2025 Independence Blue Cross MA Certification ExamBy Brian Platte / July 24, 2024 Are there any referrals or deductibles on any Keystone 65 HMO or Personal Choice 65 PPO plans? Yes No Is a PCP required for an HMO member? Yes No Is the Primary Care Physician copay on ALL Keystone 65 HMO products a $0 dollar copay? Yes No Does Personal Choice 65 PPO include a Visitor Traveler Program? Yes No Does the Keystone 65 Liberty HMO plan include drug benefits? Yes No In 2025, Part D enrollees’ out-of-pocket drug costs, also known as the TrOOP will be capped at $2,000. Yes No As in past years, it is very important to check the 2025 formulary to ensure an enrollee’s/member’s drugs are covered and the tier placement of the drugs on both formularies. Yes No The Keystone 65 Essential Rx HMO-POS plan includes a transportation benefit available to all members and provides 12 one-way trips per year. Yes No Which of the below Dental Services has a $0 copayment? Oral Exam and Cleaning every six months Bitewing X-ray every year Panoramic X-ray every three years 1 fluoride treatment per year All of the above Which of the plans below has a $0 premium? Personal Choice 65 Prime Rx PPO Personal Choice 65 Saver RX PPO Keystone 65 Basic Rx HMO All of the Above Members will pay a lower copayment for Tier 1 and Tier 2 generic drugs filled at one of the plan’s preferred pharmacies. Yes No Which of the below statements is incorrect regarding the new Personal Choice 65 Plus Rx PPO plan? Features $0 Primary Care Physician (PCP) copay Features $0 Specialist copay Includes Rx Coverage with no deductible and $0 copay for Tier 1 and Tier 2 generic drugs Requires referrals for specialist care Over-the-Counter (OTC) benefits are included with all Medicare Advantage plans? True False The new Keystone 65 Essential Rx HMO-POS plan offers one of the highest comprehensive dental annual allowances at $3,000. True False Do all Independence Medicare Advantage plans include a fitness benefit through One Pass? Yes No Keystone 65 HMO and Personal Choice 65 PPO are only offered in Philadelphia, Bucks, Chester, Delaware, and Montgomery True False In 2025, the dental benefits will be administered by Dominion National. True False In 2025, all MA-PD plans have a $0 copay for Tier 1 preferred generic drug and Tier 2 generic drugs at Preferred Retail Pharmacies and Mail Order. True False In 2025, what is the cost-sharing responsibility for covered insulins on our formulary? $0 $20 $35 33% All 2025 Medicare Advantage plans include 6 routine chiropractic visits, 6 routine podiatry visits and 6 routine acupuncture visits as part of all individual Medicare Advantage plans. True False ResultsVote
