Independence Blue Cross
The following Independence Blue Cross plans are accepted at Oak Street Health locations.
The following plans are accepted in 2022. Accepted plans for 2023 will be updated shortly.
| Plan Name | Effective Year | Benefit Package | Summary |
|---|---|---|---|
| Keystone 65 Basic Rx (HMO) | 2022 & 2023 | H3952-056 | Download |
| Keystone 65 Basic Rx (HMO) | 2022 & 2023 | H3952-055 | Download |
| Keystone 65 Focus Rx (HMO-POS) | 2022 & 2023 | H3952-054 | Download |
| Keystone 65 Focus Rx (HMO-POS) | 2022 & 2023 | H3952-053 | Download |
| Keystone 65 Group Medical Only (HMO) | 2022 & 2023 | H3952-802 | |
| Keystone 65 Group Rx (HMO) | 2022 & 2023 | H3952-804 | |
| Keystone 65 Liberty Medical Only (HMO) | 2023 | H3952-059 | |
| Keystone 65 Preferred Medical Only (HMO) | 2022 & 2023 | H3952-044 | Download |
| Keystone 65 Preferred Medical Only (HMO) | 2022 & 2023 | H3952-008 | Download |
| Keystone 65 Preferred Rx (HMO) | 2022 & 2023 | H3952-045 | Download |
| Keystone 65 Preferred Rx (HMO) | 2022 & 2023 | H3952-020 | Download |
| Keystone 65 Select Medical Only (HMO) | 2022 & 2023 | H3952-050 | Download |
| Keystone 65 Select Medical Only (HMO) | 2022 & 2023 | H3952-048 | Download |
| Keystone 65 Select Rx (HMO) | 2022 & 2023 | H3952-051 | Download |
| Keystone 65 Select Rx (HMO) | 2022 & 2023 | H3952-049 | Download |
| Personal Choice 65 Elite Rx (PPO) | 2022 & 2023 | H3909-017 | Download |
| Personal Choice 65 Group Medical Only (PPO) | 2022 & 2023 | H3909-801 | |
| Personal Choice 65 Group Rx (PPO) | 2022 & 2023 | H3909-802 | |
| Personal Choice 65 Medical Only (PPO) | 2022 & 2023 | H3909-007 | Download |
| Personal Choice 65 Prime Rx (PPO) | 2022 & 2023 | H3909-014 | Download |
| Personal Choice 65 Prime Rx (PPO) | 2022 & 2023 | H3909-015 | Download |
| Personal Choice 65 Rx (PPO) | 2022 & 2023 | H3909-009 | Download |
| Personal Choice 65 Rx (PPO) | 2022 & 2023 | H3909-001 | Download |
| Personal Choice 65 Saver Rx (PPO) | 2022 & 2023 | H3909-016 | Download |
