Our Medicare Dual Eligible Special Needs Plan (D-SNP) gets you hospital and doctor visits, prescription drugs and additional benefits like transportation, food and utilities.
Coverage That Helps Your Whole Life
Coverage That Helps Your Whole Life
Our Medicare Dual Eligible Special Needs Plan (D-SNP) gets you hospital and doctor visits, prescription drugs and additional benefits like transportation, food and utilities.
Highmark Wholecare D-SNP Benefits
Now you can choose how to spend the monthly dollar amounts on a variety of benefits using one card.
-
Grocery Benefits
D-SNP plan members can purchase items such as fruits, vegetables, meats, dairy items and more using their My Healthy Flex Card.
-
Utility Benefits
My Healthy Flex Card funds can help D-SNP members pay for utility costs like gas, electric, and more.
-
Over-the-Counter Benefits
Highmark Wholecare D-SNP members can use their My Healthy Flex Card to pay for items like cold medicine, vitamins, dental care and more.
See if you qualify for the Special Supplemental Benefits for Chronically Ill* (SSBCI) benefits
See if you qualify for the Special Supplemental Benefits for Chronically Ill* (SSBCI) benefits
There are specific requirements you must meet to qualify for SSBCI. If we cannot verify your eligibility through existing claims information, your provider may need to complete the SSBCI Attestation Form. Print the form and bring it to your next appointment if requested.
There are specific requirements you must meet to qualify for SSBCI. If we cannot verify your eligibility through existing claims information, your provider may need to complete the SSBCI Attestation Form. Print the form and bring it to your next appointment if requested.
Getting D-SNP Coverage
You can join a Highmark Wholecare D-SNP plan if you live in our service area, and are eligible for Medicare and Medicaid.
-
Medicaid Eligibility
To qualify for D-SNP, you'll need to either qualify for or already receive Medical Assistance (Medicaid).
-
Medicare Eligibility
You may be eligible for Medicare Parts A and B if you are age 65+, younger than 65 with certain disabilities or have ESRD.
-
Pennsylvania Residence
Highmark Wholecare D-SNP is available to individuals living in one of our 57 Pennsylvania service area counties.
Joining a Highmark Wholecare D-SNP is Easy
Joining a Highmark Wholecare D-SNP is Easy
Whether you're new to Medicare or currently enrolled in a plan, we can help find the best plan for you.
Whether you're new to Medicare or currently enrolled in a plan, we can help find the best plan for you.
Your Medicare D-SNP Choices
When you select a Diamond D-SNP or Ruby D-SNP, you’ll get:
- $0 to low monthly premiums
- Dental, vision and hearing allowances
- Over-the-counter, home and bathroom safety allowances
You’ll also get many kinds of treatment for zero – or little – cost along with personalized coaching for health conditions.
Accessing Your Member Portal
As a Highmark Wholecare member, you’ll use your online member portal to change your primary care provider (PCP), request ID cards, view claims and more.
-
Apply for D-SNP
You have many ways to apply for your Highmark Wholecare D-SNP. Enroll by phone, online and mail.
Wholecare Call Center 1 (800) 392-1147 -
Get Help Applying
We can answer questions and help you apply for D-SNP coverage.
Interested in Medicaid?
Interested in Medicaid?
Highmark Wholecare Medicaid provides a wide range of benefits to help you live a healthy and happy life.
Highmark Wholecare Medicaid provides a wide range of benefits to help you live a healthy and happy life.
* Special supplemental benefits are for people who are chronically ill with long-term conditions like diabetes, asthma, obesity, immunodeficiency, functional challenges, and behavioral health. You also need to be at risk of going to the hospital and need extra help from care management. There are other conditions that may qualify you for benefits. Highmark will help determine if you qualify for these benefits and may ask you for more information. Not all members will qualify.
Gateway Health Plan, Inc. d/b/a Highmark Wholecare is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare offers HMO plans with a Medicare Contract. Enrollment in these plans depends on contract renewal.
Medicare Ombudsman Website
Best Available Evidence
Y0037_1359_M_2027
Last Updated: October 1, 2026
