Highmark Inc. Medicare Advantage Plans Reviews

checkmark Fact checkedReviewed by: Leron Moore, Medicare consultant - Updated: Oct 07, 2021


Is a Highmark Medicare Advantage Plan a good fit for you?

Quick Highmark Inc. Medicare Advantage Plans review: 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.   

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? 

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 beyond the Part B 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 Highmark Inc. plans:

Highmark Inc. Medicare Advantage Plans
Plan name  Monthly premium  Annual medical deductible  Office visits  Telehealth  Emergency room  Annual maximum out-of-pocket cost 
Community Blue Medicare HMO Signature  $0 
Not listed 
$0 primary/$30 specialist 
$0 primary/ $0 home health/$30 specialist/$40 mental health/$35 physical therapy/$45 substance abuse  $90 
Complete Blue PPO Distinct  $35 Not listed $0 primary/$30 specialist In-Network: $0 primary/ $0 home health/$30 specialist/$40 mental health/$25 physical therapy/$45 substance abuse    Out-of-Network: $0 primary/30% home health/$30 specialist/$50 mental health/$35 physical therapy/$50 substance abuse  $90 In-Network: $6,500 
 Out-of-Network: $10,000 
Community Blue Medicare HMO Prestige    $250  Not listed 
$0 primary/$25 specialist 
$0 primary/ $0 home health/$25 specialist/$40 mental health/$30 physical therapy/$45 substance abuse    $90  $6,700 

*Based on pricing in 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.  

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.  

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Reviewed by:

Leron Moore, Medicare consultant

Leron Moore has guided Medicare beneficiaries and their families as a Medicare professional for nearly 15 years. 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.