With the growing Medicare Advantage market, Independence Blue Cross (IBX) continues to offer health plans to help our age 65+ members (your patients) maintain a healthy well-being. IBX plans provide members with quality health care coverage focused on improving affordability, while featuring more choices and benefits.
Along with offering a robust line of Medicare Advantage products, IBX is debuting two new plans: Personal Choice 65SM Plus Rx PPO and Keystone 65 Essential Rx HMO-POS.
New! Personal Choice 65SM Plus Rx PPO
Personal Choice 65SM Plus Rx PPO is now available to individual members in our five-county service area: Bucks, Montgomery, Delaware, Chester, and Philadelphia counties. Benefits of this product include:
- $0 copayments for in-network primary care and specialist visits
- $1,500 annual allowance for comprehensive dental services
- $0 Part D deductible
New! Keystone 65 Essential Rx HMO-POS
Our Keystone 65 Essential Rx HMO-POS plan is also available to individual members in our five-county service area. Benefits of this product include:
- $0 copays for in-network primary care visits
- Grocery* and transportation benefits
- $3,000 annual allowance for comprehensive dental services
- $0 Part D deductible
The Inflation Reduction Act and Medicare Part D changes
The Centers for Medicare & Medicaid Services (CMS) has made significant changes for 2025, including implementing components of the Inflation Reduction Act (IRA) that will impact Medicare Advantage beneficiaries. To help providers navigate these changes, IBX has a dedicated resource page that includes policy updates and the latest news.
What's new and improved for 2025
With a longstanding history in the Philadelphia area, IBX continues to improve benefit offerings that focus on quality and affordability, while giving our members (your patients) the extras they can't live without.
- $0 copays for Tier 1 and NEW! Tier 2 generics at a preferred pharmacy or through mail order for most members.
- Dental allowances up to $3,000 per year to help pay for comprehensive dental services like fillings, root canals, crowns, partial bridges, dentures, and (NEW!) implants for most plans.
- Annual allowance that can cover (NEW!) medical, dental, vision, or hearing services or supplies for select plans.
Benefit highlights
- IBX provides access to age-friendly programs including comprehensive caregiver support through an expanded relationship with Carallel, which provides high-touch support and tools designed with the caregivers' needs in mind. In addition, certain members with dementia and other brain health conditions will have access to Isaac Health, which offers virtual and in-home clinical services for these types of diseases.
- Part B Premium Giveback, which helps reduce the amount members pay each month for their Medicare Part B premium, is available on Keystone 65 Basic HMO, Keystone 65 Focus HMO-POS, Keystone 65 Liberty HMO, Personal Choice 65 Prime PPO, and Personal Choice 65 Saver PPO.
- Members have free fitness memberships with access to a large national fitness network, including all YMCAs in the five-county area.
- The IBX Care Card provides quarterly allowances for over the counter (OTC) items, along with a flexible benefit allowance for medical, dental, vision, and hearing services and supplies. Please note that benefits vary by plan.
Vital Care & Vital Care Plus Programs
The Vital Care Program — for members who have been diagnosed with both congestive heart failure and diabetes — is available to all eligible members with Keystone 65 Basic Rx HMO, Keystone 65 Essential Rx HMO-POS, Keystone 65 Liberty Medical-Only HMO, Keystone 65 Preferred Rx HMO, and Keystone 65 Select HMO. These members are eligible for reduced copayments for cardiologist, endocrinologist, and podiatrist (Medicare-covered and routine) visits.
The Vital Care Plus Program is available to eligible Keystone 65 Focus HMO-POS members with the same benefits as the Vital Care Program; however, a lower copayment for pulmonologist visits is also included. In addition, these members have an extra $10 per quarter added to their OTC allowance, and they only need to be diagnosed with diabetes. Members do not need to have a congestive heart failure diagnosis to take part in the program.
Eligible members are automatically enrolled into these programs; however, they may opt out if they choose to do so.
Learn more
If you have any questions about these changes, contact Provider Customer Service at 1-800-ASK-BLUE (1-800-275-2583).
*The grocery benefit mentioned is part of a special supplemental program for the chronically ill. Members must be diagnosed with either Diabetes, Chronic or Disabling Mental Health Conditions, Chronic Heart Failure, Hypertension, Obesity, or other eligible conditions to qualify. Eligibility for this benefit cannot be guaranteed based solely on your condition. All applicable eligibility requirements must be met before the benefit is provided. Contact us to confirm your eligibility for this benefit. Keystone 65 Essential HMO-POS members must also qualify for Medicare's Low-Income Subsidy or “Extra Help" program to be eligible to receive the grocery benefit.
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