Medicare Advantage

2019 Highmark Medicare Advantage & Medigap Plans

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Highmark Health offers a full array of Medicare Advantage and Medigap supplement plans. The company has a long history of providing health benefits to millions of members while maintaining consistently strong product and service ratings. In business for over 75 years, Highmark Health offers health insurance plans in Pennsylvania, Delaware and West Virginia. They provide nearly 5 million members with a comprehensive line of health insurance products.

Members have access to a large network of doctors, healthcare specialists, and hospitals. Medigap Blue plan members can see any provider or hospital that accepts Medicare. The company’s Plan D offerings offer an extensive formulary of prescription medications.

Highmark Medicare Is One Of The Highest Rated Medicare Plans

With an A.M. Best rating of A (Excellent) for financial stability and good star ratings from the Centers for Medicare and Medicaid Services for their Medicare Advantage plans, Highmark Health is among the top-rated plan providers. Offerings include Medicare Advantage (Part C), prescription drug coverage (Part D) and Medigap supplement plans.

Highmark Medicare has several Medicare Advantage plans available depending on where you live. When it comes to Medicare, the only accurate way to know what’s out there is to get a personalized quote based on your zip code and other information, like your age, gender and when you want to buy a plan. That said, below we provide you with an overview of what you might expect from Highmark Medicare Advantage in 2019. Here are three plans side by side, specifically for Lehigh County in Pennsylvania.

Highmark Medicare Advantage Plans

Highmark Medicare Advantage Plans For 2019
Community Blue Medicare HMO Signature Freedom Blue PPO Basic Freedom Blue PPO Deluxe
Monthly premium $0 $93 $290
Copay (primary) $0 $15 (in & out of network) $5 (in & out of network)
Deductibles $0 for medical $0 for drug $0 for medical $0 for medical (in network)
Network In-network coverage only Coverage for network and non-network care Coverage for network and non-network care
Rx coverage? Yes No Yes
Rx cost $0 copay for tier 1 N/A $0 copay for tier 1
Special features Routine vision, routine dental, hearing aids and routine chiropractic; Silver Sneakers fitness program Routine vision, routine dental, hearing aids and routine chiropractic; Silver Sneakers fitness program; transportation benefits Routine vision, routine dental, hearing aids and routine chiropractic; Silver Sneakers fitness program; transportation benefits
Out-of-pocket max $6,700 $6,700 $6,700 (in network)
CMS Star Rating 4.5 4.5 4.5

Comparing 2019 Highmark Medigap Plans

If you prefer original Medicare or need to keep it because it works better for you, then you may also want a Medicare supplement plan, also known as Medigap, to help offset your out-of-pocket expenses. Medigap plans are standardized at the federal level. In every state except for Massachusetts, Minnesota and Wisconsin – which set their own standards – Medigap plans are standardized. That means Plan A in Pennsylvania will look the same as Plan A in New Mexico.

Highmark only sells policies in select states in 2019. Those policies are Medigap Plans A, B, C, D, F, high-deductible F, G and N – though not every plan is available in every service area. If you’re interested in a Highmark Medigap policy, get a quote based on your zip code. In the following sections, we’ve outlined what each Medigap policy covers and included a quote for monthly premiums based on information for a 65-year-old woman living in Lehigh County, Pennsylvania.

2019 Highmark Medigap Plan A

Every insurer that offers Medigap plans must include Plan A among the selections. This Medicare supplement plan covers a few basic services. It’s often one of the lowest-priced Medigap plans, but that’s not always the case. Check pricing carefully. Since Plan A covers the fewest benefits, it may be worth exploring a more benefit-rich option if it’s cost effective. In our example, a 65-year-old living in Lehigh County, Pennsylvania, would pay about $108 each month to have Plan A coverage from Highmark. The plan covers the following benefits:

  • Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
  • Part A hospice care coinsurance or copayment
  • Part B coinsurance or copayment
  • The first three pints of blood

2019 Highmark Medigap Plan B

The only difference between Plan A and Plan B is that Plan B also covers the Medicare Part A deductible, which will be $1,364 per benefit period in 2019. Over the course of a year, coverage for the Part A deductible could add up to significant savings. Still, Plan B doesn’t usually cost much more than Plan A. In 2019, a Highmark Medigap Plan B policy for our 65-year-old in Lehigh County would cost about $111 a month. If you purchase Plan B, your Medigap coverage will pay for:

  • Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Part B coinsurance or copayment
  • The first three pints of blood

2019 Highmark Medigap Plan C

One of the most comprehensive Medigap plans is Plan C. In fact, it covers so many benefits that it will no longer be available for new signups in 2020. That’s when new rules eliminating plans that cover the Medicare Part B deductible will go into effect. (Plan F is the only other Medigap policy to cover the Part B deductible.) But if you sign up now, you’ll still be able to keep Plan C for 2020 and beyond. This is one of Highmark’s most expensive Medigap plans. It’s second only to Plan F at a negligible difference of about 30 cents. Our 65-year-old in Lehigh County would have a monthly premium of just under $150. Plan C covers:

  • Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B deductible
  • Part B coinsurance or copayment
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

2019 Highmark Medigap Plan D

One option with moderate coverage is Medigap Plan D. This plan includes most of Plan C’s benefits, but it requires you to be responsible for the Part B deductible, which will be $185 in 2019. Plan D would cost our Lehigh resident just under $121 each month. The premium pays for these benefits:

  • Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B coinsurance or copayment
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

Highmark Medigap Plan F

The Medicare supplement plan that covers the most benefits is Medigap Plan F. However, like Plan C, this option will no longer be available starting January 1, 2020, since it includes coverage for the Part B deductible. You can still buy this policy until then and keep it in place after that date, but it may become more expensive to maintain as fewer people have access to it over time. At slightly under $150 per month, Plan F costs the most among Highmark plans in 2019.

High-deductible Plan F is an alternative option that costs half as much ($76 a month for our Lehigh resident). The benefits are the same, but they don’t kick in until you meet the deductible, which will be $2,300 in 2019. Compare the costs between regular Plan F and the high-deductible version to see if paying that deductible might be worth the savings in your monthly premium. Plan F covers:

  • Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B deductible
  • Part B coinsurance or copayment
  • Part B excess charges
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

Highmark Medigap Plan G

Medigap Plan G is the most comprehensive plan outside of Plan F, but unlike Plan F, it will still be around after 2020. It covers everything that’s included in Plan F except the Part B deductible, which, as you might recall, is just $185 for the year. Although Plan G covers more than Plan D does, Highmark charges only 30 cents more for it each month. Our Lehigh resident would pay about $121 a month for Plan G, which covers:

  • Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B coinsurance or copayment
  • Part B excess charges
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

Highmark Medigap Plan N

If you like the idea of Plan D coverage but not the price tag, consider Medigap Plan N instead. The only difference between these two policies is that Plan N requires a $20 copay for some doctor appointments and a $50 copay for some emergency room care (if it doesn’t lead to inpatient hospital admission). Because of these copay requirements, this is one of Highmark’s most affordable Medigap plans. A 65-year-old in Lehigh County would pay a little over $109 a month for Medigap Plan N from Highmark. The following benefits are included in Plan N:

  • Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B coinsurance or copayment
  • The first three pints of blood
  • 80% of foreign travel medical expenses (up to the plan limit)

Medigap policies aren’t easy to wade through, especially since so many of them appear to cover the same set of benefits. But comparing Medicare Advantage plans isn’t always easy, either. If you’re stuck on which plan to choose or need help finding a policy that fits your budget, talk to us. We’re here to help. We can guide you to the right policy in no time. Get a personalized quote based on where you live to see what’s available from Highmark or other companies in 2019.

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