ACA Plans

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

Save money on your ACA plan

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.

Platinum – The highest monthly premiums but the lowest out-of-pocket costs.

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.

Looking forward to 2021

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
  • Lower 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.



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



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

Enhanced community care 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.

Shop for plans

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.

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.

* $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.

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.