How do the HMO Proactive Plans and “Tiered Network” plans work?

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girl_ipad_reform_smallerTiered or Narrow Network Plans: Under the Affordable Care Act, insurance carriers have introduced “tiered network”, or narrowed network plans. Keystone Proactive Plans have a ” 3 tiered” network of providers. Although each carrier has different types of networks and benefit levels, the plans have the same general concept, steering the members by giving them a choice of providers that offer medical services at a lower out of pocket expense. Choosing a more expensive provider or facility may cost the member more out of pocket costs. United Healthcare offers 3 tiers in their “Navigate” plans, and Aetna uses “Savings Plus” designated providers to split the provider network into “designated” or “non designated” participating providers. In states outside of PA, check with your local carriers.

Total Benefit Solutions clients who choose these types of plans typically supplement their choice of medical plan with personal supplemental coverage. Click here for more information on supplemental plans.

Watch the video to find out more about Keystone’s proactive plans!

 

 

What are the Keystone Proactive HMO Plans? Click the link to download the Keystone HMO Proactive plans brochure from Independence Blue Cross

 

 

Searching for Keystone proactive Doctors by tier:

Hospital listing by tier: Click here

Searching for providers by tier? Please note you must select the proactive plans from the list

Go to this link:

https://ibxweb.healthsparq.com/healthsparq/public/#/one/city=Philadelphia&state=PA&country=&insurerCode=IBXBLUE_I&brandCode=IBXBLUECOMM&productCode=all

 

Choose a health plan:

 

 

 

 

 

From the drop down select, Medical then Keystone Proactive:

 

 

 

 

 

 

Now your search will return physicians with Tier listings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Download “Talk to your doctor about the Keystone Proactive plans”

Keystone HMO  Proactive provider Quality Standards


Aetna “Savings Plus” plans are similar with two tiers of providers.

Click here to download Aetna Savings Plus Brochure-2015


Need a quote or to get enrolled? Click here!

Questions? Ask your Total Benefit Solutions, Inc account manager today at (215)355-2121

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