independence blue cross keystone first patient portal

How does Keystone first determine if a service is medically necessary?

Your PCP or other health care provider must give Keystone First information to show that the service or medication is medically necessary. Keystone First nurses review the medical information. The nurses use clinical guidelines approved by the Department of Human Services to see if the service or medication is medically necessary.

Is Independence Blue Cross owned by Blue Cross?

© Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.

How do I contact the member portal or Keystone First?

Log in to the member portal now. and start your journey to a better, healthier you. If you have questions about the member portal or Keystone First, call Member Services at 1-800-521-6860 (TTY 1-800-684-5505).

Why should I sign up for independence health insurance?

Sign in to access information about your claims and coverage, get reliable health information, and access decision-making tools to help you make the most of your benefits. Independence offers you several convenient ways to pay your health insurance bill.

Is Independence Blue Cross the same as Keystone?

Keystone 65 Focus Rx HMO (Keystone 65 Focus) is an Independence Blue Cross (Independence) Medicare Advantage HMO benefit product.

Is Keystone First Independence Blue Cross?

In 2012, backed by parent companies Independence Blue Cross and Blue Cross Blue Shield of Michigan, Keystone Mercy became Keystone First. Today, Keystone First serves more than 300,000 Medical Assistance recipients in the five-county Greater Philadelphia area.

Is Keystone first HMO or PPO?

We offer Keystone First VIP Choice (HMO-SNP) and Keystone First Community HealthChoices (CHC) as options. Visit the COMPASS website for more information on Community HealthChoices eligibility.

Is Keystone first considered Medicare?

Do you also have Medicare? Keystone First has a Medicare plan called Keystone First VIP Choice. You can find out more about our Medicare plan at the Keystone First VIP Choice website Opens a new window.

Is Keystone First Pennsylvania Medicaid?

Putting you first. 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.

Is Blue Cross Independence Medicare?

Independence Blue Cross (Independence) offers affordable Medicare Advantage plans in Philadelphia, Bucks, Chester, Delaware, and Montgomery Counties. Compare plan types below to see which one best meets your needs.

Which is better PPO or HMO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

What is PPO good for?

PPO stands for preferred provider organization. Just like an HMO, or health maintenance organization, a PPO plan offers a network of healthcare providers you can use for your medical care. These providers have agreed to provide care to the plan members at a certain rate.

What is Medicaid called in PA?

Medical AssistancePennsylvania's Medicaid program, also known as "Medical Assistance", provides comprehensive health care coverage for vulnerable populations and people with limited incomes.

Is Keystone 65 a Medicare plan?

Keystone 65 Basic Rx (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Independence Health Group, Inc.. Plan ID: H3952-055.

Is Medicare and Medicaid the same?

The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.

Does Keystone First cover weight loss programs?

Coverage policy Keystone First considers the use of bariatric surgery to be clinically proven and, therefore, medically necessary, in children and adolescents with severe obesity, when all of the following criteria are met: • Age of member is from 13 years to 17 years (InterQual®, 2018b, 2018c).

Which is better PPO or HMO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

Where is Independence BCBS headquarters?

Philadelphia, PAIndependence Blue Cross / Headquarters location

What is PPO good for?

PPO stands for preferred provider organization. Just like an HMO, or health maintenance organization, a PPO plan offers a network of healthcare providers you can use for your medical care. These providers have agreed to provide care to the plan members at a certain rate.

What is Keystone POS?

Keystone Point-of-Service lets you maintain freedom of choice by allowing you to select your own doctors and hospitals. You maximize your coverage by having care provided or referred by your primary care physician (PCP).

New to IBX?

Register today to find a doctor, view your ID card, and learn more about your health plan. You can even register 15 days in advance of your plan start date.

Need help?

For help with log in and registration, please call 1-800-ASK-BLUE 8 a.m. to 6 p.m., Monday - Friday.

What is a PCP in a keystone plan?

You pick a primary care physician (PCP), or family doctor, to coordinate your care. Your PCP will treat you for general health needs and refer you to specialists as needed. With a Keystone HMO plan, you will not be covered for care that you receive from doctors or hospitals outside the Keystone Health Plan East network ...

How many copays are there for Keystone HMO?

There is a maximum of 5 copays per admission. 2 Keystone HMO Silver and Keystone HMO Bronze are not available for purchase through the Pennsylvania Insurance Exchange (Pennie) and must be purchased through Independence directly.

Quality Management Program

Learn about the Independence Blue Cross Quality Management program and processes for maintaining standards of care.

Worksheets, forms, and guides

Use these resources to help track your patient’s condition and care. Topics include basic preventive health, immunization, behavioral health, and breast cancer risk.

Internet resources

Check out tools and information from nationally recognized health sources, including the Centers for Disease Control; the National Heart, Lung, and Blood Institute; and the National Cancer Institute.

Interventions and reminders

Learn about the periodic reminders we send to our members regarding important health screenings and preventive health care.

CMS star rating program

Learn about the Centers for Medicare & Medicaid Services’ (CMS) quality rating system and how improved ratings for Independence health plans benefit our members.

Comprehensive Care Program

Learn more about this next-generation care delivery program for high-risk patients to receive care when and where they need it.

Condition Management Program

Use this program to help engage your patients in managing their chronic conditions and making more informed decisions about certain significant medical conditions.

Make a payment

Independence offers you several convenient ways to pay your health insurance bill.

Estimate costs

Did you know that you can estimate your out-of-pocket costs before you schedule a doctor’s appointment or medical procedure? You can with the new Care Cost Estimator tool.

Save on medical costs

The type of health plan you have will dictate where you need to seek primary care, blood work, outpatient surgery, or other health services.

Find a doctor

Search for a participating provider by name, locations, specialty, or medical procedure.

What is a keystone first nurse?

Keystone First nurses review the medical information. The nurses use clinical guidelines approved by the Department of Human Services to see if the service or medication is medically necessary. If the request cannot be approved by a Keystone First nurse, a Keystone First doctor will review the request. If the request is approved, we will let you ...

Is Keystone First responsible for copay?

Genetic laboratory testing. As a Keystone First member, you are not responsible to pay for medically necessary, covered services. You may, however, be responsible for a copay.

Is Keystone First covered by Medicare?

The service provided is not covered by Keystone First ...

Let's improve health outcomes for members with diabetes

Diabetes remains a leading cause of death in the United States, with total direct and indirect medical costs estimated at $245 billion, according to the American Diabetes Association (ADA). The ADA reports that an increased number of cases are reported every year.

Healthy Families, Safe Communities - Keystone First Putting Safety First

We invite you to partner with Keystone First and join us in making a long-term commitment to being anti-violence advocates. We are launching Healthy Families, Safe Communities, an education campaign including materials and resources for both members and providers.

Let Us Know

Learn about our program developed to assist your practice in engaging and managing the healthcare needs of chronically ill Keystone First members.

Contact us

If the provider directory is not available, please contact Provider Services at 1-800-521-6007.