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Upcoming changes for Keystone 65 Select HMO 

September 28, 2012    


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

Keystone 65 Select also includes a worldwide travel benefit for emergency and urgently needed care, which will give members peace of mind while they are traveling anywhere in the world. Emergency and urgently needed care coverage under Keystone 65 Select plans includes emergency medical items and services provided outside the United States at an emergency department or urgent care center.

Medicare beneficiaries were recently 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. Members receive access to the SilverSneakers Fitness Program; preventive care; health resources and wellness programs; and support for managing chronic conditions, such as asthma, diabetes, and chronic obstructive pulmonary disease (COPD).

New for 2013, cardiovascular disease risk reduction visits, depression screenings, obesity screenings, screenings and counseling to reduce alcohol misuse, and screening for sexually transmitted infections (STI) and counseling to prevent STIs will be covered.

Medicare Part D prescription drug coverage is optional.

Keystone 65 Select HMO benefit highlights

Service

Cost to member

Primary care physician (PCP) visits

$15 copay per visit

Specialist visits

$45 copay per visit

Emergency department

$65 copay (not waived if admitted)

Urgent care

$15 – 65 copay per visit (not waived if admitted)

Outpatient surgery

$350 copay (per date of service) for 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). Unlimited days each benefit period.

Preventive dental, routine eye, hearing services

Available with the Keystone 65 Select HMO Choice Program.

Fitness program

SilverSneakers

Please contact your Network Coordinator if you have any questions.

SilverSneakers® is a registered mark of Healthways, Inc., an independent company.





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