Highmark ppo blue penn state

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Eliance providers follow high quality protocols driven by advanced clinical initiatives that have been shown to improve medical outcomes and reduce health-related costs. For employees using the Eliance Network co-pays and out-of-pocket expenses are reduced.

The vast majority of services are available; however, if a service is not available within the Eliance Network, employees may access additional networks at the Tier 2 benefit level.

Where do I find Care? This simple tool can help you find the most appropriate Lancaster General Health Provider based on your location. You can also view claims information, print or order ID cards and access insurance-related forms online, by logging onto Capital Blue Cross.

You have significant power and responsibility for your health care decisions when you participate in a HSA-qualified health plan. The LG Consumer Plan requires no employee cost sharing — this means no health insurance premiums will be deducted from your pay! Without the expense of bi-weekly healthcare premiums with this Plan, you are able to deposit money in your HSA.

Where you can save on taxes and have flexibility and control over your health care costs. The money in your HSA remains yours, even if you terminate employment, switch health plans or retire. We are confident that this new partnership positions us to continue offering our employees the excellent medical and prescription drug benefits they depend upon now and will offer them positive health care experiences.

Other employee benefits not related to medical or prescription insurance coverage, such as dental, vision, optional life insurance, long-term disability, and accidental death and dismemberment benefits, will not be impacted by the transition to Highmark.

Comprehensive information, including answers to frequently asked questions, is available on the Penn State Human Resources website. Employees who have additional questions can call HR Services at In addition to the community and provider partnerships Highmark Blue Shield has today, all benefits-eligible employees can access the Penn State concierge customer service team at to navigate their entire health care journey and maximize their benefits.

Penn State is self-insured, which means the University and its employees together cover the full cost of employee health care and prescription drugs each year. The University contracts with companies such as Aetna or Highmark to administer its medical and prescription benefits plans, and regularly revisits those contracts with the goal of maintaining access to high quality care and controlling costs for employees. The site includes:.

Dates, times, and locations for in-person presentations, as well as links to a series of online webinars; and. During the presentations in person or via webinar , attendees will receive an overview of the upcoming benefits and prescription plans and will be able to ask questions.

Prior to the benefit presentations, HR strongly encourages all benefits-eligible employees to review plan options on the HR Benefits Open Enrollment website.

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Plans are offered without underwriting during Open Enrollment or when converting from a business group plan that utilized Highmark. Premiums illustrated below are female rates. Costs of your treatment are paid by the insurer and not Medicare. Often, drug coverage Part D is also included. Contracts and rates shown below are for Allegheny County. Prices, coverage, and available plans can differ in other counties. Plan ID is H Prescription drug benefits are not included.

Drug coverage is not included. Medicare does not offer prescription benefits, so you can easily obtain benefits if you are already enrolled in Parts A and B. Also, if you have an Advantage plan, you may not be eligible for separate Part D benefits. All contracts listed below provide catastrophic coverage. Coverage is offered to individuals and families within required service area.

Having existing medical benefits is not required. Plans are issued at any time throughout the year. Policy becomes active on the first day of the month after the application is received. Spouses and dependents may apply on the same application as the primary insured. Non-covered services may be eligible for network reductions through United Concordia. Both single and family options are offered. Benefits are guaranteed, with pre-existing conditions covered.

And the effective date coincides with the termination date of prior coverage. Available plan options are shown below:. Allegheny Health Network — Offers wellness services, healthcare education, and research through many locations in the area, including the following hospitals: Allegheny General, Cannonsburg, Forbes, Jefferson, Saint Vincent, and West Penn. Additional outpatient surgery and Urgent Care facilities are also available.

GeoBlue Travel Insurance — Expatriates and international travelers can apply for medical benefits that cover the ER, office visits, wellness exams, evacuation, and hospital stays. Students, teachers, missionaries, and volunteers can also secure coverage. Short and long-term travel plans are available through Worldwide Insurance Services. Silver Tier. Plan A — Basic coverage including Part B coinsurance.

Prescription Drug Coverage Part D Medicare does not offer prescription benefits, so you can easily obtain benefits if you are already enrolled in Parts A and B.

Benefits can vary; always confirm member coverage. The online portal is designed to facilitate the processing of authorization requests in a timely, efficient manner. If you are a Highmark network provider and have not signed up for NaviNet, learn how to do so here.

Highmark recently launched a utilization management tool, Predictal, that allows offices to submit, update, and inquire on medical inpatient authorization requests. Fax: If you are unable to use NaviNet, you may also fax your authorization requests to one of the following departments.

The associated preauthorization forms can be found here. Telephone: For inquiries that cannot be handled via NaviNet, call the appropriate Clinical Services number , which can be found here. Highmark contracts with WholeHealth Networks, Inc.

Additional information about the programs and links to prior authorization codes are available under Care Management Programs in the left website menu. Authorization number not appearing, unable to locate member, questions about clinical criteria screen.

Contact Us. Provider Directory. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies.

Requiring Authorization. Pharmacy Policy Search.

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