Highmark Blue Cross Blue Shield provides comprehensive qualified high deductible plans in Western Pennsylvania. As an “HSA-friendly” plan so it can be used in conjunction with a Health Savings Account. Health Savings Blue is a perfect Marketplace fit for the self employed, families or individuals that want quality coverage at a reasonable price.
As a guaranteed-issue Exchange policy, applying for coverage only requires a simple application to be completed, and a face-to-face meeting is not necessary. Coverage is offered in the 17 counties of Western Pa during Open Enrollment periods. However, you can also qualify for a Special Enrollment Period that may allow you to apply for a policy at any time throughout the year.
How Does It Work?
There are numerous deductible options. For example, if coverage is for just one person, you may select a deductible as low as $1,300 or as high as $3,400. The family deductible range is $2,600 to $6,800, although the maximum out of pocket costs are higher. As you may expect, a lower amount will result in higher pricing, since there is less potential out of pocket cost to the customer and more for the insurer.
All preventive treatment is paid in full with no copays, deductibles, coinsurance or waiting periods. A full list of covered items is available through the Department of Health and Human Services or we can email you a complete listing. Most other treatment is provided at negotiated repricing, meaning that until the deductible is met, you receive a substantial discount in cost, courtesy of Highmark. The discounts may range from 5%-20% (office visits) to as much as 50%-85% (lab tests and other diagnostic expenses).
What Counties Must I Live In To Purchase Coverage?
Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Indiana, Lawrence, Crawford, Erie, Mercer, Westmoreland, Forest, Potter, Clarion, Elk, Venango, McKean, Warren, Somerset, Jefferson, Huntingdon, Clearfield, Centre, Bedford, Cameron, Washington, Blair, and Cambria. NOTE: HSA plans in Pennsylvania (all parts) are offered by many other carriers, including UPMC, Aetna and UnitedHealthcare.
PPO 3400 – $3,400 deductible with a maximum out-of-pocket expense of $6,350 per year. The coinsurance on this plan is 30%, so once the deductible is met, the policy will pay 70% of covered expenses. Paid premiums and network-negotiated discounts do not count towards the deductible or maximum out-of-pocket expenses. This is a Bronze-tier contract.
PPO 2750 – $2,750 deductible with a $4,000 maximum out-of-pocket expense per year. Coinsurance is only 20%, which results in savings on smaller claims. This policy is also classified as a “Community Blue Flex” contract, which keeps premiums the lowest of all of the Highmark HSA plans.
The “Community Blue Flex” feature offers owners of the policy two in-network choices instead of one. Costs are better controlled and the number of available providers is still high. The two options are available on most submitted claims.
“Enhanced Value” is the cheapest choice with lower cost-sharing. Typically, the majority of treatment, including office visits, diagnostic testing, inpatient and out patient surgery can utilize this option. “Standard Value” offers fewer choices and is more expensive. However, in specific situations, the price difference may not be substantial and you may prefer this option.
PPO 2500 – $2,500 deductible with $3,500 maximum out-of-pocket expense. Coinsurance is a low 10% and this plan is more expensive than the previous two policies. Like the previous option, the PPO 2500 is a Silver-tier contract, and is eligible for “cost-sharing,” which can reduce the deductible. However, HSA-eligibility may be impacted.
PPO 1300 – Gold-tier contract with low $1,300 deductible and $2,300 maximum out-of-pocket expense. Naturally, it is the most expensive plan and may not be your best choice if there are no existing medical conditions at the time of enrollment.Tags: Apply For Highmark Insurance, Highmark Blue Cross Blue Shield HSA, Highmark high deductible rates