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Effective January 1, 2014, there will be several changes to our current Medicare Advantage HMO and PPO plans including the following highlights:

• Keystone 65 Select HMO with Rx will now be available with a $0 premium in Philadelphia and Bucks counties.
• Keystone 65 Select HMO plan will feature a $0 premium for medical-only plans in Philadelphia, Bucks, Chester, Delaware, and Montgomery counties.
• Our Personal Choice 65^SM PPO coverage area has expanded to Chester, Delaware, and Montgomery counties, where members can choose a medical plan with prescription drug coverage for a $98.50 monthly premium.

Medicare Advantage HMO and PPO members should have already received their 2014 Annual Notice of Changes/ Evidence of Coverage. They will have until December 7, 2013, to make any changes to their health care plans.

We are also pleased to introduce the Member Help Team, IBC?s new Medicare Customer Service program. Recognizing that Medicare-eligible members have unique needs, the Member Help Team ensures they receive special care and attention. This dedicated service team is designed to work closely with other areas within IBC ? as well as with billing agencies, pharmacies, and doctor?s offices ? to respond to members? concerns quickly and resolve their issues the first time around. Members will experience this new service when they call the Customer Service number on the back of their ID cards.

The following tables highlight some of the Medicare Advantage HMO and PPO benefits changes for 2014. Please note that this is a list of our significant benefits changes, not a comprehensive list of all benefits changes.

Please contact your Network Coordinator if you have any questions.

Medicare Advantage HMO and PPO monthly plan premiums

Plan type Keystone 65 Select HMO Keystone 65 Preferred HMO Personal Choice 65^SM PPO Medical Only Philadelphia/Bucks: $0

Chester/Delaware/ Montgomery: $0 Philadelphia/Bucks: $125.40

Chester/Delaware/ Montgomery: $184.80 Philadelphia/Bucks: $145 Medical with Choice Program (hearing/dental/vision) Philadelphia/Bucks: $7

Chester/Delaware/ Montgomery: $7 Not available Not available Medical with Rx Philadelphia/Bucks: $0

Chester/Delaware/ Montgomery: $43 Philadelphia/Bucks: $182.60

Chester/Delaware/ Montgomery: $252 Philadelphia/Bucks: $222.50

Chester/Delaware/ Montgomery: $98.50 Medical with Rx and Choice Program Philadelphia/Bucks: $7

Chester/Delaware/ Montgomery: $50 Not available Not available

Medicare Advantage HMO and PPO benefits highlights

Service category Keystone 65 Select HMO Keystone 65 Preferred HMO Personal Choice 65^SM PPO Primary care physician visits $15 copay per visit for medical only

$18 copay per visit for medical with Rx $5 copay per visit $10 copay per visit Specialist visits $45 copay per visit $40 copay per visit $40 copay per visit Emergency room (United States and worldwide) $65 copay per visit (not waived if admitted) $65 copay per visit (not waived if admitted) $65 copay per visit (not waived if admitted) Urgent care $15 - $45 copay; not waived if admitted to the hospital

(urgent care center: $25 copay) $5 - $40 copay; not waived if admitted to the hospital

(urgent care center: $20 copay) $10 - $40 copay; not waived if admitted to the hospital

(urgent care center: $20 copay) Outpatient surgery $75 copay per visit for ambulatory surgical centers;

$0 - $400 copay per visit for outpatient hospital facility $75 copay per visit for ambulatory surgical centers;

$0 - $400 copay per visit for outpatient hospital facility $75 copay per visit for ambulatory surgical centers;

$0 - $400 copay per visit for outpatient hospital facility Inpatient hospital $245 per day for days 1 ? 7 ($1,715 per stay maximum);

unlimited days each benefit period $215 per day for days 1 ? 7 ($1,505 per stay maximum);

unlimited days each benefit period $850 per admission;

unlimited days per admission Dental, vision, hearing Benefits available for additional $7 per month in plan premiums Dental: $15 copay for exams and cleanings once every 6 months

Vision: $40 copay; up to $100 for eyewear every 2 years

Hearing: $40 copay; up to $500 for hearing aids (2 aids) every 3 years Not covered

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