Are you turning 65? Or are you on Medicare and losing coverage or moving?
See if you qualify for an enrollment period to sign up for a plan
Ready to Enroll Online?
Health Insurance Company: Independence Blue Cross
Medicare Advantage Plan Details
$0 /mo
monthly premium
Keystone 65 Focus Rx (HMO-POS)
Additional Coverage
Overall Star Rating (2024)
Rx
Dental
Vision
Hearing
4
out of 5 stars
General Plan Details
Medical Deductible
$0
Out-of-Pocket Maximum
$6500
Rx Drug Coverage
Yes
Rx Deductible
$0
Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$40 copay per visit
Additional Benefits
Dental Coverage
Yes
Vision Coverage
Yes
Mental Health Coverage
Yes
Transportation for non-emergency
No
Fitness Benefits
Yes
Worldwide emergency
Yes
Telehealth
Yes
Part B Give Back
No
Doctor & Hospital Coverage
Primary Doctor Office Visit
In-network: $0 copay
Out-of-network: 20% coinsurance per visit
Specialist Office Visit
In-network: $40 copay per visit
Out-of-network: 20% coinsurance per visit
Periodic Exam Coverage
In-network: $0 copay
Out-of-network: 20% coinsurance
Emergency Room
$100 copay per visit (always covered)
Ambulance Coverage
In-network: $230 copay
Out-of-network: 20% coinsurance
Lab, X-Ray, Radiology Coverage
Outpatient diag procs/tests/lab services:
Medicare-covered diagnostic procedures/tests: In-network: $0 copay
Out-of-network: 20% coinsurance
Medicare-covered lab services: In-network: $0 copay
Out-of-network: 20% coinsurance
Outpatient diag/therapeutic rad services:
Medicare-covered diagnostic radiological services (e.g., CT, MRI, etc): In-network: $0-160 copay
Out-of-network: 20% coinsurance
Medicare-covered x-ray services: In-network: $30 copay
Out-of-network: 20% coinsurance
Outpatient Surgery Coverage
Outpatient hospital:
Medicare-covered outpatient hospital services: In-network: $325 copay per visit
Out-of-network: 20% coinsurance per visit
Hospitalization Coverage
Inpatient hospital-acute:
In-network: $210 per day for days 1 through 6
$0 per day for days 7 through 90
$0 per day for days 90 and beyond
Out-of-network: 20% per stay
Inpatient hospital psychiatric:
In-network: $210 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: 20% per stay
Rehabilitation Coverage
Occupational therapy services:
In-network: $20 copay
Out-of-network: 20% coinsurance
Physical therapy and speech and language therapy services:
In-network: $20 copay
Out-of-network: 20% coinsurance
Urgent Care Coverage
$10-40 copay per visit (always covered)
Skilled Nursing Facility (SNF)
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Out-of-network: 20% per stay
Mental Health Coverage
Medicare-covered individual sessions: In-network: $30 copay
Out-of-network: 20% coinsurance
Medicare-covered group sessions: In-network: $20 copay
Out-of-network: 20% coinsurance
Dental, Vision, Hearing Benefits
Dental Services
Oral exams: In-network: $0 copay
Out-of-network: No Data
Prophylaxis (cleaning): In-network: $0 copay
Out-of-network: No Data
Dental x-rays: In-network: $0 copay
Out-of-network: No Data
Vision Benefits
Eye exams:
Routine eye exams: In-network: $0 copay
Out-of-network: No Data
Eyewear:
Contact Lenses: In-network: $0 copay
Out-of-network: No Data
Eyeglasses: In-network: $0 copay
Out-of-network: No Data
Hearing Benefits
Hearing exams:
Routine hearing exams: In-network: $40 copay
Out-of-network: 20% coinsurance
Hearing aids:
Hearing aids (all types): In-network: $699-999 copay
Out-of-network: No Data
Rx Drug Coverage - Preferred Retail Cost
Tier 1: Preferred Generic
$0.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$8.00 copay (30-day supply)
$16.00 copay (90-day supply)
Tier 3: Preferred Brand
$47.00 copay (30-day supply)
$141.00 copay (90-day supply)
Tier 4: Non-Preferred Drug
$100.00 copay (30-day supply)
$300.00 copay (90-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
33% coinsurance (90-day supply)
Rx Drug Coverage - Standard Retail Cost
Tier 1: Preferred Generic
$9.00 copay (30-day supply)
$27.00 copay (90-day supply)
Tier 2: Generic
$20.00 copay (30-day supply)
$60.00 copay (90-day supply)
Tier 3: Preferred Brand
$47.00 copay (30-day supply)
$141.00 copay (90-day supply)
Tier 4: Non-Preferred Drug
$100.00 copay (30-day supply)
$300.00 copay (90-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
33% coinsurance (90-day supply)
Rx Drug Coverage - Standard Mail Order Cost
Tier 1: Preferred Generic
$0.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$8.00 copay (30-day supply)
$16.00 copay (90-day supply)
Tier 3: Preferred Brand
$47.00 copay (30-day supply)
$94.00 copay (90-day supply)
Tier 4: Non-Preferred Drug
$100.00 copay (30-day supply)
$200.00 copay (90-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
33% coinsurance (90-day supply)
More Additional Benefits
Annual physical exams
Yes
Chiropractic Coverage
Yes
Acupuncture
Yes
Massage Therapy
No
Health Education
Yes
Counseling Services
No
Support for Caregivers of Enrollees
No
Personal Emergency Response System (PERS)
No
In-home support services
No
Home and bathroom safety devices
No
Meals for short duration
No
Plan Links
Ready to Enroll Online?
Or call and get free advice from licensed insurance agents
(888) 311-4264
TTY 711
Mon-Fri: 8am-9pm, Sat: 9am-8pm ET
No Obligation to Enroll
Looking for other plans in your area?
Where This Plan is Available
State:
Pennsylvania
Counties:
Bucks, Philadelphia
View all plans in your Pennsylvania County
Additional Plan Info
Plan Year:
2024
Insurance Company Website:
© 2024 Amabo LLC, Amabo Agency LLC
1250 Broadway, 36th Floor, New York, NY 10001
Medicare65quote.com is not connected with or endorsed by the United States government or the federal Medicare program. For official government information, please contact Medicare.gov or 1-800-MEDICARE (24 hours a day / 7 days a week). Plans shown on Medicare65quote.com may not represent every plan available in the market. Medicare65quote.com is a free service with no obligation to enroll. By using Medicare65quote.com you agree to our Terms of Service and Privacy Policy.
Insurance Ad - No Government Affiliation. This ad is not from the government. It’s from Amabo LLC, an independent Third-Party Marketing Organization with insurance agency partners selling plans from many insurance companies. The purpose of this site is the solicitation of insurance.
Partner Disclosure: HealthCompare Insurance Services does not offer every plan available in your area. Currently we represent 18 organizations, which offers 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE (24 hours a day / 7 days a week), or your local State Health Insurance Program (SHIP) to get information on all of your options. HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.
Enrollment in a plan may be limited to certain times of the year unless you qualify for a special enrollment period or you are in your Medicare Initial Election Period. Not all plans offer all benefits mentioned. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Part B Giveback Disclaimer: the standard Part B premium for 2024 is $174.70. Monthly savings varies and may be subject to processing delays and may not be immediate. Not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower.
Every year, Medicare evaluates plans based on a 5-star rating system.
MULTIPLAN_HCIHNAMABO24WEB_M