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Health Plans

Money Saving Programs

If you get extra help from Medicare in paying for your Medicare prescription drug plan costs, your monthly plan premium will be lower than if you did not get that extra help. The amount of extra help you get will determine your total monthly plan premium as a member of our plan. For more information on low income subsidies (LIS), visit Centers for Medicare and Medicaid Services.

Download our Guide to Savings for Medicare Beneficiaries.

2019 Low-income Subsidy

Our table shows you what your monthly plan premium will be if you get extra help.

Keystone 65 HMO Plans

Scroll or swipe to reveal all table data.

Plan premium

Plan premium based on your income level of extra help¹

 

Without extra help

100%

75%

50%

25%

Keystone 65 Basic Rx HMO

(medical + prescription drug coverage)
$0.00 (Philadelphia and Bucks residents)

$0.00 (Chester, Delaware, and Montgomery residents)
$0.00 (Philadelphia and Bucks residents)

$0.00 (Chester, Delaware, and Montgomery residents)
$0.00 (Philadelphia and Bucks residents)

$0.00 (Chester, Delaware, and Montgomery residents)
$0.00 (Philadelphia and Bucks residents)

$0.00 (Chester, Delaware, and Montgomery residents)
$0.00 (Philadelphia and Bucks residents)

$0.00 (Chester, Delaware, and Montgomery residents)

Keystone 65 Focus Rx HMO-POS

(medical + prescription drug coverage)
$10.00 (Philadelphia and Bucks residents)

$35.00 (Chester, Delaware, and Montgomery residents)
$0.00 (Philadelphia and Bucks residents)

$0.00 (Chester, Delaware, and Montgomery residents)
$2.50 (Philadelphia and Bucks residents)

$8.70 (Chester, Delaware, and Montgomery residents)
$5.00 (Philadelphia and Bucks residents)

$17.50 (Chester, Delaware, and Montgomery residents)
$7.50 (Philadelphia and Bucks residents)

$26.20 (Chester, Delaware, and Montgomery residents)

Keystone 65 Select Rx HMO

(medical + prescription drug coverage)
$68.00 (Philadelphia and Bucks residents)

$98.00 (Chester, Delaware, and Montgomery residents)
$31.00 (Philadelphia and Bucks residents)

$61.00 (Chester, Delaware, and Montgomery residents)
$40.20 (Philadelphia and Bucks residents)

$70.20 (Chester, Delaware, and Montgomery residents)
$49.50 (Philadelphia and Bucks residents)

$79.50 (Chester, Delaware, and Montgomery residents)
$58.70 (Philadelphia and Bucks residents)

$88.70 (Chester, Delaware, and Montgomery residents)

Keystone 65 Preferred Rx HMO

(medical coverage including hearing, dental, and vision + prescription drug)
$229.00 (Philadelphia and Bucks residents)

$289.00 (Chester, Delaware, and Montgomery residents)
$192.00 (Philadelphia and Bucks residents)

$252.00 (Chester, Delaware, and Montgomery residents)
$201.20 (Philadelphia and Bucks residents)

$261.20 (Chester, Delaware, and Montgomery residents)
$210.50 (Philadelphia and Bucks residents)

$270.50 (Chester, Delaware, and Montgomery residents)
$219.70 (Philadelphia and Bucks residents)

$279.70 (Chester, Delaware, and Montgomery residents)

Scroll or swipe to reveal all table data.

Personal Choice 65 PPO

Scroll or swipe to reveal all table data.

Plan premium

Plan premium based on your income level of extra help¹

 

Without extra help

100%

75%

50%

25%

Personal Choice 65 Rx PPO

(medical + prescription drug coverage)
$289.00 (Philadelphia and Bucks residents)

$160.00 (Chester, Delaware, and Montgomery residents)
$252.00 (Philadelphia and Bucks residents)

$123.00 (Chester, Delaware, and Montgomery residents)
$261.20 (Philadelphia and Bucks residents)

$132.20 (Chester, Delaware, and Montgomery residents)
$270.50 (Philadelphia and Bucks residents)

$141.50 (Chester, Delaware, and Montgomery residents)
$279.70 (Philadelphia and Bucks residents)

$150.70 (Chester, Delaware, and Montgomery residents)

¹ This does not include the Medicare Part B premium you must continue to pay. Independence Blue Cross's premium includes coverage for both medical services and prescription drug coverage. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

  • 1-800-MEDICARE. TTY/TDD users call 1-877-486-2048 (24 hours a day/seven days a week);
  • Pennsylvania Office of Medical Assistance Programs (Medicaid) at 1-800-537-8862;
  • the Social Security Administration at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

If you have any questions, please call the plan at 1-877-393-6733, (Speech- and hearing-impaired: 711) from 8 a.m. to 8 p.m. EST, seven days a week. Please note that on weekends and holidays from April 1 through September 30, your call may be sent to voicemail.

CMS defines brand and generic drugs based on what kind of application the drug manufacturer filed with the FDA.

  • Drugs filed with a New Drug Application (NDA) are considered brand for purposes of catastrophic and LIS cost share.
  • Drugs filed with an Abbreviated New Drug Application (ANDA) are considered generics.
  • This will not always match up to the brand/generic formulary tier assignments defined by Independence

Best Available Evidence Policy

Early in 2006, a number of factors contributed to the problem of incorrect cost-sharing levels for individuals eligible for Medicare and Medicaid, called full-benefit dual eligibles and other low-income (LIS) eligible individuals. The purpose of this link is to provide a member with information on CMS best available data policy, which is the policy CMS uses to determine eligibility in financial assistance programs.

In certain cases, CMS systems do not reflect a beneficiary's correct low-income subsidy (LIS) status at a particular point in time. To address these situations, CMS created the best available evidence (BAE) policy. This policy requires Plans to establish the appropriate cost-sharing for low-income beneficiaries when presented with evidence that the beneficiary's information is not accurate.

Learn more about the Best Available Evidence Policy.

PACE/PACENET/PACE Plus

The Pharmaceutical Assistance Contract for the Elderly (PACE), PACE Needs Enhancement Tier (PACENET), and PACE Plus programs offer coverage for generic and brand-name drugs with minimal copayment for each covered prescription filled.

Learn more or apply now.

Extra Help with Medicare Part D Prescription Drug Coverage

Extra Help is a program for Medicare beneficiaries to assist in paying their monthly premiums, annual deductibles, and prescription copayments related to their Medicare Part D prescription drug coverage plan.

Learn more or apply now.

Medicare Savings Programs

Depending on which program you qualify for, a Medicare Savings program will pay your Medicare premiums for Parts A and B, your Medicare deductibles, your Medicare copayments, or a combination of these expenses. The Medicare Savings programs are offered by the Department of Public Welfare and are known in Pennsylvania as Healthy Horizons. There are three types of Healthy Horizons Medicare Savings programs available.

Learn more.

Website last updated: 12/14/2018
Y0041_HM_19_67199b Accepted 12/21/2018

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