The plan you love from the brand you trust.

See how your Highmark Individual or Family plan keeps you protected in 2021

ACA Benefits

Why mess with a good thing?

Get all the benefits you count on, from the brand you trust. Many of our health plans feature:

  • No referrals to see an in-network specialist.
  • Access to 96% of hospitals and 95% of doctors in the U.S. through the BlueCard®program. Plus, in-network routine care is covered in 190 countries around the world.+
  • $0 copays on most commonly used prescription drugs.*
  • $0 telemedicine visits through Amwell.
  • $0 preventive care, including preventive screenings, wellness exams, immunizations,vaccines & contraceptives.
  • Low copays on common services, like PCP and specialist visits, and lab work.

As always, you have the peace of mind of knowing that you're covered in an emergency anywhere you go.

See which prescriptions are covered

The list of the drugs that your plan covers is called a "formulary." Here are some of the things you should know about Highmark's individual and family plan formulary:

  • A plan's formulary categorizes prescription drugs into 1 of 4 tiers. Each tier has a different cost-sharing structure.
  • You can save money when your doctor prescribes drugs covered in the lower tiers, which includes generic drugs and some brand-name drugs, while higher tiers cove rboth brand-name and generic.
  • Highmark uses a closed formulary – which means your plan only covers prescriptions that are listed on the formulary.**

Check to see if your prescriptions are covered in your formulary.

ACA prescriptions

Where to go: Northeastern PA's In-Network Hospital List

What's the key to a great health care experience? High-quality care that's close to home.

See which facilities are in-network, including labs, testing facilities, imaging centers, and more.


Search all doctors and hospitals near you.

*$0 prescription drugs applicable to Tier 1 drugs.

+According to the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

**In some exception cases, such as medical necessity, Highmark may cover non-formulary drugs.

Amwell is a trademark of American Well Corporation and may not be used without written permission. American Well is an independent company that provides telemedicine services and do not provide Blue Cross and/or Blue Shield products or services. American Well is solely responsible for their telemedicine services.

Please reference the Preventive Schedule for a full listing of preventive and routine care available to you for little to no cost sharing when using in-network providers.

BlueCard® is a registered mark of the Blue Cross Blue Shield Association.