Keystone 65 Select Medical Only (HMO)
plan information last updated February 8, 2023
Company: Independence Blue Cross
Plan enrollment: 1,038
Total monthly premium: $34
Max annual payment: No Maximum Payment
Plan link on Medicare.gov: Plan on Medicare.gov
Plan website: www.ibxmedicare.com
Plan member phone number: 800-645-3965
Plan prospect phone number: 877-393-6733
OTC Hearing Aid Coverage
Supplemental OTC Benefit Amount Per Period: $30.00
Benefit Amount is Every: Every three months
Can The Benefit Rollover Periods? No
Total Annual OTC Supplmental Benefit: $120.00
IMPORTANT NOTE:
Plans may not include hearing aids in their eligible OTC supplemental items. Please call the plan to verify if they include hearing aids in their OTC supplement catalog.
Prescription Hearing Aid Coverage
Does plan cover hearing aids?: Yes
How many hearing aids does the plan allow?
2 per Every year
What is the max coverage amount?
No maximum
Is the benefit ONLY available in-network? Can be out of network
Is there a maximum out of pocket cost? No out of pocket maximum
Does the member have to pay Coinsurance? No coinsurance required
Is a CoPay required? Yes
Minimum CoPay: $499
Maximum CoPay: $799
Is Prior Authorization Needed? No
Is Physician Referral Needed? No
