2019 PLAN CHANGES

Blue Looks Good in 2019

Many of our plans for 2019 will include:

  • NEW lower annual deductibles
  • 2 free PCP visits
  • 2 free mental health visits
  • Free preventive care
  • NEW $5 Rx copay for many commonly used drugs

*All 2018 members will be automatically re-enrolled in a similar plan for 2019

Schedule a Call

Have questions? Schedule a call with a Highmark licensed representative to walk you through your plan options for 2019.

Schedule a Call or call now 855-865-4325

Armstrong, Clarion, Forest and Warren Counties:

  • Now Available: New my Direct Blue EPO Plans Make Life Easier

We want you to feel 100% secure with your health insurance coverage. That’s why this year’s plan options were designed with you in mind. We’ve made some changes to simplify health care in a way that fits better with your busy life. In short, we’re making our plans easier to use.

Erie County:

New lower premiums for most 2019 plans

2019 Premium Changes

Rate Change Notice

 

Your 2019 plan and rate details will be sent to you in early November.

Consent Decree with UPMC Does NOT Apply to my Direct Blue plans

Understanding your Prescription Drug Formulary

We want to make sure that our plans provide the coverage you need and prescription drugs are an important part of that. The list of the drugs that your plan covers is called a “formulary.”

In 2019, Highmark plans will continue to use the Essential Formulary, which:

  • New for 2019: Offers $5 copays for many commonly used drugs (Tier 1) and includes both generic and brand name drugs
  • Groups drugs into four levels or “tiers.”
  • Saves you money when your doctor prescribes drugs on the lower tiers.
  • Lower tiers include generic drugs while higher tiers covers both brand-name and generic drugs
  • Is a closed formulary—your plan pays only for drugs listed.

If your doctor prescribes a drug that is not included in the Essential Formulary, you may have to pay 100% out of pocket.

Before you enroll in a plan, make sure your prescriptions are covered.

In-Network Hospitals for 2019

Good News! St. Clair Hospital and Washington Hospital are back in-network for 2019

We’ve made some changes for 2019 - Before you pick a plan and use your health insurance, check to see which facilities are in-network.

New hospitals for 2019:

  • St. Clair Hospital (Allegheny County)
  • Washington Hospital and Weirton Medical Center1 (Washington County)
  • Armstrong County Memorial (Armstrong County)
  • Warren General Hospital (Warren County)
  • Clarion Hospital (Clarion County)
  • Ellwood City Hospital (Lawrence County)
  • Sharon Regional Medical Center and Edgewood Surgical Hospital (Mercer County)
  • Washington Hospital - Greene (Greene County)
  • Olean General Hospital (McKean County)
  • Edgewood Surgical Hospital (Mercer County)
  • Tyrone Hospital (Blair County)

1Out-of-state facility additions

 

View all hospitals in your area