About Your Coverage
Keystone First VIP Choice covers Pennsylvania residents living in Bucks, Chester, Delaware, Montgomery, and Philadelphia counties who are on both Medicaid and Medicare.
Find a doctor
It is important to choose a primary care provider (PCP) from the Keystone First VIP Choice provider network. As our member, you will get health care coverage from your PCP.
- You may go to any of the doctors in this directory. Services do not require a referral.
- Check with your PCP before going to see a specialist.
For complete information about your health care coverage, see your Evidence of Coverage (PDF).
What if I get a bill?
If a provider sends a bill directly to you, do not pay the bill. Please submit the bill to Keystone First VIP Choice for processing and determination of your liability, if any.
About medical emergencies
A "medical emergency" is when you, or any other prudent layperson with an average knowledge of health and medicine, believe that you have medical symptoms that require immediate medical attention to prevent loss of life, loss of a limb, or loss of function of a limb. The medical symptoms may be an illness, injury, severe pain, or a medical condition that is quickly getting worse.
If you have a medical emergency:
- Get help as quickly as possible. Call 911 for help or go to the nearest emergency room or hospital. Call for an ambulance if you need it. You do not need to get approval or a referral from your PCP.
- As soon as possible, make sure that our plan has been told about your emergency. We need to follow up on your emergency care. You or someone else should call to tell us about your emergency care, usually within 48 hours.
You do not need approval from the plan to receive care in an emergency. The hospital cannot turn you away. It is the law. You have the right to get the care you need. You have the right to say no to treatment. You also have the right to ask for or say no to a transfer to another hospital.
- Call your PCP to make an appointment for care after your emergency. Do not go back to the emergency room where you were treated unless your PCP tells you to.
- You must use Keystone First VIP Choice providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers neither Medicare nor Keystone First VIP Choice will be responsible for the costs.
Questions about your coverage? Call Member Services at 1-800-450-1166 (TTY 711), 8 a.m. to 8 p.m., seven days a week.