Keystone Health Plan East:

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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 member’s overall medical needs are coordinated by one doctor, the primary care physician (family doctor or pediatrician). All specialty care needs are referred by the member’s 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 expenses.

  • 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 programs included
  • Worldwide coverage and recognition of the Blue Cross and Blue Shield symbols on member ID cards

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.*

*Non-routine care 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

Affirmative Statement 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.

 

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