Keystone 65 Preferred Rx, a Philadelphia County, Pennsylvania Medicare Advantage plan from Keystone 65, is a Health Maintenance Organization (HMO) option for people with Medicare. It gives you all of the same health insurance benefits as original Medicare and offers extras that Medicare does not cover.
The insurance premium is $190.00 per month. You also have co-payments and/or co-insurances with each healthcare service that you use. You can learn more about the basic coverage costs on the co-payments page.
The real benefit of an HMO plan like Keystone 65 Preferred Rx is lower, predictable out-of-pocket expenses. Although more restrictive than original Medicare, a Medicare Advantage HMO plan limits your annual out-of-pocket costs. With Medicare Parts A and B, there's no cap, leaving you vulnerable to excessive medical bills.
With an HMO you are required to use healthcare providers in the plan's network. If you don't you will incur additional costs. Also, be aware that your primary care physician must make refer you before you see a specialist.
The Centers for Medicare and Medicaid Services (CMS) reviews and rates the quality of all plans. The 1 (worst) to 5 (best) star ratings assist people considering plans and offer an unbiased measure of quality.
The CMS has awarded Keystone 65 Preferred Rx Above Average as compared to all others (as of 15 October, 2014).out of 5 stars. That means Medicare deems this plan
Medicare Advantage plans are limited to a maximum out-of-pocket limit of $6,700 (annually). This out-of-pocket limit does not include your prescriptions or your monthly premiums. It only applies to your costs for healthcare services.
Although the mandatory limit is $6,700, the CMS allows plans to offer a lower limit that can be as low as $3,400. The out-of-pocket limit on this plan is $5,000. Be sure to take into consideration, along with the premium and the co-payments, when making your enrollment decision.
If you are comparing Keystone 65 Preferred Rx with your original Medicare benefits, it's important to remember that there are no limits to your out-of-pocket expenses with Medicare Part A or Medicare Part B. If you keep your original Medicare benefits, the only way to avoid high medical bills is to purchase Medicare Supplement insurance to supplement your coverage.
Your healthcare needs are as unique as you are, so shop around. We recommend comparing Keystone 65 Preferred Rx with:
- Advantra Silver
- HumanaChoice H5525-005
- Humana Gold Choice H8145-053
- Aetna Medicare Premier Plan
- Personal Choice 65 Rx
Keystone 65 Preferred Rx vs. Medigap Plan K
If you're looking at Keystone 65 Preferred Rx because of it premium, we suggest looking a Medigap Plan K, as well. The out-of-pocket limit on Plan K is $4,940 vs. $5,000 on this plan. You also have complete freedom to see the physician you choose. Visit Medigap Plan K vs. Medicare Advantage to see other important differences.
Who Can Join?
You can join Keystone 65 Preferred Rx if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area. You must continue to pay your Medicare Part B premium. The service area includes: Philadelphia, and all other areas of Philadelphia County, Pennsylvania.
CMS File Date: October 15, 2014.
This Medicare Advantage Plan catalog is maintained by 9/14/2015. For more information, download the Summary of Benefits , visit the Keystone 65 website, or call Keystone 65 at N/A.and was last updated on