Independence Blue Cross

Keystone HMO Silver

Prescription Drug Information

Inpatient Coverage

Emergency and Urgent Care

Links

Plan Overview

Medical Deductible	Individual: 3000 Family: 6000 Per Person: 3000
Prescription Drug Deductible	Individual: Included in Medical Family: Included in Medical Per Person: Included in Medical
Medical Out-of-Pocket Maximum	Individual: 8000 Family: 16000 Per Person: 8000
Drug Out-of-Pocket Maximum	Individual: Included in Medical Family: Included in Medical Per Person: Included in Medical

Office Visit

Primary Doctor	Standard: $35 Copay
Specialist	Standard: $70 Copay

Prescription Drug Information

Preferred Brand Drugs	Standard: 50% Coinsurance after deductible
Non Preferred Brand Drugs	Standard: 50% Coinsurance after deductible
Generic Drugs	Standard: $20 Copay
Specialty Drugs	Standard: 50% Coinsurance after deductible

Inpatient Coverage

Hospital Services	Standard: 30% Coinsurance after deductible
Inpatient Services	Standard: 30% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room

Standard: 30% Coinsurance after deductible

Related Articles

You may be interested in these relevant articles from across the HealthMarkets.com network.

How To Be An Alzheimer’s Caregiver: 5 Things You Need To Know

Are you an Alzheimer’s caregiver for a spouse, family member, or friend? You’re not…Read More

Read More

What is a drug formulary, and what does it cover?

There are a lot of things to consider when choosing a health plan. If…Read More

Read More

Get in Shape Faster: 3 Exercises to Improve Your Health

Ready to get in shape, but you’re short on time? Chances are pretty good…Read More

Read More