Independence Blue Cross
Medicare
in
Pennsylvania
Independence Blue Cross
Plans Available
in
Pennsylvania
Plans Available in Pennsylvania
Monthly premiums, out-of-pocket maximums, and CMS star ratings for 14 plans.
| Plan Name | Type | Monthly Premium | Max Out-of-Pocket | Star Rating |
|---|---|---|---|---|
| Keystone First VIP Choice (HMO D-SNP) | HMO | $32.70 | $9,250.00 | ★★★★★ |
| Keystone 65 Essential Rx (HMO-POS) | HMO-POS | $31.00 | $8,500.00 | ★★★★★ |
| Keystone 65 Liberty Medical Only (HMO) | HMO | Not Applicable | $6,750.00 | ★★★★★ |
| Keystone 65 Basic Rx (HMO) | HMO | $0.00 | $8,500.00 | ★★★★★ |
| Keystone 65 Focus Rx (HMO-POS) | HMO-POS | $0.00 | $6,750.00 | ★★★★★ |
| Keystone 65 Select Rx (HMO) | HMO | $47.00 | $6,750.00 | ★★★★★ |
| Keystone 65 Select Medical Only (HMO) | HMO | Not Applicable | $6,750.00 | ★★★★★ |
| Keystone 65 Preferred Rx (HMO) | HMO | $188.00 | $4,200.00 | ★★★★★ |
| Keystone 65 Preferred Medical Only (HMO) | HMO | Not Applicable | $4,200.00 | ★★★★★ |
| Personal Choice 65 Achieve Rx (PPO) | PPO | $0.00 | $10,100.00 | ★★★★★ |
| Personal Choice 65 Plus Rx (PPO) | PPO | $214.00 | $6,300.00 | ★★★★★ |
| Personal Choice 65 Medical Only (PPO) | PPO | Not Applicable | $9,900.00 | ★★★★★ |
| Personal Choice 65 Rx (PPO) | PPO | $227.00 | $9,900.00 | ★★★★★ |
| Together Blue Medicare HMO Signature (HMO) | HMO | $0.00 | $4,900.00 | ★★★★★ |
Key Benefits Across Independence Blue Cross Plans
Primary care copays, specialist visits, OTC credit, and dental maximums.
| Plan Name | PCP Copay | Specialist | OTC Credit | Dental Max |
|---|---|---|---|---|
| Keystone First VIP Choice (HMO D-SNP) | $0.00 | $0.00 | $55.00 | Included |
| Keystone 65 Essential Rx (HMO-POS) | $0.00 | $35.00 | $60.00 | Included |
| Keystone 65 Liberty Medical Only (HMO) | $0.00 | $55.00 | $30.00 | Included |
| Keystone 65 Basic Rx (HMO) | $0.00 | $38.00 | $60.00 | Included |
| Keystone 65 Focus Rx (HMO-POS) | $0.00 | $30.00 | $60.00 | Included |
| Keystone 65 Select Rx (HMO) | $0.00 | $40.00 | $30.00 | Included |
| Keystone 65 Select Medical Only (HMO) | $0.00 | $40.00 | $30.00 | Included |
| Keystone 65 Preferred Rx (HMO) | $0.00 | $40.00 | $30.00 | Included |
| Keystone 65 Preferred Medical Only (HMO) | $0.00 | $40.00 | $30.00 | Included |
| Personal Choice 65 Achieve Rx (PPO) | $0.00 | $55.00 | $30.00 | Included |
| Personal Choice 65 Plus Rx (PPO) | $0.00 | $0.00 | $30.00 | Included |
| Personal Choice 65 Medical Only (PPO) | $0.00 | $40.00 | $30.00 | Included |
| Personal Choice 65 Rx (PPO) | $0.00 | $40.00 | $30.00 | Included |
| Together Blue Medicare HMO Signature (HMO) | $0.00 | $10 | $0.00 | $0.00 |
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Where
Independence Blue Cross
Plans Are Available
in
Pennsylvania
Other
Pennsylvania
Medicare Carriers
