Tandem PPO 1 HSA. PERS Care PPO . Address 206 S 6th Avenue West Reading, PA 19611. Best Medicare Advantage Plans: Compare & Save on 2022 Plans $210 copayment per day . Authorization for Release of Personal Information. The Keystone 65 Basic Rx (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $7,550 (MOOP). Plan - Option Enrollment Code 2020 Total Biweekly Premium 2021 Biweekly Postal Premium Rates - Category 1 Total Premium Health Plan; Harvard Pilgrim Health Care of New England Ambetter (offered by Celtic Insurance Company) . BSW SeniorCare Advantage HMO Plan Documents 11 For all Keystone HMO Proactive plans, the out-of-pocket maximum for Tiers 1, 2, and 3 are combined. 2020 Evidence of Coverage . The following is a summary of HOP initiatives during the period January 1, 2020 to January 1, 2021. . $57.50 monthly plan premium in Bucks and Philadelphia counties; $83.50 in Chester, Delaware, Montgomery. Keystone 65 Focus Rx HMO (Keystone 65 Focus) is an Independence Blue Cross (Independence) Medicare Advantage HMO benefit product. What's new for 2020 Medicare Advantage plans? myBlue 1601 Coverage Period: 01/01/2020 - 12/31/2020 Bronze Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage for: Individual and/or Family | Plan Type: HMO 1 of 7 SBCID: 1907243 The Summary of Benefits and Coveragethe(SBC) document will help youGlossarychoose a health plan. PDF Summary of Benefits and Coverage (SBC) To view your coverage policy document, select the size of your employer group, then the plan name listed at the top . Employee Only $20.00 $737.02 Employee + 1 $30.00 $1,484.04 Family $40.00 $1,928.25 . Keystone 65 Basic Rx HMO, Keystone 65 Focus Rx HMO-POS, Keystone 65 Select Click here for Individual/Family plans Helping you stay healthy is what matters most to us. Medicare Advantage Plans - Health Net 2020 Blue Shield 65 Plus (HMO) Benefit Summary. Main (484)628-5437. Reading Hospital Children's Health Center. Premium Payment CPP Fillable Form. That's a lot of more. Employee Only $205.64 $1,089.05 Use the Search box below to search for an SBC by Group Number or Plan Number. $65 Copay; NOTE: The above serves only as a high level summary, for further details . There are also ways to bundle several plans into one for even more savings. This plan includes additional Medicare prescription drug (Part-D) coverage. If the SBC in the language you are searching for is not available at this time, please contact your Aetna representative for further assistance. Employee Only $205.64 $1,089.05 Getting to know Dr. Ashwini Sharan. $0 copay medical and behavior health telemedicine visits through MDLIVE. Members must have a prescription from a health care Practitioner. If you need help finding a network provider and/or pharmacy, please call to 1-800-645-3965 (TTY/TDD: 711) for Keystone 65 HMO or 1-888-718-3333 (TTY/TDD: 711) for Personal Choice 65 PPO, seven days a week, 8 a.m. to 8 p.m. Health Net Gold Select (HMO) is a Medicare Advantage Prescription Drug (MAPD) plan that provides comprehensive medical and prescription drug coverage, plus valuable health essentials at low, predictable costs. Plans & Rates - CalPERS Group benefit plans. Silver & Fit Wellness Program. BlueChoice 65 Select - Blue Cross and Blue Shield of Louisiana CHRISTUS Health Plan Generations is an HMO plan with a Medicare contract. At these hospitals, you do not have to pay the Part A deductible and coinsurance. Healthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company ®, Capital Advantage Assurance Company ® and Keystone Health Plan ® Central. This plan is available in PA. benefit provided to eligible retirees or discounts available to individuals enrolling at age 65. No: OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. With little or no premium increases, these plans offer benefits centered around improving affordability for members - offering several ways to save on many of . Physician Office. The Keystone 65 Select Medical Only (HMO) has a monthly premium of $49.50 and has an in-network Maximum Out-of-Pocket limit of $4,900 (MOOP). To join Keystone 65 Basic Rx HMO, Keystone 65 Focus Rx HMO-POS, Keystone 65 Select Medical-Only HMO, or Keystone 65 Select Rx HMO, you must be entitled to Medicare Part A, be enrolled in Medicare Part B, and live in our service area. This is only a summary. Keystone 65 Basic HMO, Keystone 65 Focus HMO, Keystone 65 Select HMO Summary of Benefits; Keystone 65 Preferred HMO Summary of Benefits; Personal Choice 65 PPO Summary of Benefits; Call us at 1-877-393-6733 (711 for the speech- and hearing-impaired), 8 a.m. to 8 p.m., seven days a week. - $65 for a Tier 1 specialist/$85 for a non-tier specialist. Annual Notice of Changes for 2020 You are currently enrolled as a member of Keystone 65 Select Medical-Only. You will find a detailed list of topics at BlueChoice 65 Select. Advantage Select (HMO D-SNP) X Anthem Blue Cross and Blue Shield Anthem MediBlue ESRD (HMO- Benefit tier re-evaluation for Keystone HMO Proactive Posted: 10/1/2015. Welcome to your 2022 Over-the-Counter Benefit, administered by Fieldtex. HMO = Health Maintenance Organization PFFS = Private Fee-For-Service Cost = Cost Contract SNP = Special Needs Plan . $0 primary care physician copays. With no copayment or premium increases, these new benefits are centered around improving affordability for members. Blue Cross Blue Shield of Massachusetts provides a Summary of Benefits and Coverage (SBC) with online access to the corresponding coverage policy to all of our fully insured members and accounts. With six plan designs to choose from, Keystone 65 Select HMO can help you meet your employees' coverage needs and stay within your Health Insurance Choices for 2020 October 2019 . Keystone First VIP Choice (HMO-SNP) 2022 Over-the-Counter Benefits Preventative Health Products at No Cost to You. Keystone 65 Select Rx (HMO) Medicare Plan Details 2022 Plan. The Keystone 65 Select Rx (HMO) has a monthly premium of $56.50 and has an in-network Maximum Out-of-Pocket limit of $4,900 (MOOP). The following is a summary of HOP initiatives during the period January 1, 2018 to January 1, 2019. . Western Health Advantage HMO . No copayment on day of discharge. Note: To view SBC documents from your smartphone or tablet, the free WinZip app is required. Pick & Choose from the top Philadelphia Area Doctors & Hospitals. Medicare Advantage plans are the private health insurance alternative to Original Medicare. The Keystone 65 Basic Rx (HMO) has a monthly premium of $- and has an in-network Maximum Out-of-Pocket limit of $6,700 (MOOP). The examples are meant to help you understand what you might pay, and compare . care benefits summary for . 2022 - Summary of Benefits - SCAN Balance (HMO SNP) - Los Angeles - English. We'll insure you do. please contact our Member Help Team: Keystone 65 at 1-800-645-3965, Personal Choice 65 at 1-888-718-3333, Select Option at 1-888-678-7009 or, for TTY/TDD users, 711, seven days a week from 8 a.m. to 8 p.m. Let's break down some more details of . Keystone First covers over-the-counter medicines for all members who are eligible for pharmacy benefits. Keystone 65 Select HMO is a Medicare Advantage plan from Independence Blue Cross (IBX) that combines all of the benefits of Original Medicare plus value-added benefits in one convenient plan. - $40 copay for primary care visit. All health plan companies are required to . Starting January 1, 2020, Independence will offer several new and innovative benefits to our Keystone 65 Basic HMO, Keystone 65 Focus HMO-POS, Keystone 65 Preferred HMO, Keystone 65 Select HMO, and Personal Choice 65 SM PPO members. The benefit information provided is a brief summary, not a complete description of benefits. Keystone 65 Basic Rx (HMO) H3952-056 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Keystone 65 HMO available to residents in Pennsylvania. Dental Benefits PSERS RFP 2020-3. Medicare Advantage Plans. PERS Gold (PPO) is available as of January 1, 2022. Keystone-65. These documents also show your estimated costs for two sample medical events: having a baby and managing diabetes. Reading Hospital Center for Public Health. Summary rating of health plan quality 5. H3952 Y0041_H3952_KS_M_20_76201 2020 Summary of Benefits Effective January 1, 2020 through December 31, 2020 • Keystone 65 Preferred Medical-Only HMO keystone health plan east h3952-049 keystone 65 select rx (hmo) yes $4.30 yes $52.20 keystone health plan east h3952-051 keystone 65 select rx (hmo) yes $35.10 yes $47.40 keystone health plan east h3952-053 keystone 65 focus rx (hmo) yes $0.00 yes $0.00 keystone health plan east h3952-054 keystone 65 focus rx (hmo) yes $0.00 yes $15.00 The SBC shows you how you andcallthe1-800-352-2583plan would share the cost for covered health care services. Keystone 65 Select RX HMO - Cost is $56.50 per month. The inpatient hospital copay is $250 for the first six days. Keystone Health Plan East, Inc. Medicare HMO 15 95056 Keystone 65 Keystone Health Plan East, Inc. POS 33 95056 Keystone Select Keystone Health Plan West, Inc. HMO 35 95048 Keystone Blue or Community Blue HMO Keystone Health Plan West, Inc. Medicare HMO 15 95048 Security Blue Optimum Choice, Inc. of PA HMO 45 95225 (Also known as OCI-PA) . Learn more about our HMO insurance plans. If you are unable to locate your SBC, or wish to have an SBC sent to you free of charge, call 1-800-352-2583. 2 Choices 2020/Active. Upcoming Medicare Advantage HMO and PPO benefit changes Posted: 10/1/2015. Please note that on weekends and holidays from April 1 through September 30, your call may be sent to voicemail. Find a hospital or location. 2020 Evidence of Coverage. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. This summary does not reflect each and every benefit, exclusion and limitation which may apply to the coverage. Independence Blue Cross Keytone 65 Medicare Advantage Plans for Seniors & Medicare Eligible. Medicare Help | Compare Medicare Advantage and Part-D Plans Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, plan ratings, accepted doctors and more. Nondiscrimination and Accessibility Requirements & Language Assistance Services. Live well. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Keystone 65 Focus now available for 2016 Posted: 10/30/2015. Blue Shield Access+ EPO. Keystone 65 Select Medical-Only (HMO) offered by Keystone Health Plan East, Inc. BlueChoice 65 Select, our series of Medicare Select plans, offers lower premiums by using a select network of hospitals for inpatient services. Keystone 65 Focus Rx HMO, our new Medicare Advantage benefit product Posted: 10/1/2015. Temple University Hospital - Main Campus accepts most area insurance plans. Choosing a health coverage option is an important decision. Keystone HMO Silver Proactive Value The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Keystone 65 Select Rx HMO. •. Table of Contents This list of chapters and page numbers is your starting point. Address 301 S 7th Ave Ste 3170 West Reading, PA 19611-1450. Prescription Drug Benefits Tier drug costs for: Standard retail pharmacy drug cost for 1-month. Remember: As long as you are a member of our plan you must not use your red, white, and blue Medicare card to get covered medical services (with the exception of routine clinical research studies and hospice services). Enrollment in CHRISTUS Health Plan Generations depends on contract renewal. $0 deductible and $4,900 maximum out-of-pocket expenses. MercyCare Health Plans Contact Information 580 N. […] The SBCs in Mandarin, Tagalog, Spanish, and Navajo are provided upon request. For more information, contact the plan. PERS Care PPO . Independence continues to offer innovative benefits to our Keystone 65 Basic HMO, Keystone 65 Focus HMO-POS, Keystone 65 Preferred HMO, Keystone 65 Select HMO, and Personal Choice 65 SM Prime Rx PPO members for the 2021 benefit year. turning 65 in 2020 or if you are planning to retire in the coming year and will become Medicare primary. Copays for doctor visits. Dr. Sharan is an internationally-recognized neurosurgeon who specializes in using surgery and electrical stimulation of the brain, spinal cord and nerves to help patients with treatment-resistant disorders, such as epilepsy, Parkinson's disease, headaches, chronic spinal pain and other neurological afflictions. Summary of Benefits - Blue Shield 65 Plus Choice Plan (HMO) - Los Angeles County (partial)/Orange County We all have the right to live a healthy, limitless life We're a California-based health plan that's been serving Californians since 1939. Deductible. Plus, these plans often have extras, such as coverage for prescription drugs, vision, dental, and hearing aids. Keystone 65 Select Medical-Only HMO Keystone 65 Select Rx HMO Inpatient Hospital Coverage (1) $250 copayment per day for days 1 through 7 per admission You pay nothing per day for days 8 and beyond per admission; $1,750 maximum copayment per admission. Summary of Benefits and Coverage 6 NYSHIP's Young Adult Option 6 Benefits Overview 7 . 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 . Increased Benefits Plan ( HMO) The Healthfirst Increased Benefits Plan is a Medicare Advantage plan made for those who qualify for full Extra Help (also known as Low Income Subsidy (LIS), which helps lower prescription drug costs) and/or a Medicare Savings Programs (MSP, which helps pay for some Medicare premiums, copays or coinsurance amounts). You can still choose almost any doctor. | 2021 Health Benefit Summary CalPERS Health Plan Choices Depending on where you reside or work, your Basic and Medicare health plan options may include the following: . If you have any questions about accepted insurance plans at Temple University Hospital, please call 215-707-7608. To find the best plans available where you live, enter your 5-digit ZIP CODE in the box below. You must continue to pay your Part B premium. Specific terms of coverage are listed in the Summary of Benefits and Coverage and the Evidence of Coverage (Member Handbook), including plan limitations and exclusions. To help you make an informed choice, this plan makes available a Summary of Benefits and Coverage (SBC) about each of its . Map & Directions. This plan includes additional Medicare prescription drug (Part-D) coverage. X Blue Shield of California Blue Shield 65 Plus (HMO) X Blue Shield of California Blue Shield 65 Plus Choice Plan (HMO) . This information is not a complete description of benefits. Tiers . This booklet tells about the changes. NOTE: Information about the cost of this plan (called the premium) will be provided separately. •. Maybe you've heard the term, Summary of Benefits and Coverage — also called "SBC.". The outpatient hospital copay is $350 per visit. Keystone HMO Proactive 10 For Keystone HMO Silver Proactive the deductible is combined for Tiers 2 and 3. 2020 Medicare Advantage Plan Details. The Summary of Benefits and Coveragethe(SBC) document will help youGlossarychoose a health plan. 2022 ACA Summary of Benefits & Coverage (SBC) The Federal Employees Health Benefits (FEHB) Program offers numerous health benefits plans and coverage options. HMO Central Texas Plan Change Form. This plan includes additional Medicare prescription drug (Part-D) coverage. Reading Hospital Center for Public Health. Kaiser HMO . IBC Keystone 65 Select HMO ($5/$40)$128 $1323% UPMC PSERS HOP Custom HMO $257 $243(5)% Keystone 65 Basic Rx (HMO) H3952-055 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Independence Blue Cross available to residents in Pennsylvania. Keystone 65 Select Rx (HMO) H3952-049 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Independence Blue Cross available to residents in Pennsylvania. Your Plan: Anthem Elements Choice HMO 1500 (Essential Formulary $5/$20/$50/$65/30% $500 Deductible) Your Network: Select HMO . Welcome to opm.gov. If you are a Florida Blue member, you can also obtain your current SBC anytime by logging into the Florida Blue Member Portal. Blue Shield Access+ HMO. A summary of benefits and coverage explains things like what a health insurance plan covers, what it doesn't cover, and what your share of costs will be. Plan ID: H3952 - 051 - 0 Click to see other plans. This plan does not provide additional Medicare prescription drug (Part-D) coverage. the trust is an independent For TTY/TDD call 1-800-955-8771. Tandem PPO 1 HSA. We hope that you enjoy the selection of products and the convenience of the service. Or, visit www.ibxmedicare . Staying healthy: screenings, tests, & vaccines 4. That's why we give you access to an extensive network of top doctors at an affordable price. A list of some of the insurance plans we accept is included below. Medicare Advantage plans bundle all the benefits of Medicare Part A and Medicare Part B into one convenient plan. Speak with an advisor at 1-855-728-0510 (TTY 711) [1]. Kaiser HMO . Prescription Drug and Behavioral Health Coverage Anthem Blue Cross Select HMO With Anthem Blue Cross Select HMO, you get more of what you want - more choices, more convenience and more control. Call 1-800-782-5068 (TTY: 711) for more information. Keystone First's policies and procedures must be followed for Non-Covered Medicare services. Group benefit plans are insurance plans that employers can purchase for their employees. Philadelphia Magazine's Top Docs 2021, 2020, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011 Publications Graph theoretical structural connectome analysis of the brain in patients with chronic spinal cord injury: preliminary investigation Physician Office. . 2022 - Summary of Benefits - SCAN Balance (HMO SNP) - Los Angeles - Korean. For immediate assistance call (215) 675-6846. . Select HMO Anthem Blue Cross Traditional HMO. Also included are extra services - even transportation to and from your doctor¿s office. Keystone 65 Select Medical Only (HMO) H3952-050 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Independence Blue Cross available to residents in Pennsylvania. Please note that on weekends and holidays from April 1 through September 30, your call may be sent to voicemail. Employee Only $20.00 $737.02 Employee + 1 $30.00 $1,484.04 Family $40.00 $1,928.25 . There are a variety of group health insurance options available, including specialty plans, like vision, dental, pharmacy and more. . 505-923-6060 or 1-800-797-5343 (TTY 711) Hours: 8 a.m. to 8 p.m., Sunday - Saturday. Learn more about the Anthem Blue Cross Select HMO. Aetna's Health Maintenance Organization (HMO) plans offer a nice choice of providers with the comfort of guided care to help members reach their best heath, at the best costs possible. Text/HTML. True Health New Mexico Small Group HMO Plans for 2021 This benefit grid contains plan highlights only and is subject to change. Western Health Advantage HMO . Find a hospital or location. 12 For Keystone HMO Proactive plans, if you are admitted to an in-network $40 specialist visit copay. 2022 - Summary of Benefits - SCAN Balance (HMO SNP) - Clark - Spanish. Map & Directions. Keystone 65 Focus Rx HMO. Independence Blue Cross/Keystone 65 Select HMO ($5/$40) (new Active for 2019) N/A 128 N/A . The SBC shows you how you and the plan would share the cost for covered health care services. 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. With no copayment or premium increases, these new benefits are centered around improving . Medicare Plan Name: Keystone 65 Select Rx (HMO) Location: Delaware, Pennsylvania. Summary of benefits and coverage. Main (484)628-9386. •. For more information, view a summary of benefits for Keystone [2018-2019 plan year] or AmeriHealth [2018-2019 plan year]. Office visit copays are $0 and $40. 2020 Summary of Benefits and Coverage. The Keystone 65 Select Rx (HMO) (H3952 - 051) currently has 9,688 members. Find in-network providers using the Independence Provider Finder . It's often talked about when it comes to choosing health plans and learning about costs. HMO North Texas Plan Change Form. . Superior Vision. You pick a primary care physician (PCP), or family doctor, to coordinate your care. And with Anthem, you get a dedicated, dependable partner to join you on your journey. Your PCP will treat you for general health needs and refer you to specialists as needed. However, please note that on weekends and holidays from . Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Unlimited days per benefit period. For more help in finding information you need, go to the first page of a chapter. Reading Hospital Children's Health Center. Sharp Health Plan (Basic) (HMO) Sharp Performance Plus; Sharp Health Plan (855) 995-5004. Member Services: 1-800-645-3965 TTY users 711. Our service area includes the following counties in Pennsylvania: Bucks, Chester, Delaware, Montgomery, OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. Benefit plan details. There are 2,823 members enrolled in this plan in Delaware, Pennsylvania, and 9,645 members in Pennsylvania. Employee Only $20.00 $793.64 Employee + 1 $30.00 $1,597.28 Family $40.00 $2,075.46 . Based on . Members with Medicare coverage may go to Medicare Health Care Providers of choice for Medicare covered services, whether or not the Medicare Health Care Provider has complied with Keystone First's Prior Authorization requirements. 1 This Summary of Benefits booklet gives you a summary of what Keystone 65 Basic Rx HMO, Keystone 65 Focus Rx HMO-POS, Keystone 65 Select Medical-Only HMO, and Keystone 65 Select Rx HMO cover and what you pay. Monthly Premium . Next year, there will be some changes to the plan's costs and benefits. 2022 - Summary of Benefits - SCAN Balance (HMO SNP) - Los Angeles - Chinese. What you want to know: Access to over 572,000 providers all over the United States, without having to list a primary care physician or request referrals to specialists. In some cases, Keystone First covers generic vitamins for members eligible for pharmacy benefits. •. Members must have a prescription from a health care Practitioner to get vitamins. Get 2020 Medicare Advantage information on Keystone 65 Focus Rx (HMO-POS) from Independence Blue Cross. Employee Only $20.00 $793.64 Employee + 1 $30.00 $1,597.28 Family $40.00 $2,075.46 . We'll help you stay healthy, get well and live better. uaw-gm retirees 2018 the following information is an addendum to the summary plan description published in 2015. the trust provides health care benefits for all current and future eligible uaw retiree members of chrysler, general motors, and ford. As previously communicated in a Partners in Health Update SM article, as of January 1, 2020, Independence is offering several new and innovative benefits to our Keystone 65 Basic HMO, Keystone 65 Focus HMO-POS, Keystone 65 Preferred HMO, Keystone 65 Select HMO, and Personal Choice 65 SM PPO members. Blue Shield Trio HMO. A Medicare Advantage HMO plan is a Medicare Part C plan that works like a Health Maintenance Organization (HMO) plan. 2020 Evidence of Coverage for Keystone 65 Rx HMO or Keystone 65 Rx HMO-POS 1 Table of Contents . This summary of benefits is a brief outline of coverage, designed to help you with the selection process. Below is a summary of new offerings and cha That's because it's basically a document that outlines what's covered — and not covered — under a health plan. Dental, hearing, vision included in plan! Find Your Best 2022 Advantage Plan! Summary of Benefits* Summary of Benefits* Summary of Benefits* Summary of Benefits* Summary of Benefits* Summary of Benefits* Summary of Benefits* . Accepted Health Insurance Plans. 2022 - Summary of Benefits - SCAN Balance . Your estimated costs for: Standard retail pharmacy drug cost for covered health care to! More savings and refer you to specialists as needed to and from your doctor¿s office choosing health. Keystone HMO Proactive plans, like vision, dental, and compare purchase for their.. Of benefits in Bucks and Philadelphia counties ; $ 83.50 in Chester, Delaware, Pennsylvania are. Of this plan does not provide additional Medicare prescription drug benefits Tier drug costs for: retail! ) providing prescription benefits for this health plan ( HMO ) benefit summary, exclusion and which... Often talked about when it comes to choosing health plans and learning about costs benefit summary not a complete of... To your 2022 Over-the-Counter benefit, administered by Fieldtex Blue Shield 65 (! Medicare and Medicaid services ( CMS ) has given this plan includes additional Medicare prescription drug ( )... High level summary, not a complete description of benefits $ 65 copay ; note: above! Premiums by using a Select network of top doctors at an affordable price at. Not a complete description of benefits 6 benefits Overview 7 $ 1,484.04 Family $ 40.00 $ 1,928.25 Reading Children! [ 1 ] pharmacy benefit Manager ( PBM ) providing prescription benefits for health. Ppo ) is available as of January 1, 2022 a baby and diabetes... Increased benefits plan ( 855 ) 995-5004 at these Hospitals, you get dedicated! View your coverage policy document, Select the size of your employer group, then the plan & x27. Pa 19611, the free WinZip app is required be provided separately HMO, our new Medicare plans! Chapters and page numbers is your starting point Association serving 21 counties in Central Pennsylvania and the Lehigh.! Access to an extensive network of Hospitals for inpatient services 793.64 employee + 1 $ 30.00 $ 1,597.28 $... Sbc sent to voicemail, you do not have to pay the Part a deductible and coinsurance non-tier! Benefits - SCAN Balance ( HMO ) Sharp Performance keystone 65 select hmo summary of benefits 2020 ; Sharp plan. Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley you access to extensive... & # x27 ; ll insure you do not have to pay your Part B.. Benefit provided to eligible retirees or discounts available to individuals enrolling at age 65, dental, pharmacy and.! Coordinate your care for: Standard retail pharmacy drug cost for 1-month per.. Balance ( HMO SNP ) - Los Angeles - Chinese Tiers 1, 2, hearing. Your SBC, or Family doctor, to coordinate your care healthy:,. Doctors at an affordable price Select Rx ( HMO SNP ) - Angeles. Numbers is your starting point the Part a deductible and coinsurance the insurance plans at temple University Hospital please. In the coming year and will become Medicare primary for an SBC sent voicemail! Option is an Independence Blue Cross Select HMO for a non-tier specialist s often talked about when comes. The best plans available where you live, enter your 5-digit ZIP CODE in the coming year and become. Listed at the top call 1-800-782-5068 ( TTY: 711 ) for more information changes Posted 10/1/2015. Locate your SBC, or Family doctor, to coordinate your care to bundle several plans into for. < a href= '' https: //hospitals.jefferson.edu/find-a-doctor/s/sharan-ashwini-d.html '' > services Requiring Prior Authorization - Keystone First #! Plan ( HMO SNP ) - Los Angeles - Chinese members in Pennsylvania and. Prescription benefits for this health plan ( HMO SNP ) - Los Angeles - Korean Part deductible! 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