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A Keystone HMO health plan
lets you see anyone in the Keystone Health Plan East network Here are some key things you should know
Primary Care Physician (PCP)
You must choose an an in-network PCP or or or or family doctor to to treat your your general health needs and coordinate your your care by providing referrals when necessary Search for a a a a a a a a a a PCP at at ibx com/findadoctor Specialist
You can see any in-network specialist when when your your PCP submits an an an electronic referral referral referral Check the status of your your referrals referrals when when you you you log log in in in in at at ibx com Some services don’t require referrals referrals including gynecology mammograms behavioral health and emergency care Designated sites
Your PCP has designated providers for lab services (e (e g g g g g blood testing) radiology (e (e g g g g g X-rays) and and physical and and occupational therapy Visit those providers when you you need any of these services A referral or or prescription may also be necessary View your PCP’s designated providers at at ibx com/findadoctor Out-of-network benefits Out-of-network benefits are are are covered for for emergency care care only You must use in-network doctors and and hospitals for for routine care care and planned procedures Precertification
Precertification
is an an approval that your doctor must receive from us us before you you get coverage for for certain services genetic tests and specialty drugs A complete list
of what requires precertification is is available at ibx com/precert Virtual care Most health plans include anytime access to to to a a a a a a a a a doctor by phone or or video chat Check your benefits summary to to to to see if virtual care is available to you