Extra benefits

As a Highmark Health Options member, you’ll get additional benefits that aren’t normally included in standard Medicaid benefits.

Covered extra benefits

Remember to show your member ID card at every visit to get covered care.

 

  • Eligible members can earn up to $175 for attending scheduled exams before and after baby’s birth.
  • Free home-delivered meals for pregnant and new moms. Get two meals a day for 14 days after a hospital stay.
  • Free Pacify account and app for video visits and calls, 24/7. No appointment needed. Experts answer in 5 minutes or less. Ask about breastfeeding, formula feeding, pumping, weaning, adding solid foods, crying and colic, and teething. Plus look up these topics on the app.
  • Free Count the Kicks app for tracking baby’s daily movements in the third trimester of pregnancy.

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For eligible members up to age 12 with autism, ADHD, or other similar diagnosis.

Covers professional development, mentorship, and employment assistance for high school juniors and seniors (age 16–18) and members transitioning out of treatment or incarceration. Includes opportunities that can lead to getting a job and continuing education.

Age 18 and older: For eligible members diagnosed with both prediabetes and high BMI.

  • Age 21 and older: Covers an additional $500 for dental care.
  • Expecting moms of any age are eligible for two extra cleanings before and 6 weeks after giving birth.

Covers one water faucet filter system plus two extra filters per household per year. Note: One filter lasts about 4 months.

A 12-week online program provides eligible members with personalized help and access to affordable healthy food options.

Provides the chance to earn rewards of $5–$25 for activities like wellness visits and screenings. Rewards are put on a debit card.
 

Provides free meal delivery to the home for eligible members who had a hospital stay, including new moms.

Age 18 and older: Helps eligible members eat healthier, move more, and lose weight.

For eligible members diagnosed with asthma.

Ages 13–17: Earn a $5 gift card by attending quarterly virtual meetings to offer feedback and express concerns about their health and well-being.

 

Covers one box per eligible member.

Ages 5–18: Covers cost for 4-H clubs, health camps, and other supervised activities, including an ATV safety course.

Age 18 and older: Covers the cost of one Class X Hunting/Fishing/Trapping license per year upon receiving annual flu shot.

 

Note, if you got your flu shot this year and want to claim your Healthy Reward for your free Class X Hunting/Fishing/Trapping license, call the Healthy Rewards helpline at 1-833-957-0027 (TTY: 711), Monday – Friday, 8 a.m. to 5 p.m.

Age 18 and older: Helps members live happier, healthier lives with social groups in their own neighborhood.

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Not covered benefits and services

Some services are not available through Highmark Health Options, Medicaid, or CHIP. If you choose to get these services, you may have to pay the entire cost of the service. Highmark Health Options is not responsible for paying for these services and others:

  • All services not considered medically necessary.
  • Services from non-enrolled or non-participating providers.
  • Services that require a prior authorization but did not get a prior authorization.
  • Sterilization of a mentally incompetent or institutionalized individual.
  • Except in an emergency, inpatient hospital tests that are not ordered by the attending physician or other licensed practitioner, acting within the scope of practice, who is responsible for the diagnosis or treatment of a particular patient’s condition.
  • Organ transplants, except in some instances.
  • Treatment for infertility and the reversal of sterilization.
  • All cosmetic services, except in the case of accidents or birth defects.
  • Christian science nurses and sanitariums.

Note, this isn’t a complete list of the services not covered by Medicaid.

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