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001716 Keystone65 App  Form

001716 Keystone65 App Form

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Coinsurance usually paid by Medigap. However I understand that I may either keep my current policy or cancel it if I am satisfied with Keystone 65. Signature Beneficiary or authorized representative X Date Please keep the gold copy of this Signature spouse Beneficiary or authorized representative X Date enrollment form as temporary ID valid Authorized representative must provide supporting documentation for example copy of durable power of attorney papers. for 90 days from enrollment date....
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What is a tiered network plan if you're looking for an HMO plan that can save you money an HMO with a tiered network may be right for you like a standard HMO it requires you to choose a primary care physician to coordinate your care and refer you to specialists when needed you're covered for in-network coverage only meaning you can only go to doctors and hospitals within the HMO network with an HMO tiered network plan the network is divided into three groups that we call tiers all three tiers have high quality doctors and hospitals but don't think that high quality has to equal high cost these tiers help you choose providers that offer you the best value on care this means you have a choice on how much you pay for care you'll pay less when you see providers from tier 1 more when you choose to your 3 and somewhere in between for tier 2 there are some services that cost the same across all 3 tiers like emergency services and preventive care our HMO tiered network plan is called keystone


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