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Health Plans
Download the Plan Brochure

Download the full 2018 health plans brochure to compare plan types, costs, coverage and benefits.

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Compare Health Insurance Plans

This chart compares health plan benefits and estimated out-of-pocket costs for Independence Blue Cross in-network services, including doctor and hospital visits, specialty care, and prescription drugs. Deductible amounts shown are for individuals. For more plan details, review each plan’s Summary of Benefits & Coverage or use our guided shopping tool to get custom recommendations for the best health plan match, most affordable plan option and what people like you buy.

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Plan Name

Deductible

Primary Care
Physician Visit

Specialist Visit

Inpatient Hospital

Generic Prescription

Keystone HMO Platinum

$0

$20

$40

$400/day1

$10

Prescription Drug
  • FutureScripts Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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Personal Choice® EPO Platinum

$0

$15

$50

$300/day1

$10

Prescription Drug
  • FutureScripts Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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Keystone HMO Gold Proactive

Tier 1: $0
Tier 2: $0
Tier 3: $0

Tier 1: $15
Tier 2: $30
Tier 3: $45

Tier 1: $40
Tier 2: $60
Tier 3: $80

Tier 1: $350/day1
Tier 2: $700/day1
Tier 3: $1,100/day1

$15

Prescription Drug
  • Generic: $15
  • Preferred brand: 50% with $200 copay max
  • Non-preferred drug: 50% with $300 copay max
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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Keystone HMO Gold

$0

$35

$65

$750/day1

$15

Prescription Drug
  • Generic: $15
  • Preferred brand: 40% with $200 copay max
  • Non-preferred drug: 50% with $200 copay max
  • Search for a drug
  • Low-cost Generic Icon
  • FutureScripts Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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Personal Choice® PPO Gold

$0

$30

$65

$750/day1

$15

Prescription Drug
  • Generic: $15
  • Preferred brand: 40% with $200 copay max
  • Non-preferred drug: 50% with $200 copay max
  • Search for a drug
  • Low-cost Generic Icon
  • FutureScripts Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
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popular plan
Keystone HMO Silver Proactive

Tier 1: $0
Tier 2: $5,500
Tier 3: $5,500

Tier 1: $40
Tier 2: $50 no deductible
Tier 3: $60 no deductible

Tier 1: $80
Tier 2: $100 no deductible
Tier 3: $120 no deductible

Tier 1: $500/day1
Tier 2: Subject to deductible and $900/day1
Tier 3: Subject to deductible and $1,300/day1

$15

Prescription Drug
  • Generic: $15
  • Preferred brand: 50% with $400 copay max
  • Non-preferred drug: 50% with $500 copay max
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
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Keystone HMO Silver Proactive Select4

Tier 1: $0
Tier 2: $5,500
Tier 3: $5,500

Tier 1: $40
Tier 2: $50 no deductible
Tier 3: $60 no deductible

Tier 1: $80
Tier 2: $100 no deductible
Tier 3: $120 no deductible

Tier 1: $500/day1
Tier 2: Subject to deductible and $900/day1
Tier 3: Subject to deductible and $1,300/day1

$15

Prescription Drug
  • Generic: $15
  • Preferred brand: 50% with $400 copay max
  • Non-preferred drug: 50% with $500 copay max
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • Available Off Exchange Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

Shop / Compare Plans

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costs with our step-by-step
shopping experience.

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popular plan
Keystone HMO Silver Proactive Value4

Tier 1: $1,500
Tier 2: $5,500
Tier 3: $5,500

Tier 1: $40 no deductible
Tier 2: $50 no deductible
Tier 3: $60 no deductible

Tier 1: $80 no deductible
Tier 2: $100 no deductible
Tier 3: $120 no deductible

Tier 1: Subject to deductible and $500/day1
Tier 2: Subject to deductible and $900/day1
Tier 3: Subject to deductible and $1,300/day1

$15

Prescription Drug
  • Generic: $15
  • Preferred brand: 50% with $400 copay max
  • Non-preferred drug: 50% with $500 copay max
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • Available Off Exchange Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
shopping experience.

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Keystone HMO Silver4

$2,500

$35 no deductible

$70 no deductible

30% after deductible

$15 no deductible

Prescription Drug
  • Generic: $15 no deductible (integrated with medical deductible)
  • Preferred brand: 50% with $300 copay max after deductible
  • Non-preferred drug: 50% with $400 copay max after deductible
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • Available Off Exchange Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
shopping experience.

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popular plan
Personal Choice® PPO Silver

$2,500

$30 no deductible

$70 no deductible

25% after deductible2

$15 no deductible (integrated with medical deductible)

Prescription Drug
  • Generic: $15 no deductible
  • Preferred brand: 50% with $300 copay max after deductible
  • Non-preferred drug: 50% with $400 copay max after deductible
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
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Personal Choice® EPO Silver Reserve

$2,700

30% after deductible

30% after deductible

30% after deductible

30% after deductible (integrated with medical deductible)

Prescription Drug
  • Generic: 30% after deductible
  • Preferred brand: 30% after deductible
  • Non-preferred drug: 30% after deductible
  • Search for a drug
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • HSA Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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Personal Choice® EPO Silver Reserve Select4

$2,700

30% after deductible

30% after deductible

30% after deductible

30% after deductible (integrated with medical deductible)

Prescription Drug
  • Generic: 30% after deductible
  • Preferred brand: 30% after deductible
  • Non-preferred drug: 30% after deductible
  • Search for a drug
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • HSA Icon
  • Available Off Exchange Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
shopping experience.

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Keystone HMO Bronze4

$6,850

$50 no deductible

$100 no deductible

Subject to deductible and $700/day1

$15 after deductible (integrated with medical deductible)

Prescription Drug
  • Generic: $15 after deductible
  • Preferred brand: 50% after deductible with $300 copay max
  • Non-preferred drug: 50% after deductible with $400 copay max
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • Available Off Exchange Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

Shop / Compare Plans

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costs with our step-by-step
shopping experience.

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Personal Choice® PPO Bronze

$5,500

$50 no deductible

50% after deductible

25% after deductible3

$15 after deductible (integrated with medical deductible)

Prescription Drug
  • Generic: $15 after deductible
  • Preferred brand: 50% after deductible
  • Non-preferred drug: 50% after deductible
  • Search for a drug
  • Low-cost Generic Icon
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
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popular plan
Personal Choice® EPO Bronze Reserve

$6,650

0% after deductible

0% after deductible

0% after deductible

0% after deductible (integrated with medical deductible)

Prescription Drug
  • Generic: 0% after deductible
  • Preferred brand: 0% after deductible
  • Non-preferred drug: 0% after deductible
  • Search for a drug
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • HSA Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
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popular plan
Personal Choice® EPO Bronze Basic4

$7,350

Visits 1-3: $40 no deductible
Visits 4+: 0% after deductible

0% after deductible

0% after deductible

0% after deductible (integrated with medical deductible)

Prescription Drug
  • Generic: 0% after deductible
  • Preferred brand: 0% after deductible
  • Non-preferred drug: 0% after deductible
  • Search for a drug
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
  • Available Off Exchange Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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Personal Choice® EPO Catastrophic

$7,350

Visits 1-3: $50 no deductible
Visits 4+: 0% after deductible

0% after deductible

0% after deductible

0% after deductible (integrated with medical deductible)

Prescription Drug
  • Generic: 0% after deductible
  • Preferred brand: 0% after deductible
  • Non-preferred drug: 0% after deductible
  • Search for a drug
  • Mandatory Generic Icon
  • Preferred Pharmacy Icon
Plan Details

Summary of Benefits and Coverage

Benefits Chart

Full Benefits Booklet

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costs with our step-by-step
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Scroll or swipe to reveal all table data.

Legend

  • most popular plans = Most popular plans
  • Adult Vision Icon Adult Vision coverage included in this plan.
  • FutureScripts Pharmacy Icon FutureScripts Pharmacy network includes more than 68,000 pharmacies.
  • HSA Icon HSA – This plan is compatible with a health savings account.
  • Low-cost Generic Icon Low-cost Generics are available at an even lower cost than standard generics.
  • Mandatory Generic Icon Mandatory Generics – If you get a brand name drug when a generic is available, you pay the difference in cost plus the brand name cost-sharing. Choosing generics saves you money.
  • Available Off Exchange Icon Off-exchange only. Plan is not available for purchase through the Federal Health Insurance Marketplace.
  • Preferred Pharmacy Icon Preferred Pharmacy network means your coverage is available at more than 50,000 pharmacies.
  • 1 Amount shown reflects copay per day. There is a maximum of 5 copays per admission.
  • 2 For PPO Silver, inpatient maternity hospital services are subject to 30% coinsurance after deductible
  • 3 For PPO Bronze, inpatient maternity hospital services are subject to 50% coinsurance after deductible.
  • 4 These plans are not offered on the Federal Health Insurance Marketplace and must be purchased through Independence directly.

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