This keystone bridges the gap between Medicare coverage and a more robust health insurance plan for many senior citizens in the Keystone State. Keystone Health Plan Central provides health insurance products and related administrative services to more than 225,000 members in 21 counties in central Pennsylvania and the Lehigh Valley. Keystone Health Plan Central’s key products also include SeniorBlue, an Medicare Advantage HMO insurance plan that provides supplemental coverage to Medicare and CHIP, which provides low-cost insurance to uninsured children. The company is a subsidiary of Capital BlueCross; Highmark formerly owned 50% of the company, Capital BlueCross bought out Highmark’s share in 2003.

Contact Information
Address: 2500 Elmerton Ave.
Harrisburg, PA 17110
Phone: 717-541-7000
Fax: 717-541-6915

Financial Highlights
Fiscal Year End: December
Revenue (2005): 490.60 M
Employees (2005): 450

Key People
• Chairman: Anita M. Smith
• President and CEO: Joseph M. (Joe) Pfister
• CFO: Brian Britt

Keystone Health Plan Central will pay $600,000 to settle allegations that it failed to provide timely information to more than 3,000 Medicare beneficiaries in Pennsylvania about rate and benefit changes to its Medicare HMO plan that took effect Jan. 1, 1998. Under the settlement agreement, Keystone also must cease enrolling members into any Medicare HMO plan it operates without clearly advertising that the rates and benefits could be changed each year.

Keystone Health Plan® Central HMO overview

Customers can maximize their Health Maintenance Organization (HMO) benefits by selecting their primary care provider (PCP) from our large network of over 7,000 providers in Central PA and the Lehigh Valley. Your PCP coordinates most of the medical services you need, either treating you directly or making referrals to an appropriate specialist or hospital.

HMO customers are responsible for a copayment for office visits to their PCP or to referred specialists. Some services may be subject to a coinsurance (a percentage of the medical bill).

Keystone Health Plan Central typically covers the services listed below (subject to applicable contract terms and exclusions).
Physician office visits
Preventive care (routine physicals, select screenings, annual gynecological exams, annual mammograms (women 40 and over), well baby care, childhood immunizations)
Maternity and newborn care
Lab tests and x-rays
Physical, occupational, and speech therapy
Home health care
Skilled nursing facility care
Hospice care
Outpatient and inpatient hospital services and procedures
Emergency care
Medical supplies and equipment
Mental health services
Substance abuse (drug and alcohol) treatment