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Health Plans

Find a Provider or Pharmacy

Your Independence Blue Cross coverage gives you access to one of the largest provider networks in Southeastern Pennsylvania. Additionally, Independence Blue Cross contracts with FutureScripts® Secure to provide Medicare Part D prescription benefit management services, and one of the largest pharmacy networks.

Find a Doctor, Hospital, Pharmacy, Vision, Dental or Ancillary Provider

Search our online provider directory to find doctors, hospitals, pharmacy, vision, dental or ancillary providers who participate in the Keystone 65 HMO and Personal Choice PPO Medicare Advantage products available from Independence Blue Cross.
Find a Provider

Find a Pharmacy

Independence Blue Cross contracts with FutureScripts® Secure to provide Medicare Part D prescription benefit management services.
Find a Pharmacy

Find a Provider Online Search Tips

  • Select your health plan by clicking the drop down box under Choose a health plan and selecting Medical
  • You can narrow your search by typing in a location (e.g., city, zipcode) as well as search for a specific doctor, hospital or specialty
  • Once you add your search criteria, click Search to display your results
  • From here you can refine your search by selecting options under Refine your results and choosing from different criteria, such as Accepting New Patients, Quality Recognitions, Specialty Languages Spoken by Staff, Gender
  • Your results will be displayed on an interactive map and in list form. You may view a specific provider’s details, including plans accepted, admitting privileges, and designated site locations, by clicking their name.
  • To print your results as a PDF, click the Save & Print button on the right-hand side
  • You can compare up to five providers by clicking the Compare box under the providers of your choosing; once you have made your selections, click Compare Doctors in the upper right corner of the screen, and then select Open Compare Drawer

Download a Select Option PDP Pharmacy Directory

This pharmacy directory is available for Medicare Part D Prescription Drug Plan retirees who are eligible for Medicare benefits offered by their former employer or Health and Welfare Fund.

2017



Request a Printed Provider/Pharmacy Directory

If you need help finding a network provider and/or pharmacy, please call 1-877-393-6733 (TTY/TDD: 711) or view our online searchable directory above. If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, or request a printed Provider/Pharmacy Directory.


About Our Provider and Pharmacy Directory

This directory provides a list of Keystone 65 Focus HMO, Keystone 65 Select HMO, Keystone 65 Preferred HMO, and Personal Choice 65 PPO's network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage.

This directory is for Keystone 65 Focus HMO, Keystone 65 Select HMO, Keystone 65 Preferred HMO, and Personal Choice 65 PPO's service areas. For more information on our service area, please reference the Find a Plan page.

Some network providers may have been added or removed from our network after this directory was last updated. We do not guarantee that each provider is still accepting new members.

For Keystone 65 HMO members

You should use this directory to select a primary care physician. You must choose a network physician to be your primary care physician (PCP). Your primary care physician will coordinate all specialty care for you. Your primary care physician will refer you to a specialist for all specialty care visits. Your primary care physician will give you a referral if you need to seek care from a network specialist.

The "network providers" listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. In most situations, your network PCP must give you approval in advance before you can use other providers in the plan's network, such as specialists, hospitals, skilled nursing facilities, or home health care agencies. Members have a choice of specialists, with PCP referral when required; however, members must receive care for routine X-ray facilities, laboratory, physical therapy, and occupational therapy at the PCP's designated site. Covered services that need prior authorization (approval in advance) are marked in the Benefits Chart in your Evidence of Coverage.

Please refer to Chapter 4 in your Evidence of Coverage for more information on covered health services that you get from non-contracting providers. If a non-contracting provider submits a bill directly to you and asks you to pay for covered services you received from the non-contracting provider, you should not pay the bill. Instead, please submit the bill to Keystone 65 for processing and determination of your liability, if any. It is best to ask a non-contracting provider to bill Keystone 65 first, but if you already paid for the covered services, we will pay you for our share of the cost. If you get a bill for the services, you may send the bill to Keystone 65 for payment. We will pay the non-contracting provider for our share of the bill and will let you know what, if anything, you must pay. You won't have to pay a non-contracting provider any more than what the non-contracting provider would have received from you if you had been covered under the Original Medicare plan.

If you need care when you are outside the service area, your coverage is limited (see definition of limited circumstances). The only services we cover when you are outside our service area, but within the United States and its territories, are care for a medical emergency, urgently needed care, and renal dialysis. We also provide coverage outside of the United States for a medical emergency and for urgently needed care. See Chapter 4 of your Evidence of Coverage for more information about care for a medical emergency and urgently needed care. If you have questions about what medical care is covered when you travel, please call the Member Help Team at 1-800-645-3965, seven days a week, 8 a.m. to 8 p.m. TTY/TDD users should call 711.

Emergency care and urgently needed care can always be obtained in or out of the service area from the nearest available provider. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider within the United States and its territories. You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services within the United States and its territories. If you obtain routine care from out-of-network providers within the United States and its territories, neither Medicare nor Keystone 65 will be responsible for the costs.

For Personal Choice 65 PPO members

You should use this directory to locate a physician, pharmacy, hospital or other health care provider in the Personal Choice 65 network. You do not need a referral from a physician for specialty care covered services.

The "network providers" listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. Our plan will cover services from either in-network or out-of-network providers, as long as the services are covered benefits and medically necessary. However, if you use an out-of-network provider, your share of the costs for your covered services may be higher.

Please refer to Chapter 4 of your Evidence of Coverage for more information on covered health services that you get from non-contracting providers. If a non-contracting provider submits a bill directly to you and asks you to pay for covered services you received from the non-contracting provider, you should not pay the bill. Instead, please submit the bill to Personal Choice 65 for processing and determination of your liability, if any. It is best to ask a non-contracting provider to bill Personal Choice 65 first, but if you already paid for the covered services, we will pay you for our share of the cost. If you get a bill for the services, you may send the bill to Personal Choice 65 for payment. We will pay the non-contracting provider for our share of the bill and will let you know what, if anything, you must pay. You won't have to pay a non-contracting provider any more than what the non-contracting provider would have received from you if you had been covered under the Original Medicare plan.

You may get covered emergency medical care whenever you need it, anywhere in the United States or its territories. For more information, see the Medical Benefits Chart in Chapter 4 of your Evidence of Coverage. Our plan also covers emergency care outside of the United States and its territories. See Chapter 4 of your Evidence of Coverage (Medical Benefits Chart (what is covered and what you pay)) for more information. Call the plan for details if travelling outside the United States. If you have an emergency, we will talk with the doctors who are giving you emergency care to help manage and follow up on your care. The doctors who are giving you emergency care will decide when your condition is stable and the medical emergency is over. After the emergency is over you are entitled to follow-up care to be sure your condition continues to be stable. Your follow-up care will be covered by our plan. If you get your follow-up care from out-of-network providers, you will pay the higher out-of-network cost-sharing. Sometimes it can be hard to know if you have a medical emergency. For example, you might go in for emergency care – thinking that your health is in serious danger – and the doctor may say that it wasn't a medical emergency after all. If it turns out that it was not an emergency, as long as you reasonably thought your health was in serious danger, we will cover your care. However, after the doctor has said that it was not an emergency, the amount of cost-sharing that you pay will depend on whether you get the care from network providers or out-of-network providers. If you get the care from network providers, your share of the costs will usually be lower than if you get the care from out-of-network providers.

"Urgently needed care" is a non-emergency, unforeseen medical illness, injury, or condition that requires immediate medical care. Urgently needed care may be furnished by in-network providers or by out-of network providers when network providers are temporarily unavailable or inaccessible. The unforeseen condition could, for example, be an unforeseen flare-up of a known condition that you have. When you are outside the service area and cannot get care from a network provider, our plan will cover urgently needed care that you get from any provider at the lower in-network cost-sharing amount. Our plan also covers urgently needed care outside of the United States and its territories. See Chapter 4 of your Evidence of Coverage (Medical Benefits Chart (what is covered and what you pay)) for more information. Call the plan for details if travelling outside the United States. Please note that non-urgently needed care is not covered outside the United States.

In most situations, if you are in the plan's service area and you use an out-of-network provider, you will pay a higher share of the costs for your care. However, if the circumstances are unusual or extraordinary, and network providers are temporarily unavailable or inaccessible, we will allow you to get covered services from an out-of-network provider at the lower in-network cost-sharing amount.

If you have questions about what medical care is covered when you travel, please call the Member Help Team at 1-888-718-3333, seven days a week, 8 a.m. to 8 p.m. TTY/TDD users should call 711.

How do you find Keystone 65/ Personal Choice 65 providers in your area?

The Find a Provider/Find a Pharmacy tool contains primary care physicians, specialists, hospitals, urgent care centers and pharmacies.

To find a provider or pharmacy participating in our network:

  • Click on Find Provider or Pharmacy button
  • On the next screen, in the top right box, enter city, state, or zip code for the area you are searching
  • Under "Plans" on the left of the screen, select the plan you are interested in
  • Then click on one of the four options (Find a PCP, Urgent Care, Hospital, or Pharmacy)
  • The next screen will display the results for your search
  • To start over, click the "Doctors, Facilities, Urgent Care & Pharmacies" text on the upper left corner

Website Last Updated: 3/20/2017
Y0041_HM_17_43499e Approved 2/22/2017