When choosing a plan, there are a few important things to consider first.
The time in which you can sign up for a plan is called the Open Enrollment Period (OEP). OEP begins on November 1 and runs through December 15. You’ll need to enroll in a plan during that time for coverage that begins January 1. You may be eligible to enroll in a plan outside of this timeframe through a Special Enrollment Period (SEP), as long as you’ve experienced a Qualifying Life Event (QLE) like the loss of a job or the birth of a child.
Weigh your monthly premium against your annual deductible.
Do you go to your PCP regularly? Do you see a specialist? How many prescriptions do you take? Don’t just focus on monthly premiums when comparing plans. Consider other costs like deductibles, copayments for primary care providers and specialist visits, as well as prescription drug coverage. Sometimes, paying a little more per month can help you save even more money over the course of the year.
It’s also a good idea to talk to your doctor about your current health and your family health history to try and anticipate future surgeries or new prescriptions that you may need down the road.
Do you have a favorite doctor? Before you pick a plan, make sure they’re in network.
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.
These are Highmark plans that are bought through the federal or state government Exchange. These plans offer extra savings to those who are eligible that can lower monthly premiums and out-of-pocket costs.
These plans are bought directly through Highmark and do not offer financial help. Additional plans may be available off the Exchange.
Highmark Direct stores
At Highmark Direct stores you can speak one-on-one with health insurance advisors who can help you:
Highmark Direct services are available by appointment only — and please note that there are social distancing and mask guidelines in place to ensure everyone’s health and safety.
Find a Highmark Direct location near you.
Give us a call at 855-520-0302
Highmark representatives are ready to assist you Monday – Friday, 9 a.m. to 7 p.m. and Saturday 9 a.m. to 2 p.m. They can answer your questions, help you get prepared to enroll, and assist you with navigating Pennie, the new Pennsylvania state-based insurance exchange.
This year, the Commonwealth of Pennsylvania will launch Pennie, a new state-based exchange exclusively for Pennsylvania residents that allows you to browse plans, apply for financial help, and enroll. If you’ve previously used the federal exchange at healthcare.gov, Pennie will replace it.
If you qualify for financial help or would like to recheck your eligibility, Pennie is an online option for enrolling in an individual or family plan for 2021. But Highmark is still here to answer your questions, help you get prepared, and to help you enroll.
Unfortunately no, but you can call our dedicated Highmark representative who can assist you through the process.
Just like healthcare.gov, this new site will allow you to browse plans, apply for financial help, and enroll.
No. You can still enroll directly with Highmark by either using our Highmark Shop site or calling us. But if you qualify for subsidies or CSR, or want to recheck eligibility, you must go through the state exchange or call a Highmark representative.
When you’re shopping for plans, you may want to make sure that your doctors, hospitals, and prescription drugs are covered. These resources will help you do just that.
Compare plans in your area, see if you qualify for financial help, and get cost estimates.
Find A Doctor will help you find in-network doctors, hospitals, and facilities.
If you don’t have a doctor, My Care Navigator can help you find one. Call 888-258-3428.
The Rx Formulary Tool lists all the prescription drugs covered by Highmark plans.