Keystone Health Plan East HMO Proactive plans with a tiered network
Keystone HMO Proactive health plans are our most popular for good reason: You can get high-quality care and save money. Not only is your monthly premium lower, but you can save even more with the tiered network.
Keystone HMO Proactive health plans work just like a typical Health Maintenance Organization (HMO) plan in that you can visit any in-network doctor or hospital and you’ll select a primary care physician to coordinate your care and refer you to specialists.
How a tiered network provides choice and savings
With a tiered network, Keystone HMO Proactive plans also give you a way to save on your out-of-pocket costs by using certain providers. We’ve grouped our in-network providers into three tiers. Doctors and hospitals that offer high-quality care at a lower cost are in Tier 1 – Preferred. More than half of doctors and hospitals in our network are in the most affordable tier, Tier 1 – Preferred, so you have plenty of choices.
A tiered network is different from a limited network. With a tiered network, you still have access to the full provider network of doctors and hospitals. Other health insurers may offer plans with a limited network, which does not give you access to the full network of doctors and hospitals. But our tiered network gives you access to the entire Keystone Health Plan East network. And the choice to save is yours — you can choose providers in Tier 1 for some covered services and providers from Tier 2 or 3 for other covered services.
Is a Keystone HMO Proactive plan right for you?
One of our Keystone HMO Proactive plans may be the best health insurance option for you and your family if you live within one of these five counties and are looking for an affordable coverage option that still gives you access to the largest network of doctors and hospitals in the region.
To learn more about HMOs in general, read the article “What is an HMO?”
Keystone HMO Proactive plan options and benefits
Options
Some of our most affordable health insurance plans for individuals and families, the Proactive family of products can help save you money while giving you the freedom to choose each time you receive care.
- Keystone HMO Gold Proactive
- Keystone HMO Silver Proactive
- Keystone HMO Silver Proactive Lite1
- Keystone HMO Silver Proactive Select2
- Keystone HMO Silver Proactive Basic1
- Keystone HMO Silver Proactive Value2
- Keystone HMO Silver Proactive Essential1
Benefits
- Save money on monthly premiums. When you choose a Keystone HMO Proactive plan, you save money because your monthly premiums are lower than our regular HMO plans.
- Save money on out-of-pocket costs. When you choose Tier 1 – Preferred providers, you’ll pay lower out-of-pocket costs when you receive care.
- Choose quality providers that offer the best value. High quality doesn’t have to mean high cost. While all of the doctors and hospitals in our network must meet high quality standards, many offer the same health care services at a lower cost. If they cost less, you pay less.
- Choose providers from any tier. You have the freedom to choose from any tier every time you receive care. You can choose providers in Tier 1 – Preferred for some covered services, and providers from Tiers 2 or 3 for other covered services.
- Pay the same cost for select services, no matter where you go. There are some covered services that cost the same across all tiers when you use an in-network provider, such as:
- Preventive care
- Emergency room
- Emergency ambulance
- Urgent care
- Prescription drugs
- Physical and occupational therapy
- Pediatric dental and vision
- Mental health
- Outpatient lab/pathology
- Routine radiology
Resources
Want to know more about Keystone HMO Proactive plans?
- Find out which hospitals are in each tier and which have Blue Distinction Center designation.
- Still have questions about the Keystone HMO Proactive health plans? Call a licensed agent to learn more about your health options at 1-888-475-6206 (TTY:711).
- Learn the differences between an HMO plan and a PPO plan.
- Get a quote.
Additional information
Review important information to get a better understanding of our individual and family health insurance policies and guidelines and the steps Independence Blue Cross takes to help you receive appropriate covered services.
1 HMO Silver Proactive Lite, HMO Silver Proactive Basic, and HMO Silver Proactive Essential are only available for purchase through the Pennsylvania Insurance Exchange (Pennie).
2 HMO Silver Proactive Select and HMO Silver Proactive Value are not offered on the Pennsylvania Insurance Exchange (Pennie) and must be purchased through Independence Blue Cross directly.