Highmark bcbs medicare advantage

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Preferred provider organization, or PPO , plans provide the most freedom, allowing you to see any provider that accepts the insurance. You can seek out-of-network care, although it may cost more than seeing an in-network doctor. Special needs plans, or SNPs, restrict membership to people with certain diseases or characteristics.

Hence, the benefits, network and drug formularies are tailored to the needs of those members. Highmark offers one type of SNP:. For example, if you live in Erie, Pennsylvania, you have these two options from Highmark:. Premiums, deductibles, covered drugs, costs for each tier and pharmacy arrangements all differ by plan.

Highmark Medicare Advantage offers members access to dental , vision and hearing benefits. Many of its plans offer other benefits, as well. Here are a few standouts:. Fitness benefits: Many plans include the SilverSneakers fitness program, which gives members access to a large network of gyms and fitness facilities as well as local classes and events. Home health benefits: Members have access to a free House Call Visit, in which a licensed health professional comes to your home to perform a health check.

Social connection. Highmark offers some members access to the Blue Neighbors program, in which people can request that a volunteer call or visit, or participate in virtual events like bingo or trivia games.

Call the number on their member ID card from 8 a. Request a call from a Highmark Medicare Advisor. Connect with Highmark on Twitter or Facebook. Highmark Medicare Advantage plans are available in four states пїЅ Delaware, New York, Pennsylvania and West Virginia пїЅ and about , people are enrolled in Highmark plans as of October Highmark is tied with a few other health insurance companies for seventh place in terms of market share, and it saw the most Medicare Advantage growth in among the Blues plans, adding 78, new members for the plan year [0] The Chartis Group.

View all sources. Costs for Medicare Advantage plans will depend on your plan, geographic location and health needs. Of all the Blues, Highmark has the highest-priced Medicare Advantage plan in Other out-of-pocket costs to consider include:. Whether the plan covers any part of your monthly Medicare Part B premium. Whether your medical providers are in-network or out-of-network or how often you may go out of network for care. Whether you require extra benefits and whether the plan charges for them.

You can select by insurance carrier to see only UnitedHealthcare plans or compare across carriers. Average star rating, weighted by enrollment: 4. All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures. Based on the most recent year of data and weighted by enrollment, Highmark Medicare Advantage plans get an average rating of 4. For comparison, the average star rating for plans from all providers in is 4.

Of the Highmark Medicare Advantage contracts with star ratings in , two-thirds are rated 5 out of 5 and the other third are rated 4. There are no contracts rated lower than 4 stars. To get an overall star rating, the CMS ranks contracts on 40 different plan factors. Here are the measures for which Highmark contracts scored an average of 4. Diabetes care пїЅ blood sugar controlled. Getting appointments and care quickly. Health plan: Members choosing to leave the plan.

Plan makes timely decisions about appeals. Health plan: Call center пїЅ foreign language interpreter and TTY availability. Drug plan: Call center пїЅ foreign language interpreter and TTY availability. Drug plan: Members choosing to leave the plan. Medicare plan finder price accuracy. Medication adherence for hypertension RAS antagonists. Highmark contracts struggled in a few of the categories measured. AM Best is a credit rating agency that specializes in the insurance industry.

An A rating in this category indicates that AM Best believes Anthem has an excellent ability to meet its ongoing insurance obligations. In its U. Medicare Advantage Study пїЅ the eighth it's done so far пїЅ J. Power measured member satisfaction with Medicare Advantage plans based on six factors: coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment.

On these measures, Highmark scored points out of 1, and came in third out of the top nine Medicare Advantage providers and just above the industry average [0] J. Power Finds. Get more information below about some of the major Medicare Advantage providers.

These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county. Aetna Medicare Advantage plans. Anthem Medicare Advantage plans. Cigna Medicare Advantage plans. Humana Medicare Advantage plans. Kaiser Permanente Medicare Advantage plans. UnitedHealthcare Medicare Advantage plans. Wellcare Medicare Advantage plans. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania.

Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Quick Links: Manuals.

Highmark Provider Manual. Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies. Requiring Authorization. Pharmacy Policy Search. Message Center.