Health insurance questions and answers. Learn about Highmark products and services and how to choose health insurance.
Read questions about health insurance including ACA, COVID, Highmark Healthy Kids, home delivery prescriptions and more. Learn how to choose health insurance, find options to get care and read health insurance definitions in the glossary.
Yes. By law, all ACA plans cover preexisting conditions, with no annual or lifetime limits.
The annual Open Enrollment Period for individual and family plans varies by state.
PA, DE, and WV: November 1 — January 15
NY: November 16 — January 31
Anyone who qualifies for an ACA plan may enroll during this time period.
When you experience a major life event — like the birth of a child, the loss of a job, or a move to a new ZIP code — you may qualify for a Special Enrollment Period (SEP). An SEP typically gives you a 60-day window to enroll in a new individual or family plan and may occur at any time throughout the year.
All Highmark ACA plans cover the 10 Essential Health Benefits:
Hospitalization (like surgery and overnight stays)
Pregnancy, maternity, and newborn care
Mental health and substance use disorder services
Rehabilitative and habilitative services and devices
Preventive and wellness services and chronic disease management
Pediatric services, including dental and vision care
It’s quick and easy to get your prescription delivered right to your home. And, you’ll likely save money. To set up your prescription delivery, grab your Highmark card and call Express Scripts at (800) 282-2881. They are available 24/7 to help switch your prescriptions to home delivery. Or, log in to your Highmark member website and select “Prescriptions.” On the next screen, click “Mail Order Savings” to go to the Express Scripts website. Follow the on-screen prompts to set up your prescription delivery.
Yes, if the prescription is for a 90-day supply. Talk to your doctor to find out if they can change your prescription to a three-month supply.
Depending on your situation, you may be able to get a home delivery of a prescription refill early. Call the Member Services team — the number is on the back of your Highmark Blue Cross Blue Shield card — to learn more.
All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies. This website is operated by Highmark, Inc. and is not the Health Insurance Marketplace website. It also does not display all Qualified Health Plans available through the Health Insurance Marketplace website. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov.
Highmark Blue Cross Blue Shield or Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal. ®Blue Cross, Blue Shield and the Cross and Shield symbols are registered service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Visit our website to view the Access Plan required by the Health Benefit Plan Network Access and Adequacy Act. You may also request a copy by contacting us at the number on the back of your ID card. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.
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