Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Keystone 65 Preferred Rx, 2027

H3952Contract020Plan

HMO · 2 counties in Pennsylvania

Run by Keystone Health Plan East, Inc. (contract H3952), sold as Independence Blue Cross, owned by Independence Health Group, Inc.

Renews for 2027

2026 star rating, contract H3952: 4 of 5

Keystone 65 Preferred Rx (H3952-020) costs $202 a month in 2027, up $14 from 2026, with an in-network out-of-pocket limit of $4,450 ($4,200 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
Monthly premium	$188	$202	up $14
In-network out-of-pocket limit	$4,200	$4,450	up $250
Skilled nursing facility, in network	$0 a day for days 1–20, then $218 a day for days 21–100	$0 a day for days 1–20, then $221 a day for days 21–100	up $30for a 30-day stay
Ground ambulance, in network	$180 copay	$200 copay	up $20
Drug tier 4, non-preferred drug	35% of the cost	26% of the cost	down 9 points
16 lines do not change
Drug deductible	$0	$0	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$40 copay	$40 copay	no change
Emergency room	$150 copay	$150 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$275 a day for days 1–7, then $0 a day for days 8–90	$275 a day for days 1–7, then $0 a day for days 8–90	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$250 a year	$250 a year	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Over-the-counter items, yearly	$120 a year	$120 a year	no change
Counties served	2	2	no change
Drug tier 1, preferred generic	$9	$9	no change
Drug tier 2, generic	$20	$20	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 5, specialty tier	33% of the cost	33% of the cost	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked. The plan charges less at its preferred pharmacies
Tier	What the tier holds	2026, standard pharmacy	2027, standard pharmacy	2027, preferred pharmacy
Tier 1	Preferred Generic	$9	$9	$0
Tier 2	Generic	$20	$20	$0
Tier 3	Preferred Brand	25% of the cost	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	35% of the cost	26% of the cost	26% of the cost
Tier 5	Specialty Tier	33% of the cost	33% of the cost	33% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 71 plans open to everyone are sold for 2027, this one included. Against the others, 2 plans have a lower out-of-pocket limit, 2 the same, 66 a higher one. On the premium, 69 plans have a lower premium, 1 a higher one.

Out-of-pocket limits of the 71 plans open to everyone

$0 to under $2,0000 plans

$2,000 to under $4,0001 plan

$4,000 to under $6,000 (this plan)10 plans

$6,000 to under $8,00033 plans

$8,000 to $10,00027 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 2 counties: $202 a month and $4,450.

Pennsylvania

Bucks Philadelphia

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Who runs this plan?

Plan ID: H3952-020
Legal name of the contract: Keystone Health Plan East, Inc.
Sold as: Independence Blue Cross
Parent company: Independence Health Group, Inc.
Plan type: HMO
2026 star rating of the contract: 4 of 5 overall; health plan 4 of 5, drug plan 4 of 5
Members, September 2026: 1,977
Plan website, as filed with CMS: www.ibxmedicare.com

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Philadelphia, PAWhere most of its members live; premiums and limits side by side
Every Independence Blue Cross plan for 2027Its contracts, counties and plans that end
The other 12 plans of contract H3952Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.