Disclaimer | Contacts Copyright © 2021 Medicare Help, State Health Insurance Assistance Programs SHIP, 2020 Keystone First VIP Choice (HMO D-SNP) H4227-001 Formulary, See the 2020 VISTA Health Plan Inc. Formulary. In 2020 once you and your plan provider have spent $4020 on covered drugs. Enrollment in Keystone First VIP Choice depends on contract renewal. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. Full service insurance company has always been there for my business needs. The Keystone First VIP Choice (HMO D-SNP) medicare insurance plan offers a $0 premium obligation if you receive a full low-income subsidy (LIS) assistance. You generally are also responsible for paying the Part B premium. Keystone First VIP Choice (HMO SNP) is not responsible for the content of these sites. One of our helpful agents will then contact you to discuss your needs. This plan is available in PA. Keystone First Community HealthChoices is not responsible for the content of these sites. Your PCP will treat you for general health needs and refer you to specialists as needed. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Keystone HMO Children’s Health Insurance Program (CHIP) Questions about COVID-19 and Keystone HMO CHIP coverage? View 2021 Enrollment Info. You will receive notice when necessary. Provides coverage for routine eye exam for patients who needs eye glasses to correct for nearsightedness, farsightedness and presbyopia. The Keystone Insurance Group is an independent insurance agency who has the opportunity to search multiple companies for the coverage you need at the price you can afford. It is important for you to be aware of your benefits and any restrictions that may apply to your specific plan. Cowbell will distribute its standalone, admitted cyber coverage and risk insights through Keystone's vast agency network. This information is not a complete description of benefits. Keystone First VIP Choice is an HMO-SNP plan with a Medicare contract and a contract with the Pennsylvania Medicaid program. Keystone First members receive the followingmedical benefits: Preventive care/routine care. Coverage by Vista Health Plan, an independent licensee of the Blue Cross and Blue Shield Association. Independent Licensee of the Blue Cross and Blue Shield Association. Claim forms are typically found in your account on the insurance company’s website. Same-day appointments are often available, you can search for real-time availability of Dermatologists who accept Keystone First insurance and make an appointment online. Our plan offers members an extensive provider network of physicians, specialists, pharmacies and hospitals. Keystone First VIP Choice (HMO D-SNP) is a Local HMO. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Centers for Medicare and Medicaid Services (CMS) pay the insurance company to administer these benefits. This VISTA Health Plan Inc. plan does not offer additional coverage through the gap. Or, call 1‑833‑243‑8258 (TTY 711) for information on the trusted coverage and services available to you. (AKA "donut hole") You will be required to pay 25% for brand-name drugs and 25% on generic drugs unless your plan offers additional coverage. And the payment is $9.30 for 75% low income subsidy $18.70 for 50% and $28.00 for 25%. 1 dental exam and 1 cleaning, per provider/group, every 180 days (6 months). Keystone First VIP Choice (HMO D-SNP) is a 2020 Medicare Advantage Special Needs Plan plan by VISTA Health Plan Inc.. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by VISTA Health Plan Inc. above and beyond the standard PDP benefits. 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