Keystone HMO Proactive hospital tier placements

Tier 1 – Preferred $

Pennsylvania New Jersey Bucks Montgomery Burlington Aria Health — Bucks County Campus Abington Memorial Hospital Deborah Heart & Lung Center Doylestown Hospital Albert Einstein Medical Center — Virtua Willingboro Hospital Grand View Hospital Montgomery Campus Camden Lower Bucks Hospital Holy Redeemer Hospital and Medical Center Cooper Hospital University Medical Center Rothman Orthopaedic Specialty Hospital Lansdale Hospital St. Luke’s Health Network — Quakertown Campus Suburban Community Hospital Mercer Tower Health — Pottstown Memorial Robert Wood Johnson University Hospital Chester Medical Center at Hamilton Chester County Hospital St. Francis Medical Center Tower Health — Brandywine Hospital Philadelphia Tower Health — Jennersville Regional Hospital Albert Einstein Medical Center Salem Tower Health — Phoenixville Hospital Albert Einstein Medical Center — Memorial Hospital of Salem County Delaware Germantown Campus Warren Crozer-Chester Medical Center Aria Health — Frankford Campus Hackettstown Community Hospital Delaware County Memorial Hospital Aria Health — Torresdale Campus Springfield Hospital Jeanes Hospital Taylor Hospital Roxborough Memorial Hospital Tower Health — Chestnut Hill Hospital Lehigh Wills Eye Hospital St. Luke’s Health Network — Allentown Campus St. Luke’s Health Network — Bethlehem Campus

Tier 2 – Enhanced $$

Pennsylvania New Jersey Delaware Philadelphia Camden New Castle Children’s Hospital of Philadelphia Virtua Our Lady of Lourdes Hospital A.I. DuPont Hospital for Children Fox Chase Cancer Center Gloucester St. Christopher’s Hospital for Children Inspira Medical Center — Woodbury Shriner’s Hospital for Children

Tier 3 – Standard $$$

Pennsylvania New Jersey Berks Montgomery Burlington Salem St. Joseph Medical Center Main Line Health — Bryn Mawr Virtua Marlton Hospital Inspira Medical Center — Elmer Tower Health — Reading Hospital and Hospital Virtua Memorial Hospital Warren Medical Center Main Line Health — Lankenau Camden St. Luke’s Health Network — Medical Center Bucks Kennedy University Hospitals — Warren Hospital St. Mary Medical Center Philadelphia Cherry Hill Division Hospital of the University of Kennedy University Hospitals — Delaware Chester Pennsylvania Stratford Division Main Line Health — Paoli Hospital New Castle Mercy Fitzgerald Hospital Kennedy University Hospitals — Christiana Care Health System — Delaware Mercy Philadelphia Hospital Washington Township Division Christiana Hospital Main Line Health — Riddle Hospital Methodist Hospital Virtua Voorhees Hospital Christiana Care Health System — Nazareth Hospital Lancaster Hunterdon Wilmington Hospital Penn Presbyterian Medical Center Ephrata Community Hospital Hunterdon Medical Center St. Francis Hospital Lancaster General Hospital Pennsylvania Hospital Temple — Northeast Campus Mercer Lehigh Maryland Temple University Hospital Capital Health System — Fuld Campus Lehigh Valley Hospital Thomas Jefferson Capital Health System — Cecil Lehigh Valley Hospital — Muhlenberg University Hospital Hopewell Campus Union Hospital Sacred Heart Hospital

Occasionally updates are made to our network and tier placements. Visit ibx.com/findadoctor for the latest information. Be sure to select Keystone HMO Proactive under Your Plan to see the tiers.

Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East 1018676 (3/20) and QCC Insurance Company, and with Highmark Blue Shield — independent licensees of the Blue Cross and Blue Shield Association.