Keystone Health Plan East...
Keystone Health Plan East, our Health Maintenance Organization (HMO) provides a
complete range of medical benefits through a selected group of doctors and
hospitals. A members overall medical needs are coordinated by one doctor, the
primary care physician (family doctor or pediatrician). All specialty care needs are
referred by the members primary care physician. Our wide network of participating
physicians and hospitals in Pennsylvania, New Jersey and Delaware make the HMO an
easy-to-use and cost-effective program for you.
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With Keystone HMO, there are no claim forms, no deductibles, and low out-of-pocket
- Members must choose a primary care physician from our large network of selected doctors.
- All referrals for specialty care are coordinated by the primary care physician
- Direct Access OB/GYNsm1 - no referrals
required to see a network OB/GYN for routine or maternity care
- Comprehensive benefits for students and travelers out of the area through BluesCONNECTSM.
- Exclusive Healthy LifestylesSM1 wellness
programs included at no additional cost
- Special Connections SM1
- Worldwide coverage and recognition of the Blue Cross and Blue Shield symbols on member
A special feature: With Direct Access OB/GYNSM1, women are able to receive care from a network
OB/GYN without a referral from the PCP.*
provided by Reproductive Endocrinologists/Infertility Specialists and Gynecologic
Oncologists continues to require a referral form from your primary care physician.
These designs illustrate some of the benefit programs available. For more information on
the terms, limitations and exclusions of our benefit programs, please contact your
independent broker or our Marketing Department by clicking Here. Support
Regarding Incentives for Utilization Management: It is the policy of
Independence Blue Cross and its affiliates that incentives including compensation, for any
person who makes utilization management decisions are not based on quantity or type of
denial decisions rendered nor intended to in any way influence decisions regarding the
medical necessity or appropriateness of care or service.