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Frequently Asked Questions

Frequently Asked Questions About Keystone HMO Health Plans

What Is an HMO?

HMO stands for health maintenance organization. An HMO is a type of health plan that requires you to select a family doctor, often called a primary care physician or PCP. You need a referral from your PCP to see a specialist in the HMO network, such as a cardiologist (heart doctor). Typically, only emergency services are covered if you go outside the HMO’s network of participating providers. You do not have the option to see out-of-network providers when you have an HMO.

How Do Independence Blue Cross Keystone HMO Plans Work?

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. Your PCP will treat you for general health needs and refer you to specialists as needed.

What Keystone HMO Plans Does Independence Blue Cross Offer?

There are four Independence Blue Cross Keystone HMO health plans that allow you to save money when you choose health care providers within the Keystone Health Plan East network.

Compare coverage details on costs and coverage for Keystone HMO plans and see if one of these coverage health plans is best for you:

  • Keystone HMO Platinum
  • Keystone HMO Gold
  • Keystone HMO Silver
  • Keystone HMO Bronze1

Please note that Keystone HMO Silver Proactive Value and Keystone HMO Bronze are not available for purchase through the Federal Health Insurance Marketplace.

How Large Is the Keystone Health Plan East Network?

The Keystone Health Plan East Network is one of the largest in the Philadelphia region, with more than 46,000 doctors and 160 hospitals to choose from.

Can I See Keystone Health Plan East Providers Outside of the Network?

You will not be covered for care that you receive from doctors or hospitals outside the Keystone Health Plan East providers’ network. If you are considering enrolling in a Keystone HMO, be sure to check that your preferred providers are in the Keystone Health Plan East network.

What if I Have an Emergency?

If you have an emergency, you should visit the nearest hospital. Emergency services from out-of-networks providers will be covered.

Who Can I Contact for Keystone HMO Plan Inquiries?

You can contact a customer service representative for Keystone HMO related-inquiries by calling 1-800-ASK-BLUE (1-800-275-2583, TTY: 711).

1 Keystone HMO Bronze is not available for purchase through the Federal Health Insurance Marketplace.