Highmark BCBS Plans and Benefits Explained

Highmark BCBS offers a range of plans and benefits to fit different needs and budgets.

Highmark BCBS has several plan options, including Health Savings Account (HSA) plans, which allow you to set aside pre-tax dollars for medical expenses.

You can choose from a variety of deductibles, copays, and coinsurance levels to customize your plan.

With Highmark BCBS, you can also add supplemental plans to enhance your coverage, such as dental, vision, and life insurance.

Highmark BCBS is a significant player in the insurance market. It has a total of 5.6 million insureds across three states.

Highmark is the fourth largest Blue Cross Blue Shield affiliate. This gives you an idea of its size and scope.

Its largest presence is in Pennsylvania, where it has 4.7 million members. This is a substantial number, making it the largest insurance carrier in the state.

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Highmark BCBS offers individual and family coverage through the Affordable Care Act (ACA) plans. These plans are available on various health insurance marketplaces, including Pennie, Choose Health Delaware, and healthcare.gov.

If you have an income between 100-400% of the federal poverty guidelines, you may be eligible for a financial subsidy to lower your monthly premium. You can use the ACA subsidy calculator to estimate your potential health plan savings.

The ACA plans meet 10 essential mandated requirements, including:

Highmark Blue Cross Blue Shield has a long history, dating back to the 1930s.

Highmark operates under the Highmark Health enterprise, which is a diverse health and wellness system located in Pittsburgh.

Highmark serves in three total states: Pennsylvania, Delaware, and West Virginia.

They offer a wide range of plans, including Individual and family plans, Medicare, and Small Business plans.

As of today, there are a total of 5.6 million Highmark insureds in these three states.

Highmark is the largest insurance carrier in Pennsylvania, with 4.7 million members, making it the fourth largest Blue Cross Blue Shield affiliate.

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Individual and family plans are a great option for those who need health insurance. These plans are offered on various marketplaces, including Pennie in Pennsylvania, Choose Health Delaware, and healthcare.gov for West Virginians.

Individuals with income between 100-400% of the federal poverty guidelines may be eligible for a financial subsidy to help lower the cost of the monthly premium.

ACA plans, which include individual and family plans, meet the 10 essential mandated requirements of the healthcare law.

These requirements include covering preventive care at 100%, wellness checks at 100%, and dental coverage for children at 100%.

Here are the 10 essential mandated requirements of the healthcare law:

It's essential to note that outside of preventive care paid at 100%, you must typically meet your deductible before the insurance company will cover a portion of your medical bills.

Group plans are a great option for those looking for employer-sponsored health insurance. Highmark offers exclusive provider organization (EPO) plans and preferred provider organization (PPO) plans in Pennsylvania and Delaware.

EPO plans are generally more cost-effective than PPO plans. You could be responsible for 100% of the costs if you go outside of your network, except in an emergency.

A PPO monthly plan premium is typically more expensive than an EPO plan. But it has a larger network, which might be beneficial if you have a preferred doctor.

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As a Highmark Blue Cross Blue Shield member, you'll enjoy a range of benefits that can help you save money and stay healthy.

On many Highmark health plans, you can get prescription drugs with a $0 copay for Tier 1 medications. This can be a huge relief for people who need to take regular medications.

You'll also have access to $0 telemedicine visits, allowing you to consult with a doctor from the comfort of your own home.

Some plans offer discounts on select gym memberships, making it easier to stay active and healthy.

Here are some of the extra benefits you might find on your Highmark health plan:

Highmark BCBS covers a range of services for children, including Children's Home and Community Based Services (HCBS) for eligible Medicaid members.

Children's HCBS provides support for kids with complex needs, allowing them to receive care in a home or community setting rather than a traditional institutional setting.

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Highmark BCBS is rated as one of the largest health insurance companies in the US, with over 9 million members across the country.

Highmark BCBS has received a 4-star rating from the Centers for Medicare and Medicaid Services (CMS) for its Medicare Advantage plans.

The company has a strong network of over 600,000 healthcare providers and 95% of hospitals in the US.

Highmark BCBS has been recognized for its excellent customer service, with a 4.5-star rating on the National Committee for Quality Assurance (NCQA) Health Insurance Plan Ratings.

The company's financial stability is also a key factor in its high rating, with a strong financial performance and a stable credit rating.

Highmark BCBS has a wide range of health insurance plans available, including HMO, PPO, and Medicare Supplement plans.

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