SPECIAL CIRCUMSTANCE PRODUCTS

Special Circumstance Products

Conversion Coverage

Individuals or families losing group coverage from a Highmark plan may be eligible for a conversion product. These plans provide retroactive coverage to the date your group plan ended.

Are you losing your group coverage from a Highmark insurance plan, or your coverage from CHIP?

Individuals or families losing group coverage from a Highmark group plan may be eligible for a conversion product. These plans provide retroactive coverage to the date your group plan ended.

IMPORTANT: You have a limited amount of time to apply for a conversion plan, or your will lose your right to this coverage.

To find out if you might be eligible for a conversion plan, call the number on the back of your insurance card.

Shared Cost Blue PPO 7000

Highmark Health Insurance Company (HHIC) Conversion Program

This PPO plan gives you the freedom to choose the doctors and hospitals you want. You can receive care in the network at the higher level of benefits, or you can choose to receive care out-of-network at the lower level of benefits.

All Highmark members who enroll in HHIC Shared Cost Blue PPO are protected by the Consent Decree.

Need more information? Call: 1-877-959-2565

my Direct Blue HMO 7000B

Highmark Choice Company (HCC) Conversion Program

For enrollees who live in Allegheny, Erie, Washington, Westmoreland, and Crawford counties. This is a Health Maintenance Organization (HMO) plan that usually only covers care from providers who contract with the HMO. Out-of-network care is not covered (except in an emergency).

Need more information? Call: 1-877-959-2565


HIPAA Conversion Coverage

The Health Insurance Portability Act (HIPAA) of 1996 offers transitional health care coverage for those that meet eligibility requirements.

HIPAA products are not available in 2017 and 2018 from Highmark Blue Cross Blue Shield West Virginia, or Highmark Blue Cross Blue Shield Delaware.

If you have recently lost coverage from an insurer other than Highmark and want to avoid a lapse in coverage, you may be eligible for a HIPAA program.

Specific provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) were designed to provide access to individual health insurance coverage for certain eligible individuals who previously had coverage through a group, government or church health plan. Highmark complies with HIPAA regulations by offering individual plans to all HIPAA eligible applicants.

Applicants have 63 days from the date on which their prior coverage through an insurer (other than Highmark) ended to apply for the Highmark HIPAA product. The effective date for the HIPAA policy is effective as of the termination date from the applicant’s last eligible prior plan coverage. There are no pre-existing condition limitations.

In addition to completing the application, HIPAA eligible applicants must also complete a HIPAA Eligibility checklist and a HIPAA Prior Coverage Disclosure and Authorization.

You can get more information and request an application at one of our Highmark health insurance stores or by calling 1-888-529-8978.

Shared Cost Blue PPO 7000

Highmark Health Insurance Company (HHIC) HIPAA Conversion Program

This PPO plan gives you the freedom to choose the doctors and hospitals you want. You can receive care in the network at the higher level of benefits, or you can choose to receive care out-of-network at the lower level of benefits.

This Highmark Health Insurance Company (HHIC) Shared Cost Blue PPO 7000 is a HIPAA eligible plan.

All Highmark members are protected by the Consent Decree.