INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • October 9th, 2015
Contract Type FiledOctober 9th, 2015This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Approved Service Area, which is a geographical area consisting of the following twenty-one (21) Pennsylvania counties: Adams, Berks, Centre, Columbia, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lancaster, Lebanon, Lehigh, Mifflin, Montour, Northampton, Northumberland, Perry, Schuylkill, Snyder, Union and York.
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • October 8th, 2015
Contract Type FiledOctober 8th, 2015This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Limited Network Area, which is a geographical area consisting of the following eight (8) Pennsylvania counties: Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton and Perry. Keystone’s Limited Network Area is a limited geographic area within the full twenty- one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Limited Network Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for services performed by a Participating Pro
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • October 8th, 2015
Contract Type FiledOctober 8th, 2015This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Limited Network Area, which is a geographical area consisting of the following eight (8) Pennsylvania counties: Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton and Perry. Keystone’s Limited Network Area is a limited geographic area within the full twenty- one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Limited Network Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for services performed by a Participating Pro
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • October 8th, 2015
Contract Type FiledOctober 8th, 2015This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Limited Network Area, which is a geographical area consisting of the following eight (8) Pennsylvania counties: Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton and Perry. Keystone’s Limited Network Area is a limited geographic area within the full twenty- one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Limited Network Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for services performed by a Participating Pro
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • October 8th, 2015
Contract Type FiledOctober 8th, 2015This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Limited Network Area, which is a geographical area consisting of the following eight (8) Pennsylvania counties: Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton and Perry. Keystone’s Limited Network Area is a limited geographic area within the full twenty- one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Limited Network Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for services performed by a Participating Pro
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • October 8th, 2015
Contract Type FiledOctober 8th, 2015This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Limited Network Area, which is a geographical area consisting of the following eight (8) Pennsylvania counties: Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton and Perry. Keystone’s Limited Network Area is a limited geographic area within the full twenty- one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Limited Network Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for services performed by a Participating Pro
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • November 24th, 2014
Contract Type FiledNovember 24th, 2014This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s 13-County Eligibility Area, which is a geographical area consisting of the following thirteen (13) Pennsylvania counties: Adams, Centre, Columbia, Franklin, Fulton, Juniata, Mifflin, Montour, Northumberland, Schuylkill, Snyder, Union and York. Keystone’s 13-County Eligibility area is a limited geographic area within the full twenty-one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Approved Service Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • November 21st, 2014
Contract Type FiledNovember 21st, 2014This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Limited Eligibility & Service Area, which is a geographical area consisting of the following eight (8) Pennsylvania counties: Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton and Perry. Keystone’s Limited Eligibility & Service area is a limited geographic area within the full twenty-one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Limited Eligibility & Service Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • November 21st, 2014
Contract Type FiledNovember 21st, 2014This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Limited Eligibility & Service Area, which is a geographical area consisting of the following eight (8) Pennsylvania counties: Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton and Perry. Keystone’s Limited Eligibility & Service area is a limited geographic area within the full twenty-one (21) county area in which Keystone is approved to operate as an HMO. (“Keystone’s Approved Service Area”). Subscribers and their eligible Dependents may obtain the full range of Covered Services from Participating Providers only in Keystone’s Limited Eligibility & Service Area, subject to the terms and conditions of this Subscriber Agreement. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for
INDIVIDUAL HMO SUBSCRIBER AGREEMENTSubscriber Agreement • November 21st, 2014
Contract Type FiledNovember 21st, 2014This HMO Subscriber Agreement sets forth a comprehensive program of Inpatient and outpatient health care benefits for Subscribers and their eligible Dependents who reside and obtain Covered Services from Participating Providers within Keystone’s Approved Service Area, which is a geographical area consisting of the following twenty-one (21) Pennsylvania counties: Adams, Berks, Centre, Columbia, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lancaster, Lebanon, Lehigh, Mifflin, Montour, Northampton, Northumberland, Perry, Schuylkill, Snyder, Union and York. In most cases, Members must obtain Referrals for Covered Services, and benefits are provided only for services performed by a Participating Provider.