Dental benefits for members over age 21, who are eligible for dental benefits , are eligible for: 1 dental exam and 1 cleaning, every 6 months. Pulpotomies (removal of pulp) for pain relief. Re-cementing of crowns (re-gluing the crown).
First and second trimester terminations of pregnancy require prior authorization and are covered in the following two circumstances: The member’s life is endangered if she were to carry the pregnancy to term. The pregnancy is the result of an act of rape or incest.
Tom Corbett has reduced the coverage for 2 million adult Medicaid patients to basic dental care. The changes have eliminated coverage for root canals and periodontal disease work, and limited the number of dentures a patient can receive. The plan now covers little more than cleanings, fillings — and extractions.
Putting you first . Keystone First is Pennsylvania’s largest Medical Assistance (Medicaid) managed care health plan serving more than 400,000 Medical Assistance recipients in southeastern Pennsylvania including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.
Keystone First considers abdominoplasty to be clinically proven and, therefore, medically necessary when performed in conjunction with a panniculectomy that meets the above criteria. Endoscopic abdominoplasty or mini- abdominoplasty is not medically necessary for any reason.
You are 21 years of age or older and begin receiving Medicare Part D (Prescription Drug Coverage). You go to a state mental health hospital. You may also become eligible for Community HealthChoices.
In 2012, backed by parent companies Independence Blue Cross and Blue Cross Blue Shield of Michigan, Keystone Mercy became Keystone First . Today, Keystone First serves more than 300,000 Medical Assistance recipients in the five-county Greater Philadelphia area.
Keystone First Community HealthChoices (CHC) is a managed care organization.
Abortion pill ( medication abortion ) services are available by appointment only. Plan to be at the health center for 4-6 hour(s) for your entire abortion pill visit ( medication abortion ). You will need to follow up within 1-2 weeks to make sure your abortion is complete and that you are well.
NCQA Health Insurance Plan Ratings 2015-2016 – Summary Report (Medicaid)
|Rating||Plan Name||Consumer Satisfaction|
|4.0||AmeriHealth Caritas Pennsylvania||3.5|
|4.0||Health Partners Plans||3.5|
|4.0||UPMC For You||3.0|
Medicaid Services Pennsylvania covers 24 optional benefits, including prescription drugs, vision, dental, physical therapy, home health, and hospice care. It also includes the ACA’s ten essential health benefits, such as preventive care, as well as expanded mental health and substance use treatment services.
We cover exams, cleanings, and fillings for all UPMC for You members. Avesis manages UPMC for You Dental benefits. Members can call Dental Member Services at 1-888-257-0474 to get a dentist’s name or to see what dental benefits they have.
Keystone First does not cover prescription eyeglasses or prescription contact lenses for members 21 years of age and older, but there are special provisions for members with aphakia or cataracts. Call Member Services at 1-800-521-6860 for more information. *There may be co-pays for some eye care services.
Enroll Now Call 1-800-440-3989 (TTY users call 1-800-618-4225) for PA Enrollment Services. The HealthChoices enrollment specialists help people who are enrolled in the Medical Assistance program to choose a health plan. They have information about Keystone First and can answer your questions.
Keystone Login is a single, secure user credential that is used to log in to multiple online services from the Commonwealth of Pennsylvania, replacing existing PALogin credentials.