Keystone First VIP Choice (HMO D-SNP)

Keystone First VIP Choice (HMO D-SNP) is a HMO D-SNP plan offered by Independence Health Group, Inc. available for enrollment in 2025 to people living in Southeastern Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Keystone First VIP Choice (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Keystone First VIP Choice (HMO D-SNP).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Keystone First VIP Choice (HMO D-SNP) plan features an annual drug deductible of $615. During the initial coverage phase, members using standard pharmacies or standard mail order services generally pay a 25% coinsurance for Tier 1 preferred generics, Tier 2 generics, Tier 3 preferred brands, and Tier 5 specialty drugs. For Tier 4 non-preferred drugs, standard pharmacy and standard mail order costs require a 26% coinsurance. In contrast, Tier 6 select care drugs require no copay for one-month, two-month, or three-month supplies at standard pharmacies. This no-copay benefit also applies to two-month and three-month supplies of Tier 6 drugs filled through standard mail order. Knowing these coinsurance rates and copay exemptions helps beneficiaries accurately estimate their out-of-pocket prescription costs.

Additional Benefits

Keystone First VIP Choice (HMO D-SNP) offers comprehensive medical coverage featuring no copay for primary care visits, home health care, and preventive services. For specialized medical care, inpatient hospital stays require a $1,060 copay for the first two days with no coinsurance, while outpatient services and diagnostics generally carry a 30% coinsurance and no copay. Emergency services are covered with a $115 copay, and skilled nursing care is available with no copay for the first 20 days. In addition to medical care, this plan provides valuable supplemental benefits with no copay and no coinsurance, including routine dental care up to a $4,250 annual limit. Members also receive a $500 annual allowance for glasses or contacts, up to $2,000 every three years for prescription hearing aids, and 12 one-way transportation trips per year. A $55 monthly over-the-counter allowance and a chronic illness meal benefit further enhance the plan's everyday value.