This formulary is subject to change throughout the year and plan exclusions may override this list. Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company — independent licensees of the Blue Cross and Blue Shield Association. 2020 Qualified High Deductible Health Plan - July 1, 2020. The total cost of the premiums, co-payments and deductibles you pay under a Medicare Advantage plan is often lower than the total costs for coinsurance, co-payments and deductibles in Original Medicare. refers to “plan” or “our plan,” it means Keystone 65 Rx, Personal Choice 65 Rx, and Select Option Rx. Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS . Benefit designs may vary with respect to drug coverage, quantity limits, step therapy, days supply and prior authorization. INFORMATION ABOUT THE DRUGS WE COVER . Independent licensees of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Keystone First is Pennsylvania's largest Medical Assistance (Medicaid) managed care health plan serving more than 400,000 Medical Assistance recipients in southeastern Pennsylvania including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties. Personal Choice 65: Benefits underwritten by QCC Insurance Company, a subsidiary of Independence Blue Cross — independent licensees of the Blue Cross and Blue Shield Association. If you are a member with diabetes, call the Keystone First Care Management department to sign up for the program. Keystone First, coverage by Vista Health Plan, an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania. Click here to access the … HPMS Approved Formulary File . This site contains links to other Internet sites. Submission ID: 20543 Version #: 18. This document can assist medical providers in selecting clinically appropriate and cost-effective products for their patients. This formulary was current at the time of printing and is subject to change. The drugs represented have been reviewed by a National Pharmacy and Therapeutics (P&T) Committee and are approved for inclusion. Keystone 65 Rx, Personal Choice 65 Rx, and Select Option Rx Formulary (List of Covered Drugs). Enrollment in Independence Medicare Advantage plans depends on contract renewal. However, this plan does not … On January 1, 2020, the Pennsylvania Department of Human Services (DHS) made changes in the way that some medicines are covered.All Pennsylvania Medical Assistance (Medicaid) health plans were required to move to a statewide preferred drug list (PDL).If you have any questions about this change, please call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976). Please call the number listed on your member ID card if you have questions about your specific prescription drug benefits. IN THIS PLAN. We are pleased to provide the 2020 MetroPlus Health Plan Formulary as a useful reference and informational tool. You will receive notice when necessary. Health plans comparison chart Keystone HMO Proactive plans Keystone HMO plans Personal Choice PPO plans Personal Choice EPO plans Personal Choice EPO Reserve plan Personal Choice EPO Catastrophic plan. Keystone 65 Preferred Medical-Only HMO covers Part B drugs, including chemotherapy and some other drugs administered by your provider. You can see our complete plan Formulary (List of Covered Drugs) and any restrictions on our website, www.ibxmedicare.com. Keystone 65: Benefits underwritten by Keystone Health Plan East, a subsidiary of Independence Blue Cross — independent licensees of the Blue Cross and Blue Shield Association. Thank you for choosing Keystone First VIP Choice (HMO SNP), where you'll be treated like the VIP you are. 2020 Qualified High Deductible Health Plan - January 1, 2020. Healthcare benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company ®, Capital Advantage Assurance Company ® and Keystone Health Plan ® Central. This formulary is subject to change throughout the year and plan exclusions may override this list. Rather, it is offered as a tool to help Plan members and providers recognize formulary drugs to facilitate the appropriate drug therapy. Health Details: A formulary is a list of covered drugs selected by Keystone First VIP Choice in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Keystone 65 Basic Rx (HMO) offered by Keystone Health Plan East, Inc. 2020. contact Keystone First VIP Choice at . Health Partners Medicaid PDL and Supplemental Formulary; KidzPartners (CHIP) 2020 downloadable formularies (by plan) Use these links to download PDFs of our 2020 formularies: Health Partners (Medicaid): Effective January 1, 2020, the Department of Human Services (DHS) is implementing a Preferred Drug List (PDL) for all Pennsylvania Medical Assistance members. Our most popular plan, Keystone HMO Proactive, works just like a typical Health Maintenance Organization (HMO) in that you can visit any doctor or hospital in the Keystone Health Plan East network, and you select a primary care physician to refer you to specialists. This plan is administered by KEYSTONE HEALTH PLAN EAST, INC.. To switch to a different Medicare Advantage plan or to change your location, click here. ACA … You select a primary care physician also referred as a (PCP) to … Medicare beneficiaries may also enroll in Keystone 65 HMO, Keystone 65 HMO-POS, Personal Choice 65 SM PPO, or Select Option ® PDP through the … Keystone 65: Benefits underwritten by Keystone Health Plan East, a subsidiary of Independence Blue Cross — independent licensees of the Blue Cross and Blue Shield Association. refers to “plan” or “our plan,” it means Keystone 65 Rx, Personal Choice 65 Rx, and Select Option Rx. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January 1, 2021, and from time to time during the year. Coverage by Vista Health Plan, an independent licensee of the Blue Cross and Blue Shield Association. Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company — independent licensees of the Blue Cross and Blue Shield Association. You must generally use network pharmacies to use your prescription drug benefit. Call . 2020 Keystone 65 Focus Rx (HMO-POS) Formulary. For more recent information o r other questions, please contac t Journey Rx cust omer service. Formulary (List of Covered Drugs). Y0041_HM_18_71220 … The formulary, pharmacy network, and/or provider network may change at any time. 1-877-690-8196, 8 a.m. to 8 p.m., … Benefit may vary; not all plans provide this incentive. Generic drugs usually cost less … 2020 Formulary - Keystone First VIP Choice. 2020 Keystone 65 Basic Rx (HMO) Formulary. 2020 Formulary (List of covered drugs) Effective January 1, 2020. Formulary ID: 00020391 Version 18 This formulary was updated on 12/1/2020. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January 1, 2021, and from time to time during the year. Diabetes is a disease that affects how your body breaks down sugar. 2020 ACA Preventive Drug List. 2021 Qualified High Deductible Health Plan - January 1, 2021. You must generally use network pharmacies to use your prescription drug benefit. Please call the number listed on your member ID card if you have questions about your specific prescription drug benefits. Annual Notice of Changes for 2020 You are currently enrolled as a member of Keystone 65 Basic Rx. PLEASE READ: THIS DOCUMENT CON TAINS INFORM ATION ABOUT THE DRUGS WE COVER IN THIS PLAN. Low income plans. With Keystone First VIP Choice, you get all the benefits of regular Medicare and more, including: Click here to see the Keystone 65 Select Rx (HMO) health and prescription benefit details in chart format or email and view benefits chart: Plan Premium: The Keystone 65 Select Rx (HMO) has a monthly premium of $82.50. When you purchase a Keystone HMO plan from Independence Blue Cross, you may see any doctor or visit any hospital in the Keystone HMO network. Below is the Formulary, or drug list, for Keystone 65 Select Rx (HMO) from Keystone Health Plan East, Inc.. A formulary is a list of prescription medications that are covered under Keystone Health Plan East, Inc.'s 2020 Medicare Advantage Plan … Generic drugs have the same active-ingredient formula as a brand name drug. 2020 Keystone HMO Silver Proactive Author: Independence Blue Cross Subject: hmo proactive Keywords: hmo proactive, silver, 2020, ketsone health plan east, khpe, plan details Created Date: 10/10/2019 11:45:18 AM Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield — independent licensees of the Blue Cross and Blue Shield Association. Magellan Behavioral Health, Inc., an independent company, manages mental health and substance … Please understand that this formulary is not intended as a substitute for a provider’s independent, professional judgment. Dental plans… 2020 Keystone 65 Select Rx (HMO) Formulary. Below is the Formulary, or drug list, for Keystone 65 Focus Rx (HMO-POS) from Keystone Health Plan East, Inc.. A formulary is a list of prescription medications that are covered under Keystone Health Plan East, Inc.'s 2020 Medicare Advantage Plan in Pennsylvania. 2020 Qualified High Deductible Health Plan - HSA Preventive Drug List. Keystone HMO Plans (215) 675-6846 . 2020 … Benefit designs may vary with respect to drug coverage, quantity limits, days supply and prior authorization. This formulary was updated on 11/01/2020. It causes your body to have too much sugar in the blood. … This booklet tells about the changes. Keystone 65 Basic Rx HMO, Keystone 65 Focus Rx HMO-POS, and Keystone 65 Select Rx HMO cover Part D drugs. Or not enough insulin, a hormone that helps your body break down the sugar in the food you eat for energy. These HMO plans also let you save on your out-of-pocket costs when you visit certain health care providers. Benefits underwritten by Keystone Health Plan East, a subsidiary of Independence Blue Cross – independent licensees of the Blue Cross and Blue Shield Association. We cover both brand name drugs and generic drugs. Report fraud, waste and abuse. If you want to compare our plans with other available Medicare health plans, ask the other plan(s) ... You can see our complete plan Formulary (List of Covered Drugs) and any restrictions on our website, www.ibxmedicare.com. For more recent information or other questions, please . This site contains links to other Internet sites. DL 01 1608 0412 G Generic LCG Low Cost Generic. In addition to your monthly part B premium (usually $144.30) you must pay a monthly premium for the services included in the plan.The standard Part B premium amount in 2020 is $144.30. You can find out if your drug has any additional requirements or limits by looking in your plan . That is $990.00 for … Health savings account (HSA) Children's Health Insurance Program (CHIP) Coverage Eligibility Apply Member resources Health and preventive care Contact us. Members 2020. In addition, the plans cover Part B drugs such as chemotherapy and some other drugs administered by your provider. Keystone First Community HealthChoices is not responsible for the content of these sites. Providence Health Plan is pleased to provide plan members with a comprehensive prescription drug formulary designed to promote safe, effective and affordable drug therapy. Self-Employed. Simply healthy. 2020 PROVIDENCE FORMULARY J Welcome . Affordable Health Insurance plans available from Keystone Health Plan East . 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