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Quick Highmark Inc. Medicare Advantage Plans review
Highmark-Logo Highmark Inc. has a wide variety of Medicare Advantage Plans available to those in its three-state region, but the plans and your experience with the company may depend on where you live.
Medicare rating: 5 stars A.M. Best financial strength rating: A+ BBB rating: A- NCQA rating: 3 to 3.5 stars Consumer Affairs rating: 2.4 stars J.D. Power ranking: 8th out of 10

Highmark Inc. is among the top 10 largest health insurance companies in the nation, serving nearly 6 million customers in Pennsylvania, Delaware, and West Virginia. In 2015, it merged with Blue Cross of Northeastern Pennsylvania and became the fourth-largest Blue Cross Blue Shield affiliate. Today, there are six independent insurance companies under the Highmark Inc. brand. To find out if this insurer offers the scope of coverage you need, read on to learn more about its plans.

What do Highmark Inc. Medicare Advantage Plans cover?

Highmark, Inc. Medicare Advantage Plans are comparable in their scope of coverage to other Medicare Advantage Plans, offering all the benefits of Original Medicare, along with coverage for additional health services. Medicare Advantage Plans, also called Medicare Part C, often include prescription drugs, vision, and dental coverage, and wellness programs. Your out-of-pocket costs depend on the plan you choose, as do rules for how you get services, such as whether you have to choose a primary care doctor or get a referral to see a specialist.

Your hospital and medical insurance are covered and you’ll get prescription drug coverage with most plans. Additional benefits from Highmark, Inc. Medicare Advantage Plans may include:

  • Dental
  • Vision, including eyewear or contacts
  • Hearing, including hearing aids
  • Wellness program
  • Transportation
  • Telehealth
  • Over the counter drugs
  • Emergency response device
  • In-home help
  • Pest control
  • Meal deliveries
  • Housekeeping

Like all Medicare Advantage Plans, Highmark Inc. Medicare Advantage Plans offer an alternative way for you to get the benefits Original Medicare provides. These plans include hospital and medical insurance and cover expenses such as inpatient care, preventive services, and home health care. What makes these plans attractive for many is that they generally include additional benefits such as prescription drug coverage; vision, dental, and hearing services; and discounts for wellness memberships. Some plans even cover services such as pest control, housekeeping, and meal deliveries.

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What are Highmark Inc. Medicare Advantage Plan options?

Highmark Inc. offers a wide selection of Medicare Advantage Plans, letting you choose one that fits your health needs and budget. Monthly premiums may be as high as $250, depending on the plan you choose, although certain plans have no monthly premium. You are always responsible for the beyond the Part B monthly premium. you pay whether you have Original Medicare or Medicare Advantage. Over half of surveyed plans are HMOs and only cover the care you get within the plan’s network, but several PPO plans with out-of-network coverage are available.

Review these three 2022 Highmark Inc. plans (all plans include drug coverage):

Highmark Inc. Medicare Advantage Plans
Plan name Monthly premium Annual medical deductible Office visits Annual maximum out-of-pocket cost
Community Blue Medicare HMO Signature $0 $0 $0 primary/ $30 specialist $7,550
Complete Blue PPO Distinct $325 $0 $0 primary/ $3025 specialist In-Network: $6,500

In and out of network combined: Out-of-Network: $10,000
Community Blue Medicare HMO Prestige $2,560 $0

 

 $0 primary/$25 specialist

 

 $6,700

*Based on pricing in Pittsburgh, Philadelphia, PA

Pros and cons of Highmark Inc. Medicare Advantage Plans

What we like about Highmark Inc. Medicare Advantage Plans The drawbacks of Highmark Inc. Medicare Advantage Plans
  • Wide range of coverage options
  • Robust coverage for telehealth services
  • Some plans cover out-of-network providers
  • Premiums may be high
  • Plans are only available in Pennsylvania, Delaware, and West Virginia

Highmark Inc. Medicare Advantage Plans reviews and ratings

There are six independent companies under the Highmark Inc. brand, and reviews vary widely from one insurance provider to another.

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how Medicare, A.M. Best, the Better Business Bureau and more rate some of Highmark’s Medicare Advantage Plans.

Medicare rating: 4 stars For 2022, Highmark’s Medicare Advantage plans have an overall average rating of 5 stars from the Centers for Medicare & Medicaid Services. Find each plan’s star rating on Medicare.gov.
A.M. Best financial strength rating: A+ A.M. Best sets credit ratings for insurers. In September 2021 A.M. Best affirmed it’s A+ Financial Strength Rating (FSR) of Highmark Inc. and its life/health subsidiaries, collectively known as Highmark Inc. Group. An A+ rating indicates Highmark has a superior ability to meet financial obligations.
BBB rating: A- Highmark Blue Cross Blue Shield has a BBB rating of A- and has closed 46 consumer complaints in the last three years. Highmark is not BBB accredited.
NCQA rating: 3 to 3.5 stars The National Committee for Quality Assurance rates three Highmark Inc. plans. All plans have an overall rating of at least 3 on a 5-point scale. Across the three metrics, all plans score 4 or better for how well they cover preventive services. The plans score between 3.5 and 4.5 for general customer satisfaction and from 2.5 to 3.5 for performance in covering expenses related to acute or chronic conditions.
Consumer Affairs rating: 2.4 stars Highmark Inc. has a rating of 2.4 out of 5 stars with Consumer Affairs. This rating is based on 36 customer reviews. Positive reviews note the easy claims process and the professionalism of customer service representatives. Negative reviews note high costs, poor coverage and claims handling.
J.D. Power ranking: 2nd out of 10 In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. Highmark scored 834 points out of 1,000 and came in second out of the top 10 Medicare Advantage providers.

The Better Business Bureau assigns an A+ ranking for Highmark Blue Cross Blue Shield Delaware. In the past three years, the company has resolved 11 customer complaints.

The National Committee for Quality Assurance rates three Highmark Inc. plans. All plans have an overall rating of at least 3 on a 5-point scale. Across the three metrics, all plans score 4 or better for how well they cover preventive services. The plans score between 3.5 and 4.5 for general customer satisfaction and from 2.5 to 3.5 for performance in covering expenses related to acute or chronic conditions.

Highmark Inc. has a rating of 2.4 out of 5 stars with Consumer Affairs. This rating is based on 33 customer reviews. Positive reviews note the easy claims process and the professionalism of customer service representatives.

author-img
LeRon Moore
Medicare consultant

LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.

Moore holds a bachelor’s degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.

He’s passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.

author-img
LeRon Moore
Medicare consultant

LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.

Moore holds a bachelor’s degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.

He’s passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.

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