. The policy deductible is $3,500 with $8,500 maximum out-of-pocket expenses and 30% coinsurance. Low-cost and generic drug copays are $3 and $20. The out-of-network deductible is $10,000. Diagnostic tests and imaging is subject to deductible and coinsurance. $50 pediatric deductible per individual.

Keystone HMO Silver Proactive – $40 and $90 office visit copays. Physical and occupational therapy office visits also receive $90 copay. Speech therapy office visits also receive an $90 copay. The Urgent Care and ER copays are $90 and $950. Diagnostic tests are subject to a $150 copay, and imaging is subject to a $375 copay per scan. The policy deductible is $0 (Tier 1) and $6,000 (Tiers 2 and 3) with $9,450 maximum out-of-pocket expenses and 50% coinsurance.  Low-cost and generic drug copays are $7 and $25. $50 pediatric deductible per individual.

Keystone HMO Silver Proactive Select – $40 and $90 office visit copays. Physical and occupational therapy office visits also receive $90 copay. Speech therapy office visits also receive an $90 copay. The Urgent Care and ER copays are $90 and $950. Diagnostic tests are subject to a $150 copay, and imaging is subject to a $375 copay per scan. The policy deductible is $0 (Tier 1) and $6,000 (Tiers 2 and 3) with $9,400 maximum out-of-pocket expenses and 50% coinsurance. Low-cost and generic drug copays are $5 and $25. $50 pediatric deductible per individual. $50 copay for spinal manipulation visits (maximum 20 visits per year).

Keystone HMO Silver Proactive Essential – $50 and $100 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits also receive $100 copay. Speech therapy office visits also receive an $100 copay. The Urgent Care and ER copays are $100 and $975. Diagnostic tests are subject to a $150 copay, and imaging is subject to a $300 copay per scan. The policy deductible is $5,000 (Tier 1) and $8,000 (Tiers 2 and 3) with $9,450 maximum out-of-pocket expenses and 50% coinsurance. Low-cost and generic drug copays are $5 and $25. Preferred brand and non-preferred drugs are subject to 50% coinsurance. $50 pediatric deductible per individual.

Keystone HMO Silver Proactive Basic – $50 and $100 office visit copays with $0 for telemedicine calls.  Physical and occupational therapy office visits also receive $100 copay. Speech therapy office visits also receive an $100 copay. The Urgent Care and ER copays are $100 and $950. Diagnostic tests are subject to a $150 copay, and imaging is subject to a $300 copay per scan. The policy deductible is $2,500 (Tier 1) and $5,000 (Tiers 2 and 3) with $9,450 maximum out-of-pocket expenses and 50% coinsurance. Low-cost and generic drug copays are $5 and $25. Preferred brand and non-preferred drugs are subject to 50% coinsurance. $50 pediatric deductible per individual.

Keystone HMO Silver Basic – $35 and $80 office visit copays with $0 for telemedicine calls.  Physical and occupational therapy office visits also receive $80 copay. Speech therapy office visits also receive an $80 copay. The ER copay is $600. The policy deductible is $5,500 with $9,000 maximum out-of-pocket expenses and 50% coinsurance. Low-cost and generic drug copays are $5 and $25. Preferred brand and non-preferred drugs are subject to 50% coinsurance. $50 pediatric deductible per individual. $80 Urgent Care copay. $50 copay for spinal manipulation visits (maximum 20 visits per year).

Keystone HMO Silver Classic – $35 and $80 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits also receive $80 copay. Speech therapy office visits also receive an $80 copay. Urgent Care and ER visits must meet the deductible. The mental health, behavioral health, and substance abuse outpatient services copay is $70.  Diagnostic tests are subject to a $120 copay, and imaging is subject to a $250 copay per scan. The policy deductible is $3,500 with $9,000 maximum out-of-pocket expenses and 30% coinsurance. Low-cost and generic drug copays are $3 and $20. Preferred brand and non-preferred drugs are subject to 50% coinsurance. $50 pediatric deductible per individual. $50 copay for spinal manipulation visits (maximum 20 visits per year).

Keystone HMO Silver Proactive Lite – $35 and $60 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits receive $60 copay. Speech therapy office visits also receive a $90 copay. The Urgent Care copay is $90. The mental health, behavioral health, and substance abuse outpatient services copay is $90.  Routine radiology is subject to a $150 copay, and imaging is subject to a $300 copay per scan. The policy deductible is $2,000 with $9,450 maximum out-of-pocket expenses and 50% coinsurance. Low-cost and generic drug copays are $5 and $20. Preferred brand and non-preferred drugs are subject to 50% coinsurance. $50 pediatric deductible per individual. $50 copay for spinal manipulation visits (maximum 20 visits per year).

Keystone HMO Silver Proactive Value – $40 and $80 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits receive $80 copay. Speech therapy office visits also receive a $80 copay. The Urgent Care copay is $80. The mental health, behavioral health, and substance abuse outpatient services copay is $80.  Routine radiology is subject to a $150 copay, and imaging is subject to a $300 copay per scan. The policy deductible is $2,000 with $9,450 maximum out-of-pocket expenses and 50% coinsurance. Low-cost and generic drug copays are $5 and $20. Preferred brand and non-preferred drugs are subject to 50% coinsurance. $50 pediatric deductible per individual. $50 copay for spinal manipulation visits (maximum 20 visits per year).

 

Gold Plans

Keystone HMO Gold Proactive – $15 and $40 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits also receive $60 copay. Speech therapy office visits also receive an $60 copay. The Urgent Care and ER copays are $40 and $400. Diagnostic tests are subject to a $60 copay, and imaging is subject to a $120 copay per scan. The policy deductible is $0 with $9,100 maximum out-of-pocket expenses and 50% coinsurance. Generic drugs receive a $15 copay ($30 mail order). Preferred brand drugs receive a $100 copay ($200 mail order).

Keystone HMO Gold – $35 and $65 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits also receive $65 copay. Speech therapy office visits also receive an $65 copay. The Urgent Care and ER copays are $65 and $400. Diagnostic tests are subject to a $60 copay, and imaging is subject to a $120 copay per scan. The policy deductible is $0 with $8,000 maximum out-of-pocket expenses and 20% coinsurance. Generic drugs receive a $15 copay ($30 mail order). Preferred brand drugs receive a $100 copay ($200 mail order).

Personal Choice PPO Gold – $30 and $65 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits also receive $65 and $95 copays. Speech therapy office visits also receive an $65 copay. The Urgent Care and ER copays are $65 and $400. Diagnostic tests are subject to a $60 copay, and imaging is subject to a $120 copay per scan (freestanding facilities). The policy deductible is $0 with $8,000 maximum out-of-pocket expenses and 20% coinsurance. Generic drugs receive a $15 copay ($30 mail order). Preferred brand drugs receive a $100 copay ($200 mail order).

Keystone HMO Gold Classic – $40 and $80 office visit copays with $0 for telemedicine calls. Physical and occupational therapy office visits also receive $80 copays. Speech therapy office visits also receive an $80 copay. The Urgent Care and ER copays are $80 and $500. Diagnostic tests are subject to a $65 copay, and imaging is subject to a $125 copay per scan. The policy deductible is $500 with $8,000 maximum out-of-pocket expenses and 20% coinsurance. Generic drugs receive a $15 copay ($30 mail order). Preferred brand drugs receive a $100 copay ($200 mail order).

Personal Choice PPO Gold Classic – $50 pcp office visit copay with $0 for telemedicine calls. The  ER copay is $750. The policy deductible is $1,250 with $9,100 maximum out-of-pocket expenses and 20% coinsurance. Generic drugs receive a $15 copay ($30 mail order). Generic drugs receive a $15 copay ($30 mail order). Preferred brand drugs receive a $100 copay ($200 mail order).

 

Keystone HMO Proactive Tiers

Three Keystone HMO Proactive network tiers are available (Tier 1 – Preferred, Tier 2 – Enhanced, and Tier 3 – Standard). When utilizing Tier 1 physicians, specialists, hospitals, and medical facilities, your out-of-pocket expenses will be the smallest. ER, Urgent Care, and preventative expenses offer identical costs. Major hospitals in each tier are listed below:

Tier 1 Hospitals -Doylestown, Grand View, Jefferson Bucks, Lower Bucks, Chester County, Brandywine, Jennersville Regional, Phoenixville, Crozier-Chester Medical Center, Delaware County Memorial, Springfield, Taylor, St Luke’s Health Network, Albert Einstein Medical Center, Holy Redeemer, Abington, Suburban Community, Pottstown Memorial, Jefferson Frankford, Jefferson Torresdale, Roxborough Memorial, Temple University, Chestnut Hill, Virtua Willingboro, and Hackettstown Community.

Tier 2 Hospitals – Children’s Hospital Of Philadelphia, Shriner’s Hospital For Children, Fox Chase Cancer Center, St. Christopher’s Hospital For Children, Inspira Medical Center, Virtua Our Lady Of Lourdes Hospital, and A.I. Dupont Hospital For Children.

Tier 3 Hospitals – St. Joseph Medical Center, Reading Hospital And Medical Center, Paoli, Riddle, Mercy Fitzgerald, Ephrata Community, Lancaster General, Lehigh Valley, Sacred Heart, Bryn Mawr, Lankenau Medical Center, Jefferson Methodist, Penn Medicine, Temple Health, Mercy Philadelphia, Nazareth, Virtua Marlton, Virtua Memorial, Kennedy University Hospitals, Hunterdon Medical Center, Capital Health System, Inspira Medical Center, and St. Luke’s Health Network.

 

IBX Health Insurance Rates (Monthly)

25-year-old with $32,000 household income

$10 – Keystone HMO Bronze

$55 – Personal Choice EPO Bronze Basic

$82 – Personal Choice EPO Bronze Reserve

$89 – Keystone HMO Silver Proactive Essential

$103 – Keystone HMO Silver Proactive Basic

$110 – Personal Choice PPO Bronze

$125 – Keystone HMO Silver Basic

$149 – Keystone HMO Silver Proactive Lite

$165 – Keystone HMO Silver Proactive

$174 – Keystone HMO Gold Classic

$208 – Keystone HMO Silver Classic

$221 – Keystone HMO Gold Proactive

$255 – Personal Choice PPO Gold Classic

$262 – Keystone HMO Gold

$263 – Personal Choice PPO Silver

$269 – Personal Choice EPO Catastrophic

$348 – Personal Choice PPO Gold

 

35-year-old single parent with one child (2 persons) with $63,000 household income

$213 – Keystone HMO Bronze

$302 – Personal Choice EPO Bronze Basic

$355 – Personal Choice EPO Bronze Reserve

$369 – Keystone HMO Silver Proactive Essential

$398 – Keystone HMO Silver Proactive Basic

$412 – Personal Choice PPO Bronze

$441 – Keystone HMO Silver Basic

$487 – Keystone HMO Silver Proactive Lite

$519 – Keystone HMO Silver Proactive

$537 – Keystone HMO Gold Classic

$605 – Keystone HMO Silver Classic

$629 – Keystone HMO Gold Proactive

$698 – Personal Choice PPO Gold Classic

$712 – Keystone HMO Gold

$713 – Personal Choice PPO Silver

$882 – Personal Choice PPO Gold

 

40-year-old with $38,000 household income

$83 – Keystone HMO Bronze

$147 – Personal Choice EPO Bronze Basic

$183 – Personal Choice EPO Bronze Reserve

$203 – Keystone HMO Silver Proactive Basic

$217 – Personal Choice PPO Bronze

$230 – Keystone HMO Silver Basic

$259 – Keystone HMO Silver Proactive Lite

$285 – Keystone HMO Silver Proactive

$344 – Keystone HMO Gold Proactive

$349 – Keystone HMO Silver

$402 – Keystone HMO Gold

$419 – Personal Choice PPO Silver

$496 – Personal Choice PPO Gold

$516 – Personal Choice EPO Gold

 

50-year-old married couple (2 persons) with $62,000 household income

$102 – Keystone HMO Bronze

$282 – Personal Choice EPO Bronze Basic

$383 – Personal Choice EPO Bronze Reserve

$436 – Keystone HMO Silver Proactive Basic

$477 – Personal Choice PPO Bronze

$512 – Keystone HMO Silver Basic

$595 – Keystone HMO Silver Proactive Lite

$667 – Keystone HMO Silver Proactive

$831 – Keystone HMO Gold Proactive

$846 – Keystone HMO Silver

$993 – Keystone HMO Gold

$1,042 – Personal Choice PPO Silver

$1,256 – Personal Choice PPO Gold

$1,313 – Personal Choice EPO Gold

 

50-year-old married couple with two children (4 persons) with $82,000 household income

$146 – Keystone HMO Bronze

$326 – Personal Choice EPO Bronze Basic

$427 – Personal Choice EPO Bronze Reserve

$480 – Keystone HMO Silver Proactive Basic

$521 – Personal Choice PPO Bronze

$556 – Keystone HMO Silver Basic

$639 – Keystone HMO Silver Proactive Lite

$710 – Keystone HMO Silver Proactive

$875 – Keystone HMO Gold Proactive

$890 – Keystone HMO Silver

$1,037 – Keystone HMO Gold

$1,086 – Personal Choice PPO Silver

$1,300 – Personal Choice PPO Gold

$1,357 – Personal Choice EPO Gold

 

55-year-old married couple with two children (4 persons) with $92,000 household income

$69 – Keystone HMO Bronze

$379 – Personal Choice EPO Bronze Basic

$552 – Personal Choice EPO Bronze Reserve

$643 – Keystone HMO Silver Proactive Basic

$714 – Personal Choice PPO Bronze

$774 – Keystone HMO Silver Basic

$916 – Keystone HMO Silver Proactive Lite

$1,038 – Keystone HMO Silver Proactive

$1,322 – Keystone HMO Gold Proactive

$1,347 – Keystone HMO Silver

$1,601 – Keystone HMO Gold

$1,684 – Personal Choice PPO Silver

$2,052 – Personal Choice EPO Gold

$2,150 – Personal Choice PPO Gold

 

60-year-old married couple (2 persons) with $40,000 income

$0 – Keystone HMO Bronze

$0 – Personal Choice EPO Bronze Basic

$107 – Personal Choice EPO Bronze Reserve

$188 – Keystone HMO Silver Proactive Basic

$251 – Personal Choice PPO Bronze

$304 – Keystone HMO Silver Basic

$429 – Keystone HMO Silver Proactive Lite

$537 – Keystone HMO Silver Proactive

$789 – Keystone HMO Gold Proactive

$811 – Keystone HMO Silver

$1,035 – Keystone HMO Gold

$1,109 – Personal Choice PPO Silver

$1,434 – Personal Choice EPO Gold

$1,521 – Personal Choice PPO Gold

 

Independence Blue Cross Medicare Plans For Seniors

 

Medicare Supplement Monthly Rates (Medigap Freedom Plans)

Male Age-65

$68 – Plan G (HD)

$147 – Plan A

$157 – Plan N

$178 – Plan B

$203 – Plan G

 

Female Age-65

$62 – Plan G (HD)

$133 – Plan A

$143 – Plan N

$162 – Plan B

$185 – Plan G

 

Male Age-70

$77 – Plan G (HD)

$85 – Plan F (HD)

$166 – Plan A

$180 – Plan N

$202 – Plan B

$231 – Plan G

$255 – Plan F

 

Female Age-70

$70 – Plan G (HD)

$78 – Plan F (HD)

$151 – Plan A

$164 – Plan N

$184 – Plan B

$210 – Plan G

$232 – Plan F

Medicare Advantage With Prescriptions (Parts C and D)

MA contracts allow private insurers (IBX) to provide your healthcare benefits. Coverage includes Parts A and B, along with preventative care. Depending upon the carrier and plan, vision and hearing, prescription drugs, and YMCA and fitness club memberships may also be provided. Part B premiums must be paid if you enroll in an Advantage plan. Shown below are the current available plans in Philadelphia County. Rates and copays may slightly vary in Montgomery, Chester, Bucks, and Delaware Counties.

Keystone 65 Focus RX HMO-POS – Cost is $0 per month. $0 deductible and $6,500 maximum out-of-pocket expenses. Office visit copays are $0 and $40. The inpatient hospital copay is $210 for the first six days. The outpatient hospital copay is $325 per visit. The ER copay is $100 and the Urgent Care copay is $10-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$160 copay, and outpatient x-rays are subject to a $30 copay. Skilled nursing facility coverage has no copay for days 1-20. A $203 copay applies to days 21-100. Physical therapy is subject to a $20 copay, and the ambulance copay is $230 (one way). Hearing, preventative dental, and vision office visit copays are $0-$40. $25 copay for foot care. 8,025 members are enrolled in Pennsylvania.

There is no prescription drug deductible. The one month drug copays are $0 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $16 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5).

Keystone 65 Basic RX HMO – Cost is $0 per month. $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $0 and $35. The inpatient hospital copay is $250 for the first seven days. The outpatient hospital copay is $350 per visit. The ER copay is $100 and the Urgent Care copay is $15-$55. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$170 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $203 copay applies to days 21-100. Physical therapy is subject to a $25 copay, and the ambulance copay is $240 (one way). Hearing, preventative dental, and vision office visit copays are $0-$35. $25 copay for foot care.

There is no drug deductible. The one month drug copays are $0 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $16 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5). 22,505 members are enrolled in Pennsylvania.

Keystone 65 Select RX HMO – Cost is $50.50 per month. $0 deductible and $5,650 maximum out-of-pocket expenses. Office visit copays are $0 and $40. The inpatient hospital copay is $275 for the first six days. The outpatient hospital copay is $350 per visit. The ER copay is $120 and the Urgent Care copay is $15-$60. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$200 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $203 copay applies to days 21-100. Physical therapy is subject to a $20 copay, and the ambulance copay is $225 (one way). Hearing, preventative dental, and vision office visit copays are $0-$40. $20 copay for foot care.

There is no drug deductible. The one-month drug copays are $0 (Tier 1), $7 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $14 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5).

Keystone 65 Preferred RX HMO – Cost is $179 per month. $0 deductible and $3,900 maximum out-of-pocket expenses. Office visit copays are $0 and $40. The inpatient hospital copay is $225 for the first six days. The outpatient hospital copay is $350 per visit. The ER copay is $100 and the Urgent Care copay is $5-$55. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-150 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $203 copay applies to days 21-100. Physical therapy is subject to a $20 copay, and the ambulance copay is $150 (one way). Hearing, preventative dental, and vision office visit copays are $0-$40.

There is no drug deductible. The one-month drug copays are $0 (Tier 1), $7 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $14 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5).

Keystone First VP Choice HMO D-SNP – Cost is $0 per month.  Office visit copays are $0. The inpatient hospital copay is $0. The outpatient hospital copay is $0. The ER copay is $0 and the Urgent Care copay is $0. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0 copay, and outpatient x-rays are subject to a $0 copay. Skilled nursing facility coverage has no copay.  Physical therapy is subject to a $0 copay, and the ambulance copay is $0 (one way).

There is no drug deductible. The one-month drug copays are $7.75 (Tier 1) and 25% (Tier 2). The three-month mail order drug copays are $23.25 (Tier 1) and 25%.

Personal Choice 65 Rx PPO – $277 deductible and $5,000 maximum out-of-pocket expenses. Office visit copays are $0 and $35. The inpatient hospital copay is $240 for the first six days. The outpatient hospital copay is $300 per visit. The ER copay is $95 and the Urgent Care copay is $5-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-175 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $196 copay applies to days 21-100. Physical therapy is subject to a $20 copay, and the ambulance copay is $175 (one way).

The one-month drug copays are $0 (Tier 1), $7 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $14 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5).

Personal Choice 65 Elite Rx PPO – $0 deductible and $6,500 maximum out-of-pocket expenses. Office visit copays are $0 and $35. The inpatient hospital copay is $525. The outpatient hospital copay is $250. The ER copay is $95 and the Urgent Care copay is $5-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$275 copay, and outpatient x-rays are subject to a $35 copay. Skilled nursing facility coverage has no copay for days 1-20. A $196 copay applies to days 21-100. Physical therapy is subject to a $30 copay, and the ambulance copay is $225 (one way).

The one-month drug copays are $0 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $16 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5).

Personal Choice 65 Prime Rx PPO – $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $0 and $35. The inpatient hospital copay is $250 for seven days. The outpatient hospital copay is $375. The ER copay is $95 and the Urgent Care copay is $10-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$200 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $196 copay applies to days 21-100. Physical therapy is subject to a $30 copay, and the ambulance copay is $250 (one way).

The one-month drug copays are $0 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $16 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5).

Personal Choice 65 Saver Rx PPO – $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $10 and $50. The inpatient hospital copay is $350 for five days. The outpatient hospital coinsurance is 20%. The ER copay is $95 and the Urgent Care copay is $15-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$284 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $196 copay applies to days 21-100. Physical therapy is subject to a $40 copay, and the ambulance copay is $260 (one way).

The one-month drug copays are $0 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4) and 33% (Tier 5). The three-month mail order drug copays are $0 (Tier 1), $16 (Tier 2), $94 (Tier 3), $200 (Tier 4) and 33% (Tier 5).

Medicare Advantage Without Prescriptions (Part C)

Keystone 65 Select Medical Only – $34.50 per month with $4,900 maximum out-of-pocket expenses. Office visit copays are $0 and $40. The inpatient hospital copay is $250 for the first six days. The outpatient hospital copay is $350 per visit. The ER copay is $90 and the Urgent Care copay is $15-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$200 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $184 copay applies to days 21-100. Physical therapy is subject to a $20 copay, and the ambulance copay is $250 (one way).

Keystone 65 Preferred Medical Only – $178 per month with $4,000 maximum out-of-pocket expenses. Office visit copays are $0 and $40. The inpatient hospital copay is $225 for the first six days. The outpatient hospital copay is $350 per visit. The ER copay is $90 and the Urgent Care copay is $5-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$150 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $170 copay applies to days 21-100. Physical therapy is subject to a $20 copay, and the ambulance copay is $150 (one way).

Personal Choice 65 Medical Only – $184 per month with $5,000 maximum out-of-pocket expenses. Office visit copays are $5 and $35. The inpatient hospital copay is $240 for the first six days. The outpatient hospital copay is $300 per visit. The ER copay is $90 and the Urgent Care copay is $5-$40. Diagnostic tests and procedures, and lab services have a $0 copay while diagnostic radiology services are subject to a $0-$175 copay, and outpatient x-rays are subject to a $40 copay. Skilled nursing facility coverage has no copay for days 1-20. A $184 copay applies to days 21-100. Physical therapy is subject to a $20 copay, and the ambulance copay is $175 (one way).

Dental Plans For Adults

Coverage is administered by United Concordia, who is independent of IBX. QCC underwrites each policy. Preventative benefits are covered at 100%, and a large network of dentists is provided. The two available plans are listed below:

Adult Dental Preferred – $50 deductible per person and $150 deductible per family. $1,000 maximum annual benefits per person. Exams, cleanings, x-rays, consultations, and emergency treatment covered at 100% with no waiting period. An annual exam and cleaning is allowed, along with bitewing x-rays every 2-3 years, depending on age. Extractions, root canals, fillings, periodontics and oral surgery are covered at 50% after the deductible has been met. No waiting period for fillings and extractions. Crowns and dentures are not covered. However, repairs to crowns and dentures are covered at 50% after 12-month waiting period.

Monthly rates are $17.55 (ages 19-25), $18.65 (ages 26-39), $21.94 (ages 40-49), $25.78 (ages 50-63), and $26.33 (ages 64 and above).

Adult Dental Premier – $50 deductible per person and $150 deductible per family. $1,000 maximum annual benefits per person. Benefits paid for cleanings, exams, x-rays, and emergency treatment are not applied towards annual maximum. Exams, cleanings, x-rays, consultations, and emergency treatment covered at 100% with no waiting period. A semi-annual exam and cleaning is allowed, along with bitewing x-rays every 18 months. Extractions, root canals, fillings, periodontics and oral surgery are covered at 80% after the deductible has been met. No waiting period for fillings and extractions. Crowns and dentures are covered at 50% after deductible and waiting period. However, repairs to crowns and dentures are covered at 80% after 12-month waiting period.

Monthly rates are $31.42 (ages 19-25), $33.38 (ages 26-39), $39.27 (ages 40-49), $46.14 (ages 50-63), and $47.12 (ages 64 and above).

Vision Plans For Adults

Davis Vision administers plans, and a 30-day waiting period applies to all contracts (supplies and services). The two available plans are listed below:

Adult Vision Care 100 – One annual eye exam is covered with a $0 copay. Davis Vision provides the selection of frames. Fashion, Designer, and Premier frames are subject to copays of $0, $15, and $40. A $100 non-collection frame allowance is included. Lens copays are $0 for clear plastic single vision, trifocal, and lined bifocal, $15 for tinted lens, $0 for scratch-resistant coating, $35 for polycarbonate lenses, $0 for ultraviolet coating, $40, $55, and $69 for anti-reflective coating, $65, $105, and $140 for progressive lenses, $60 for high index lenses, $70 for transition lenses, and $75 for polarized lenses.

Additional contact lens benefits include four multi-pack boxes of disposable lenses, two multi-pack boxes of planned replacement, evaluation, fitting and follow-up visits. Non-collection contacts receive a material allowance of $100 and a 15% discount. Medically necessary contacts (materials, evaluation, fitting, and follow-up) are covered. Out-of-network reimbursement is $40 (eye examination), $50 (frames), $40 (single lens), $60 (bifocal/progressive lens), $80 (trifocal lens), $80 (elective contact lens), and $225 (medically necessary contacts). Monthly rates are $13.21 for an individual, $26.41 for an individual and one dependent, and $39.62 for an individual and two or more dependents.

Adult Vision Care 180 – One annual eye exam is covered with a $0 copay. Davision Vision provides the selection of frames. Fashion, Designer, and Premier frames are subject to copays of $0, $15, and $25. A $130-$180 non-collection frame allowance is included. Lens copays are $0 for clear plastic single vision, trifocal, and lined bifocal, $0 for tinted lens, $0 for scratch-resistant coating, $0 for polycarbonate lenses, $0 for ultraviolet coating, $35, $48, and $60 for anti-reflective coating, $50, $90, and $140 for progressive lenses, $55 for high index lenses, $65 for transition lenses, and $75 for polarized lenses.

Additional contact lens benefits include four multi-pack boxes of disposable lenses, two multi-pack boxes of planned replacement, evaluation, fitting and follow-up visits. Non-collection contacts receive a material allowance of $130 and a 15% discount. Medically necessary contacts (materials, evaluation, fitting, and follow-up) are covered. Out-of-network reimbursement is $40 (eye examination), $50 (frames), $40 (single lens), $60 (bifocal/progressive lens), $80 (trifocal lens), $105 (elective contact lens), and $225 (medically necessary contacts).  Monthly rates are $14.17 for an individual, $28.33 for an individual and one dependent, and $42.50 for an individual and two or more dependents.

Health And Wellness Benefits Included On Plans

Achieve Well-Being – Personalized inline tools that assist policyholders. Customers will receive assistance in managing weight, sleeping better, reducing and managing stress, and improving fitness. Badges and tokens are given for specific achievements.

Financial Well-Being – Two programs are offered to help with security and financial health. “GradFin” helps lower student debt and increase college savings in the household. Financial education, student loan refinancing, and PSLF (Public Service Loan Forgiveness) are topics that are discussed. “College Tuition Benefit” provides cash to help pay college expenses. $2,000 tuition points ($2,000) are annually provided after enrolling in the program. A $2,500 bonus is awarded in the fourth year.

Health Coaches – Qualified assistance from an RN is available 24/7. Areas of help include common health concerns, lifestyle choices, understanding diagnosis and condition, treatment and self-care skills, doctor visit preparation, and important decision-making.

Nutrition Counseling – Registered dieticians provide six free visits for each covered member.  Possible benefits include lower risk of stroke and heart disease, lower levels of cholesterol, more energy, and lower blood pressure readings.

Preventive Care – Keep minor medical issues from becoming major medical conditions. Immunizations, screenings, and annual physicals are covered services.

Reimbursements And Discounts – Participating options include GlobalFit (membership discounts at gyms), IBX Good Living (coupons for personal care products, health articles, and recipes), Blue365 (discounts and cost-reductions on weight-loss programs and gym memberships, and Blue Insider (discounts at sports events, movie tickets, Broadway shows, museums, hotels, and other shopping activities).

International Health Insurance Plans

Short-term and long-term international travel creates a need for specialized benefits. Standard Marketplace and domestic plans may leave gaps that result in thousands of dollars of out-of-pocket expenses. “GeoBlue” policies provide solid protection for an affordable price. Common benefits include office visits, prescriptions, ER care, hospitalization, non-emergency visits, and medical evacuation.

The monthly cost of coverage for a 50-year-old married couple (residing in the Philadelphia area) is $35.84 ($50,000 medical coverage with $500 deductible), $48.58 ($100,000 medical coverage with $100 deductible), and $61.74 ($1 million medical coverage with $0 deductible).

After the deductible is met, the following benefits are fully covered: surgery, anesthesia, diagnostic x-rays and lab tests, inpatient medical emergency, and ambulance service (up to $1,000). Additional benefits include accidental death and dismemberment, repatriation of remains, emergency medical transportation, personal effects and lost baggage coverage, and emergency family travel arrangements.

Small Business Plans

“Blue Solutions” provides many options for medical coverage, including HMO, EPO, POS, and PPO plans. High deductible health plans (HDHP) are also offered for employees that prefer lower premiums, spending accounts, and tax deductions when paying for qualified expenses. Dental benefits for children, and vision benefits for adults and children are provided on all plans. The drug formulary offers low-cost generic, brand, and specialty options, while a preferred pharmacy network features more than 50,000 locations. Self-service tools allow employees to better customize and track their coverage. Several popular Group policies are listed below:

Personal Choice PPO Platinum Preferred $10/$20/$150 – $0 deductible with $3,500 maximum out-of-pocket expenses. Office visit copays are $10 and $20, with Urgent Care and ER copays of $70 and $125. The inpatient hospital services copay is $150 per day (maximum five days). Generic, preferred brand, and non-preferred brand prescription copays are $7, $40, and $70.

Keystone HMO Platinum Preferred $10/$20/$100 – $0 deductible with $3,500 maximum out-of-pocket expenses. Office visit copays are $10 and $20, with Urgent Care and ER copays of $75 and $125. The inpatient hospital services copay is $100 per day (maximum five days). Generic, preferred brand, and non-preferred brand prescription copays are $7, $40, and $70.

Personal Choice PPO Gold Classic $1,000/$15/$30/80% – $1,000 deductible with $5,500 maximum out-of-pocket expenses. Office visit copays are $15 and $30, with Urgent Care and ER coinsurance of 20% after the deductible. The inpatient hospital services coinsurance is 20% after the deductible. Generic, preferred brand, and non-preferred brand prescription copays are $7, $50, and $150.

Keystone HMO Gold Classic $1,000/$25/$50/90% – $1,000 deductible with $5,500 maximum out-of-pocket expenses. Office visit copays are $25 and $50, with Urgent Care and ER coinsurance of 10% after the deductible.  The inpatient hospital services coinsurance is 10% after the deductible. Generic, preferred brand, and non-preferred brand prescription copays are $7, $50, and $150.

Personal Choice PPO Silver Classic $3,000/$30/$60/70% – $3,000 deductible with $7,350 maximum out-of-pocket expenses. Office visit copays are $30 and $60, with Urgent Care copay of $125 and ER coinsurance of 30% after the deductible. The inpatient hospital services coinsurance is 30% after the deductible. Generic, preferred brand, and non-preferred brand prescription copays are $7, 50%, and 50%.

Keystone HMO Silver Classic $4,000/$25/$50/70% – $4,000 deductible with $7,350 maximum out-of-pocket expenses. Office visit copays are $25 and $50, with Urgent Care and ER coinsurance of 30% after the deductible.  The inpatient hospital services coinsurance is 30% after the deductible. Generic, preferred brand, and non-preferred brand prescription copays are $7, 50%, and 50%.

Keystone HMO Bronze Essential $6,850/$50/$100/700 – $6,850 deductible with $7,350 maximum out-of-pocket expenses. Office visit copays are $50 and $10, with Urgent Care and ER copays of $150 and $500 after the deductible.  The inpatient hospital services copay is $700 after the deductible. Generic, preferred brand, and non-preferred brand prescriptions are subject to a deductible.

Personal Choice PPO Bronze HSA 0 $6,650/100% – HSA-eligible plan with $6,650 deductible, $6,650 maximum out-of-pocket expenses and 0% coinsurance.

Personal Choice PPO Bronze HSA 0 $5,200/50% – HSA-eligible plan with $5,200 deductible, $6,650 maximum out-of-pocket expenses and 50% coinsurance.

Large Business Group Benefit Plans

IBX provides a robust portfolio, innovative plans, and  the Power of Blue, to help keep rates down. Telemedicine services, healthy lifestyle reimbursements, tiered networks, and college tuition benefits are offered. Several plans are illustrated below:

51-99 Employees

Personal Choice PPO Keystone DPOS/POS $50/$80/$500 +$250 – $0 deductible, 0% coinsurance, and $7,900 maximum out-of-pocket expenses. $50 and $80 office visit (pcp and specialist) copays, with $0 and $100 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $80. The inpatient hospital copay is $500 per day for 5 days and the ER copay is $300.

Personal Choice PPO Keystone DPOS/POS $40/$70/$500 – $0 deductible, 0% coinsurance, and $7,900 maximum out-of-pocket expenses. $40 and $70 office visit (pcp and specialist) copays, with $0 and $100 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $70. The inpatient hospital copay is $500 per day for 5 days and the ER copay is $300.

Personal Choice PPO Keystone DPOS/POS $30/$60/$400 – $0 deductible, 0% coinsurance, and $7,900 maximum out-of-pocket expenses. $30 and $60 office visit (pcp and specialist) copays, with $0 and $100 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $60. The inpatient hospital copay is $400 per day for 5 days and the ER copay is $300.

Personal Choice PPO Keystone DPOS/POS $20/$40/$250 – $0 deductible, 0% coinsurance, and $7,900 maximum out-of-pocket expenses. $20 and $40 office visit (pcp and specialist) copays, with $0 and $85 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $40. The inpatient hospital copay is $250 per day for 5 days and the ER copay is $250.

Personal Choice PPO $15/$35/$150 – $0 deductible, 0% coinsurance, and $7,900 maximum out-of-pocket expenses. $15 and $35 office visit (pcp and specialist) copays, with $0 and $70 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $35. The inpatient hospital copay is $150 per day for 5 days and the ER copay is $200.

Keystone POS $3,500/$20/$40/70% – $3,500 deductible, 30% coinsurance, and $7,900 maximum out-of-pocket expenses. $20 and $40 office visit (pcp and specialist) copays, with $0 and $85 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $40. The inpatient hospital copay is 30% after the deductible and the ER copay is $250.

Personal Choice PPO Keystone DPOS POS $2,000/$30/$60/80% – $2,000 deductible, 20% coinsurance, and $7,900 maximum out-of-pocket expenses. $30 and $60 office visit (pcp and specialist) copays, with $0 and $100 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $60. The inpatient hospital copay is 20% after the deductible and the ER copay is $300.

Personal Choice PPO Keystone DPOS POS $3,000/$30/$60/80% – $3,000 deductible, 10% coinsurance, and $7,900 maximum out-of-pocket expenses. $30 and $60 office visit (pcp and specialist) copays, with $0 and $100 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $60. The inpatient hospital copay is 10% after the deductible and the ER copay is $300.

Personal Choice PPO Keystone DPOS POS $4,000/$30/$60/80% – $4,000 deductible, 10% coinsurance, and $7,900 maximum out-of-pocket expenses. $30 and $60 office visit (pcp and specialist) copays, with $0 and $100 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $60. The inpatient hospital copay is 10% after the deductible and the ER copay is $300.

Personal Choice PPO Keystone DPOS POS $5,000/$30/$60/90% – $5,000 deductible, 10% coinsurance, and $7,900 maximum out-of-pocket expenses. $30 and $60 office visit (pcp and specialist) copays, with $0 and $100 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $60. The inpatient hospital copay is 10% after the deductible and the ER copay is $300.

Personal Choice PPO $1,500/$20/$40/100% – $1,500 deductible, 0% coinsurance, and $7,900 maximum out-of-pocket expenses. $20 and $40 office visit (pcp and specialist) copays, with $0 and $85 Telemedicine and Urgent Care copays. Occupational therapy and spinal manipulation copays are $40. The inpatient hospital copay is 0% after the deductible and the ER copay is $250.

Grandfathered Contracts

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).

Older Plans

The two available types of Keystone HMO policies were “deductible” and “copay.” The Blue Cross “deductible” contracts were the HMO $8,000 (introduced in 2012), HMO $5,000, HMO $2,500 and HMO $1,500 plans. “Deductible” plans were the most affordable type of coverage, since the policy owner incurred a higher out-of-pocket expense on expensive claims. After the deductible, the insured was responsible for 30% of medical expenses, subject to maximum limits. Office visits were covered with a low $30 copay. Outpatient lab tests were covered at 100% and maternity benefits were also included once the deductible had been met.

The Blue Cross “copay” plans were the HMO $20, HMO $15 and HMO $10. “Copay” policies were 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 was a maximum of five copays per admission. This plan was one of the most popular policies in the state and also mirrored 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.

PAST UPDATES:

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.

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.

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.

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.

Annual net income  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 carriers hard 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. Numbers are expected to improve, as many “preparation” expenses for Marketplace products will decline.