What Is Keystone HMO?

What is the difference between Blue Cross Blue Shield HMO and PPO?

The monthly payment for an HMO plan is lower than for a PPO plan with a comparable deductible and out of pocket maximum.

CareFirst’s PPO plans offer a wide network of providers.

In exchange for a lower monthly payment, an HMO offers a narrower network of available doctors, hospitals, and specialists..

What is a Tier 2 Doctor?

Providers who meet excellent quality and/or cost efficiency standards. Members pay the lowest copayment. ** Tier 2. Providers who meet good quality and/or cost efficiency standards.

Is Horizon Omnia a good plan?

I won’t go over the criticisms of the plan, but I will cover what policyholders and business owners need to know before enrolling in one of the Horizon BCBS Omnia plans. *The bottom line is that these are great plans to save money on premiums, and out-of-pocket costs at your providers.

Does Keystone first cover eyeglasses?

Keystone First does not cover prescription eyeglasses or prescription contact lenses for members 21 years of age and older, but there are special provisions for members with aphakia or cataracts. Call Member Services at 1-800-521-6860 for more information. *There may be co-pays for some eye care services.

What type of plan is Keystone first?

Putting you first. Keystone First is Pennsylvania’s largest Medical Assistance (Medicaid) managed care health plan serving more than 400,000 Medical Assistance recipients in southeastern Pennsylvania including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

What is a Tier 2 hospital?

Tier 2 — in-network These hospitals have higher out-of-pocket costs. They are a part of the Anthem network, but without the deep discounts offered by Tier 1 hospitals. With Tier 2 facilities, members would be responsible for a higher coinsurance on most plans.

What does keystone first dental cover?

Dental benefits for members over age 21, who are eligible for dental benefits, are eligible for: 1 dental exam and 1 cleaning, every 6 months. Pulpotomies (removal of pulp) for pain relief. Re-cementing of crowns (re-gluing the crown).

Is Keystone Health Plan East part of Blue Cross?

With a Keystone Health Plan East HMO from Independence Blue Cross, you can see any doctor or visit any hospital in the Keystone Health Plan East network. You pick a primary care physician (PCP), or family doctor, to coordinate your care.

What type of insurance is personal choice?

With Personal Choice PPO plans from Independence Blue Cross, you can choose to see any doctor or visit any hospital in the Personal Choice network. You’ll pay less when you choose doctors and hospitals in the Personal Choice network, and more if you choose to see doctors and hospitals out-of-network.

What is the difference between Tier 1 and Tier 2 Health insurance?

Tier 1 usually includes a select network of providers that have agreed to provide services at a lower cost for you and your covered family members. Tier 2 provides you the option to choose a provider from the larger network of contracted PPO providers, but you may pay more out-of-pocket costs.

Who is eligible for Keystone first?

You are 21 years of age or older and begin receiving Medicare Part D (Prescription Drug Coverage). You go to a state mental health hospital. You may also become eligible for Community HealthChoices.

Is Keystone Health Plan East an HMO?

Keystone Health Plan East is a Health Maintenance Organization (HMO). This is a managed care program. Coverage is available when your care is provided or referred by a Keystone primary care physician (PCP). Your Keystone PCP may also refer you to other Keystone providers for care, if needed.