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Reminder: Upcoming changes for Keystone 65 Select HMO 

November 1, 2012    

In 2013, the Keystone 65 Select HMO premium has been reduced to $0 for medical-only plans in all counties. In addition, the premiums for the Keystone 65 Select Rx HMO plans have been reduced to $31.50 for those in Philadelphia and Bucks Counties, and $46.50 for those in Chester, Delaware, and Montgomery Counties. Keystone 65 Select also includes a worldwide travel benefit for emergency care and urgently needed care.

The Choice Care program, which includes dental services, hearing services, and vision care, is an additional $10 monthly premium. Keystone 65 HMO has a $6,700 out-of-pocket maximum for 2013.

Last month, Medicare beneficiaries were mailed their 2013 Annual Notification of Change (ANOC)/Evidence of Coverage (EOC), which outlines all of the changes for 2013. Members may enroll in a new plan for 2013 any time between October 15 and December 7, 2012.

Keystone 65 Select HMO benefit highlights

ServiceCost to member
Primary care physician visits$15 copay per visit
Specialist visits$45 copay per visit
Emergency department$65 copay (not waived if admitted)
Urgently needed care$15 – 45 copay per visit
Outpatient surgery$350 copay (per date of service) for outpatient hospital; $100 copay for Ambulatory Surgical Centers (per date of service)
Inpatient hospital$245 per day for days 1 – 7 ($1,715 per stay maximum). $0 copayment/day for 8+ days; unlimited days each benefit period.
Preventive dental, routine eye, hearing servicesBenefits package available for additional $10 per month in plan premiums

Note: All Keystone 65 HMO and Personal Choice 65SM PPO plans includes the SilverSneakers fitness benefit in 2013.

Please contact your Network Coordinator if you have any questions.

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