Keystone 65 HMO

2013 Monthly Premiums

How is this $0?

Keystone 65 Select HMO is a Medicare Advantage plan. A Medicare Advantage plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide beneficiaries with all of the Part A and Part B benefits. The Centers for Medicare & Medicaid Services (CMS) pay the private insurance company to administer these benefits.

Sometimes it is necessary to have a small premium in addition to what is received from CMS to cover the cost of care. The cost of care varies by plan and by year, which is why some plans (past and present) have a premium and others do not. Independence Blue Cross is constantly looking for ways to be more efficient and to work with our hospital and physician networks to help keep costs down. Because of these efforts, we’ve been able to cover the cost of Keystone 65 Select HMO with what CMS pays us. It’s as simple as that.

When you enroll in a Keystone 65 HMO plan, you must continue to pay your Medicare Part A premium (if applicable) and your Medicare Part B premium in addition to your Keystone 65 HMO premium. In return, you’ll receive your covered health care services.

The chart below shows the different Keystone 65 HMO plan options available in 2013 and what you will pay each month:

Keystone 65 Select HMO Plan Options

Monthly premiums

Keystone 65 Select HMO

(coverage includes medical-only)
$0.00 (Philadelphia and Bucks County residents)
$0.00 (Chester, Delaware, and Montgomery County residents)
Enroll in 2013 Keystone 65 Select/Preferred HMO

Keystone 65 Select HMO with Choice Program

(coverage includes medical + hearing, dental, and vision)
$10.00 (Philadelphia and Bucks County residents)
$10.00 (Chester, Delaware, and Montgomery County residents)
Enroll in 2013 Keystone 65 Select/Preferred HMO

Keystone 65 Select Rx HMO

(coverage includes medical + prescription drug)
$31.50 (Philadelphia and Bucks County residents)
$46.50 (Chester, Delaware, and Montgomery County residents)
Enroll in 2013 Keystone 65 Select/Preferred HMO

Keystone 65 Select Rx HMO with Choice Program

(coverage includes medical + hearing, dental, and vision coverage + prescription drug)
$41.50 (Philadelphia and Bucks County residents)
$56.50 (Chester, Delaware, and Montgomery County residents)
Enroll in 2013 Keystone 65 Select/Preferred HMO

Keystone 65 Preferred HMO Plan Options

Monthly premiums

Keystone 65 Preferred HMO

(coverage includes medical coverage including hearing, dental, and vision)
$125.40 (Philadelphia and Bucks County residents)
$184.80 (Chester, Delaware, and Montgomery County residents)
Enroll in 2013 Keystone 65 Select/Preferred HMO

Keystone 65 Preferred Rx HMO

(coverage includes medical coverage including hearing, dental, and vision + prescription drug)
$171.80 (Philadelphia and Bucks County residents)
$248.50 (Chester, Delaware, and Montgomery County residents)
Enroll in 2013 Keystone 65 Select/Preferred HMO

Dental, vision, and hearing coverage is standard with Keystone 65 Preferred plans!

Contact Us

  • Prospective members can call 1-877-393-6733 (1-877-219-5457 for the speech- and hearing-impaired), 8 a.m. to 8 p.m., seven days a week.
  • Members can call 1-800-645-3965 (1-888-857-4816 for the speech- and hearing-impaired), 8 a.m. to 8 p.m., seven days a week. However, please be aware that on weekends and holidays from February 15 through September 30, your call may be sent to voicemail.
  • Send us an email.
  • Prospective members can mail any inquiries to P.O. Box 13713, Philadelphia, PA 19101-3713.
  • Members can mail any inquiries to P.O. Box 7799, Philadelphia, PA 19101-7799.

Summary of Benefits

For details of covered services, copays, and deductibles for the Keystone 65 HMO plans, see the ibxmedicare.com Summary of Benefits Y0041_H3952_KS_13_2337 Accepted 09/23/2012


Website last updated: 9/30/2013
Y0041_HM_14_9866 Approved 11/5/2013