Independence Blue Cross
The following Independence Blue Cross plans are accepted at Oak Street Health locations.
| 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 |
| Keystone First VIP Choice (HMO D-SNP) | H4227-001 | 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 |