Highmark Health Insurance

Highmark Health Insurance: Offering ACA and Private health care plans to US Citizens

Highmark

About Highmark Health

Highmark Inc. is America’s one of the largest health insurance organization with several health insurance and multiple subsidiaries and affiliates its umbrella. The company ranks fourth-largest overall Blue Cross and Blue Shield-affiliated organization in the country based on capital.

The company, along with its affiliates and associates offer health insurance plans in Pennsylvania, Delaware, and West Virginia. They altogether offer managed health care programs and insurance to approximately 4.5 million members across the country.

Company History:

The history of Highmark Group starts from Great Depression of the 1930s. This is the time when Blue Cross and Blue Shield movement paved the way for helping citizens to get an affordable health care coverage. At that time an association was formed to fund the basic and advanced healthcare needs of the citizens. The association was floated to arrange funds to pay for hospital and medical services.

The organization later known as Blue Cross of Western Pennsylvania and it’s now Highmark Blue Cross Blue Shield. As of now, Highmark is boasting for being one of the largest health insurers in the United States.

In 1999, Highmark partnered with Mountain State Blue Cross Blue Shield and turned to be the primary licensee of the Blue Cross and Blue Shield service marks in West Virginia. Later on, in January 2011, Mountain State Blue Cross Blue Shield changed its name to Highmark Blue Cross Blue Shield West Virginia.

Operations:

Highmark estimates that they process more than 185 million health care claims a year. To provide health care insurance to the people in affordable rates, the company goes in several collaborative agreements with Blues Independence Blue Cross and Hospital Service Association of Northeastern Pennsylvania. Company’s another affiliate Gateway Health Plan provides Medicaid HMO coverage in the state of Pennsylvania.

With its HM Insurance Group, the company provides employer health risk solutions such as stop-loss insurance and limited benefit medical plans. On the other hand, United Concordia Companies provides dental coverage throughout the US and Puerto Rico. Another firm that Highmark Health operates is Allegheny Health Network. The affiliate provides hospitals and other health facilities in western Pennsylvania.

Strategy:

Highmark Health runs country’s largest commercial health plan in Pennsylvania. The company serves over 3.9 million members in its core medical plan. The provider is planning to expand its core health insurance operations by offering new programs and increasing its involvement in government health programs such as Medicare. In 2017, the company initiated a $1 billion initiative with Penn State Health aimed for providing affordable community-based health care.

Portfolio:

With its diverse portfolio of businesses, Highmark Health ensures that a broad spectrum of health care services should be easily accessible to the consumers, business customers, and government entities.

Highmark Inc. and its Blue-branded affiliates:

The subsidiary covers the insurance needs of individuals, families, and seniors with variety of health care products.

Allegheny Health Network (AHN):

It aims at powering up health care delivery, research, medical education through an integrated health care delivery network via eight hospitals and more than 2,800 affiliated physicians.

United Concordia Dental:

This Highmark subsidiary provides coverage for high-quality, cost-effective dental care through a network of nearly 127,000 dentists and more than 400,000 access points.

HM Health Solutions:

The subsidiary delivers business solutions to health plan payers to help them run their organizations efficiently

Visionworks:

The subsidiary focuses at eyewear and eye care services, including exams, at more than 700 retail optical stores in 40 states and the District of Columbia.

HM Insurance Group:

It aims to protect businesses and their employees from the financial risks.

Plans on Offer:

Highmark provides its Blue-branded health plans through the following of its companies:

  • Highmark Inc.
  • Highmark Blue Shield
  • Highmark Blue Cross Blue Shield
  • Highmark Blue Cross Blue Shield Delaware
  • Highmark Blue Cross Blue Shield West Virginia

1: Individual and Family Health Insurance Options

Highmark’s Individual and family health insurance protects against unexpected incidents in life, from a car accident to a serious illness. Individual health insurance is a type of coverage that provides benefits for a broad range of health-care services that include both inpatient and outpatient benefits. The plan is designed to ensure considerable drop in the expenses occurred on routine doctor’s visits, prescription drug coverage, preventative care and other medical services.

2: Short term Health Insurance

Highmark’s short-term plan is temporary health insurance plans are meant to cover the gap between coverage given by major medical plans. The cost of premium in these short term health insurance plans are quire less than what a person usually pay in major medical plans.

3. Medicare Advantage Plans

Highmark’s all-in-one coverage offers coverage to those who want to opt for low monthly plan premiums. The plans offer all-in-one hospital and medical coverage on the lower Monthly premiums that can be as low as $0. Plans are bundled with dental and prescription drug benefits and accepted through a wide network of doctors and hospitals.

4. Medicare Supplement [Insurance (MS]

The plan provides comprehensive coverage that covers up to 100% of Original Medicare cost-sharing and even includes coverage when you’re on travel. These plans can be combined with a prescription drug plan.

5. Medicare Part D (PDP)

The plan provides prescription drug coverage for the beneficiaries who already have original Medicare or Medicare Supplement Insurance. The plan also covers prescription drugs that Original Medicare doesn’t include. The plan includes hospital or medical coverage.

Highmark Health FAQ

No, Highmark and Blue Cross Blue Shield is not the same company, Highmark is an independent licensee of the Blue Cross Blue Shield Association.
Yes, the company is valued among its customers, as the company has a great selection of health plans, knowledgeable and experienced resources, and a wonderful reputation among the consumers. Thus, this health insurance carrier is certainly regarded as the quality health insurance company of America.
Highmark Health offers a broad range of health plan options to fit each person’s healthcare needs and budget. These plans are designed for individuals and families, who are not covered under their employer-sponsored plans and looking to purchase health coverage for themselves and their families. The individual plans offered by Highmark Health are ACA-compliant and are made available either through the Healthcare Marketplace exchanges or directly from Highmark.
  • Individual & family plans
  • Medicare Advantage or Part C plan along with Medicare Part D or standalone prescription drug coverage plans.
  • A variety of Medicare complementary and supplemental plans
  • The Federal Employee Program (FEP) plans for federal government employees and qualified retirees.
  • Children’s Health Insurance Program (CHIP)
  • Short-term health plans
  • Highmark Health from October 1, 2020, began covering dental care services for members ages 21 years and over. The dental plan will have a maximum benefit limit of $1,000 per calendar year, and individuals can have an additional extended benefit of $1,500 through prior authorization for emergency dental care. Though the plan has a copay of $3.00 per visit, but this copay is currently waived off.

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