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ACA Basics ACA Plans Shopping for ACA Special Enrollment Period Children's
Health Insurance The Caring Program Dental Plans Special Circumstance Products
Additional Products Health Care 101 HIPAA
Why Highmark Member Discounts Health and Wellness Lifestyle programs Maternity
Support HIPAA Health Care 101 Plan App
Find a Doctor Overview My Care Navigator
ACA Basics ACA Plans Shopping for ACA Special Enrollment Period Children's
Health Insurance The Caring Program Dental Plans Special Circumstance Products
Additional Products Health Care 101 HIPAA Why Highmark Member Discounts Health
and Wellness Lifestyle programs Maternity Support HIPAA Health Care 101 Plan App
Find a Doctor Overview My Care Navigator






ACA PLANS

We’ll help you find an Individual & Family plan that fits your personal health
care needs and budget.



BROWSE AND COMPARE PLANS


UNDERSTAND YOUR PLAN OPTIONS


DO I QUALIFY FOR SAVINGS?


Eighty percent of Highmark ACA plan members qualify for extra savings. So, if
you’re worried about paying for your health plan, we have two ways to help:

 * Advanced Premium Tax Credits (APTC) – These can lower your monthly premium
   and are based on your household income and household size.
 * Cost-Sharing Reduction (CSR) – This program can help lower the out-of-pocket
   costs that come when you receive care, like deductibles and copays. Depending
   on your household size and income, you may be eligible for both an APTC and a
   CSR.





What are metal levels?

ACA plans are organized by metal levels.When signing up for a plan, you can
choose how you want to split up your costs with your insurer. The quality of
care is the same for every level.

Gold – Higher monthly premiums, lower out-of-pocket costs.

Silver – Moderate premiums and out-of-pocket costs. You must select this metal
to utilize CSR.

Bronze – Lower monthly premiums, higher out-of-pocket costs.

Catastrophic – Only for people under 30 or for people undergoing certain
hardships. Protects people from the large health bills that come with
catastrophes, like being diagnosed with a complex illness.









HIGHMARK PLAN BENEFITS


Highmark Affordable Care Act (ACA) plans give you access to high-quality health
care that’s always close to home. This year, you can also look forward to:

 * $0 copays on many common prescription drugs*
 * No referrals necessary to see the specialists of your choice
 * Lowest copays when you need to see your doctor or specialist**
   
 * Some of the lowest deductibles in your area including $0 deductible plans
 * Plans that include adult dental and vision — no need to shop for a separate
   dental or vision plan
   

Need to refresh your memory on how ACA plans work? We can help.




WHY HIGHMARK?


We’ve been making health care better for over 80 years, so you can trust that
we’ll be by your side in good times and in bad. Plus, your Highmark ACA plan
gives you access to all kinds of perks and benefits.




THE HIGHMARK HEALTH PLAN APP

Paying claims and your important plan information is always at your fingertips.

BLUES ON CALL

Get expert health advice from a licensedprofessional from anywhere, 24/7.



VIRTUAL MEDICINE

Talk to your doctor from the comfort of home on your phone, tablet, or laptop.

MY CARE NAVIGATOR

We’ll help you find a doctor, make appointments, transfer records, and more.



FREE PREVENTIVE CARE

To help keep you healthy, your annual wellness visit is on us.

SHARECARE

Sharecare helps you set health goals, find personalized resources, and track
your progress.



BLUE365

We help you stay healthy with discounts on gym memberships, healthy meal
services, and more.

ENHANCED COMMUNITYCARE MANAGEMENT

Get help managing chronic conditions. Our nurse managers can help keep you on
track with your plan of care and out of the emergency room.





WHERE TO SHOP FOR PLANS


There are two ways to buy an ACA plan: through the Exchange or outside the
Exchange. Which one you choose depends on your personal needs and financial
situation, but our licensed representatives can help you make the decision.

Buy Highmark through the Marketplace


These are Highmark plans that are bought through the federal or state government
Marketplace, also called the Exchange. These plans offer extra savings to those
who are eligible that can lower monthly premiums and out of-pocket costs.

SEE HIGHMARK MARKETPLACE PLANS

Buy directly from Highmark


These plans are bought directly through Highmark and do not offer financial
help. Additional plans may be available off the Exchange.


SEE HIGHMARK PLANS


* $0 copays for all Tier 1 drugs on the Essential Formulary. Based on the top
100 non-voided, approved, in-network drug claims by Highmark ACA individual
markets members in 2020.

** Per the Pennsylvania Insurance Department: ACA Rate Filings for 2022 Plans -
Individual Market

Blues On Call is a service mark of the Blue Cross and Blue Shield Association.

Blue365 is a registered mark of the Blue Cross and Blue Shield Association.

Sharecare, RealAge Test and AskMD are registered trademarks of Sharecare, LLC.,
an independent and separate company that provides a consumer care engagement
platform for Highmark members. Sharecare is solely responsible for its programs
and services, which are not a substitute for professional medical advice,
diagnosis or treatment. Sharecare does not endorse any specific product service
or treatment. Health care plans and the benefits there under are subject to the
terms of the applicable benefit agreement.



CALL

CALL

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 * Call and talk with a Highmark licensed representative for help with
   non-Medicare plans or enrollment.
 * Monday-Friday: 8:00 am - 8:00 pm
 * Saturday: 10:00 am - 4:00 pm
 * Sunday: 10:00 am - 4:00 pm
 * (TTY/TDD:711)
 * Central PA: (877) 475-0771
 * Western PA: (866) 247-8750
 * Northeast PA: (855) 865-0316
 * Delaware: (866) 941-2844
 * West Virginia: (866) 941-2844

REQUEST A CALL

REQUEST A CALL

--------------------------------------------------------------------------------

 * Call and talk with a Highmark licensed representative for help with
   non-Medicare plans or enrollment.

SHOP

SHOP

--------------------------------------------------------------------------------

 * View Plans
 * Shop on the Health Insurance Marketplace

MEMBER HELP

MEMBER HELP

--------------------------------------------------------------------------------

 * Questions about member benefits, claims or premium payments? Please call the
   number on the back of your ID card.



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