As previously communicated in a Partners in Health UpdateSM article, as of January 1, 2020, Independence is offering several new and innovative benefits to our Keystone 65 Basic HMO, Keystone 65 Focus HMO-POS, Keystone 65 Preferred HMO, Keystone 65 Select HMO, and Personal Choice 65SM PPO members. With no copayment or premium increases, these new benefits are centered around improving affordability for members. Below is a summary of new offerings and changes.
New! Personal Choice 65
Now available to individual members in our five-county service area (i.e., Bucks, Montgomery, Delaware, Chester, and Philadelphia counties) is Personal Choice 65 Prime. Benefits of this product include:
- $0 monthly premium
- $0 Part D deductible
- lower copayment for Preferred Provider visits
The following new Medigap plans are also now available:
- MedigapFreedom: Plan G-HD will be added for individual and group members.
- MedigapSecurity: Plans D, G, and G-HD will be available if requested by a group.
Optional supplemental benefits
The Choice and Choice Plus programs offer Medicare Advantage members supplemental coverage for dental, vision, and hearing benefits for a small fee per month in addition to their monthly premium. Here is a summary of the optional supplemental benefits:
- Dental benefits include:
- exam/cleaning (every six months) and X-rays (once per year) for Choice and Choice Plus
- combined $500 allowance per year for comprehensive dental services (Choice)*
- combined $1,500 allowance per year for comprehensive dental services (Choice Plus)
- Vision benefits include:
- routine eye exam every year for Choice and Choice Plus
- $150/$200 eyewear allowance for Choice and Choice Plus*
- Hearing benefits include:
- routine exam and three hearing aid fittings and evaluations per year for Choice and Choice Plus
- $699/$999 copayment per hearing aid per year (Choice)
- $499/$799 copayment per hearing aid per year (Choice Plus)
*Restrictions apply
Better than ever: Pharmacy benefits†
Walgreens, an independent company, is now a Preferred Pharmacy as of January 1, 2020. That means that individual members can fill up to a 90-day supply of generic and preferred generic prescription drugs for only two copayments. A 90-day prescription written by the provider is required.
Also, as of January 1, 2020, Independence has begun applying Step Therapy to certain Part B drugs. Step Therapy is a type of prior authorization for drugs that start medications for a medical condition with the most preferred drug therapy and progresses to other therapies only if necessary.
†Effective January 1, 2020, Sam’s Club and Walmart pharmacies have moved to our “Standard” tier.
Vital Care Program
The Vital Care Program has been added to our Keystone 65 Basic HMO and Keystone 65 Focus HMO-POS plans. This program is for members who have been diagnosed with both congestive heart failure and diabetes.
Specific to this program is a reduced copayment for eligible members when visiting their cardiologist, endocrinologist, or podiatrist. Eligible members are automatically enrolled into the program, but they may opt out if they choose to do so. There are no additional participation requirements.
Learn more
If you have any questions regarding these changes, please call Provider Services at 1-800-ASK-BLUE (1-800-275-2583).