We are pleased to announce
that for 2013, the Keystone 65 Select HMO premium has been reduced to $0 for
medical-only plans in all counties. In addition, the premiums for the Keystone
65 Select Rx HMO plans have been reduced to $31.50 for those in Philadelphia
and Bucks Counties, and $46.50 for those in Chester, Delaware, and Montgomery
Counties. The Choice program, which includes dental services, hearing services,
and vision care, is an additional $10 monthly premium. Keystone 65 Select HMO
has a $6,700 out-of-pocket maximum for 2013.
Keystone 65 Select also includes a
worldwide travel benefit for emergency and urgently needed care, which will
give members peace of mind while they are traveling anywhere in the world.
Emergency and urgently needed care coverage under Keystone 65 Select plans
includes emergency medical items and services provided outside the United
States at an emergency department or urgent care center.
Medicare beneficiaries were recently
mailed their 2013 Annual Notification of Change
(ANOC)/Evidence of Coverage (EOC), which outlines all of the changes for
2013.
Members may enroll in a new plan for
2013 any time between October 15 and December 7, 2012. Members receive access
to the SilverSneakers? Fitness Program; preventive care; health
resources and wellness programs; and support for managing chronic conditions,
such as asthma, diabetes, and chronic obstructive pulmonary disease (COPD).
New for 2013, cardiovascular disease
risk reduction visits, depression screenings, obesity screenings, screenings
and counseling to reduce alcohol misuse, and screening for sexually transmitted
infections (STI) and counseling to prevent STIs will be covered.
Medicare Part D prescription drug
coverage is optional.
Keystone 65
Select HMO benefit highlights
|
|
Primary care physician (PCP)
visits
|
$15 copay per visit
|
Specialist visits
|
$45 copay per visit
|
Emergency department
|
$65 copay (not waived if
admitted)
|
Urgent care
|
$15 – 65 copay per visit (not
waived if admitted)
|
Outpatient surgery
|
$350 copay (per date of service)
for hospital; $100 copay for ambulatory surgical centers (per date of
service)
|
Inpatient hospital
|
$245 per day for days 1 ? 7 ($1,715
per stay maximum). Unlimited days each benefit period.
|
Preventive dental, routine eye,
hearing services
|
Available with the Keystone 65
Select HMO Choice Program.
|
Fitness program
|
SilverSneakers?
|
Please contact your Network Coordinator
if you have any questions.
SilverSneakers® is a registered
mark of Healthways, Inc., an independent company.