Plans for Independence Blue Cross
107,208 Total Members
Prescription Hearing Aid Coverage | ||||||||||||
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Company | Plan name | Plan type | OTC Supplement | OTC Rolls Over? | Annual OTC Supplement | Coverage? | Covered Amount | Coinsurance? | Copay? | Prior Authorization? | Need Referral? | Enrollees |
Independence Blue Cross |
Keystone 65 Basic Rx (HMO) H3952-055-0 |
HMO | $70 per Quarter | No | $280 | Yes | No | Yes | No | No | 21,601 | |
Independence Blue Cross |
Keystone 65 Basic Rx (HMO) H3952-056-0 |
HMO | $70 per Quarter | No | $280 | Yes | No | Yes | No | No | 16,919 | |
Independence Blue Cross |
Keystone 65 Select Rx (HMO) H3952-049-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 11,528 | |
Independence Blue Cross |
Personal Choice 65 Prime Rx (PPO) H3909-015-0 |
Local PPO | $70 per Quarter | No | $280 | Yes | No | Yes | No | No | 9,429 | |
Independence Blue Cross |
Keystone 65 Select Rx (HMO) H3952-051-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 8,349 | |
Independence Blue Cross |
Keystone 65 Focus Rx (HMO-POS) H3952-053-0 |
HMOPOS | $70 per Quarter | No | $280 | Yes | No | Yes | No | No | 8,265 | |
Independence Blue Cross |
Personal Choice 65 Prime Rx (PPO) H3909-014-0 |
Local PPO | $70 per Quarter | No | $280 | Yes | No | Yes | No | No | 7,082 | |
Independence Blue Cross |
Keystone 65 Focus Rx (HMO-POS) H3952-054-0 |
HMOPOS | $70 per Quarter | No | $280 | Yes | No | Yes | No | No | 3,602 | |
Independence Blue Cross |
Keystone 65 Preferred Rx (HMO) H3952-020-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 3,566 | |
Independence Blue Cross |
Personal Choice 65 Rx (PPO) H3909-009-0 |
Local PPO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 2,710 | |
Independence Blue Cross |
Keystone 65 Preferred Rx (HMO) H3952-045-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 2,085 | |
Independence Blue Cross |
Personal Choice 65 Elite Rx (PPO) H3909-017-0 |
Local PPO | $125 per Quarter | No | $500 | Yes | No | Yes | No | No | 2,049 | |
Independence Blue Cross |
Keystone 65 Group Rx (HMO) H3952-804-0 |
HMO | No | $0 | No | 1,615 | ||||||
Independence Blue Cross |
Personal Choice 65 Rx (PPO) H3909-001-0 |
Local PPO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 1,483 | |
Independence Blue Cross |
Personal Choice 65 Saver Rx (PPO) H3909-016-0 |
Local PPO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 1,288 | |
Independence Blue Cross |
Personal Choice 65 Group Rx (PPO) H3909-802-0 |
Local PPO | No | $0 | No | 1,179 | ||||||
Independence Blue Cross |
Keystone 65 Select Medical Only (HMO) H3952-048-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 1,038 | |
Independence Blue Cross |
Keystone 65 Group Medical Only (HMO) H3952-802-0 |
HMO | No | $0 | No | 960 | ||||||
Independence Blue Cross |
Keystone 65 Select Medical Only (HMO) H3952-050-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 899 | |
Independence Blue Cross |
Personal Choice 65 Group Medical Only (PPO) H3909-801-0 |
Local PPO | No | $0 | No | 617 | ||||||
Independence Blue Cross |
Keystone 65 Preferred Medical Only (HMO) H3952-008-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 434 | |
Independence Blue Cross |
Keystone 65 Preferred Medical Only (HMO) H3952-044-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 247 | |
Independence Blue Cross |
Keystone 65 Liberty Medical Only (HMO) H3952-059-0 |
HMO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 134 | |
Independence Blue Cross |
Personal Choice 65 Medical Only (PPO) H3909-007-0 |
Local PPO | $30 per Quarter | No | $120 | Yes | No | Yes | No | No | 129 |