Provider Information
    Find a Doctor
    Hospital Directory
Contact Us
    Send a Message
    Write or Call
Benefit Descriptions
    Group Benefits
    Individual Benefits
Search Formulary
Locate a Pharmacy
Site Index
   
 
  Highmark Blue Shield will offer the following full-service health insurance programs in Central Pennsylvania and the Lehigh Valley for effective dates beginning April 1, 2002. Click here to see the counties included in Central Pennsylvania and the Lehigh Valley.

  		 
 
ClassicBlue

ClassicBlue plans are Highmark Blue Shield’s traditional and comprehensive group health insurance indemnity programs. They’re sometimes referred to as "fee-for-service" plans in that they pay a set amount per health care service performed. ClassicBlue programs give you the widest choice of physicians and services through Participating providers. Choose ClassicBlue Traditional or ClassicBlue Comprehensive:
  • ClassicBlue Traditional provides 100% coverage for most hospital and medical-surgical covered services; Major Medical covered care is subject to an annual deductible and coinsurance.
  • ClassicBlue Comprehensive provides benefits at 80% of allowed charges after an annual program deductible is met.
ClassicBlue advantages:
  • Nearly 9,000 Participating physicians to minimize out-of-pocket expenses.
  • Many Participating hospitals for maximum convenience.
  • Broadest choice of providers.
  • No need to select a primary care physician; no referrals required.
  • Coverage when you travel anywhere around the world.
  • No claims to file when you use Participating providers.
  • Employers can choose from a wide variety of prescription drug programs.
  • 24-hour, toll-free Blues On Call health decision support line.
For more information about ClassicBlue group coverage, call 1-800-345-3806. If you don't have group coverage, click here for information about Highmark Blue Shield individual programs. 		 
 
 
PPOBlue

PPOBlue is our preferred provider organization (PPO).

PPOBlue is designed for people who want the greatest flexibility within a network-based program. Like all Highmark Blue Shield network-based programs, PPOBlue uses our broad PremierBlue Shield network. You’re free to see any health care professional in this network without a referral, and still receive the highest level of benefits. You can also choose to see providers outside the PremierBlue Shield network. When you do, there’s a deductible, benefits are paid at a lower level and you’ll incur more out-of-pocket expenses.

PPOBlue advantages:
  • Choose from nearly 8,000 PremierBlue Shield physicians and other health care professionals.
  • Many network hospitals for your convenience.
  • Higher level of benefits for covered care within the network.
  • Benefits are also provided - at a reduced level - for covered care outside the network.
  • No claims to file when you use network providers.
  • Coverage for preventive medical care.
  • Coverage when you travel anywhere around the world.
  • Employers can choose from a wide variety of prescription drug programs.
  • 24-hour, toll-free Blues On Call health decision support line.
For more information about PPOBlue group coverage, call 1-800-345-3806. If you don't have group coverage, click here for information about Highmark Blue Shield individual programs. 		 
 
 
SelectBlue
This managed care plan may not cover all your health care expenses. Read you contract carefully to determine which health care services are covered.

SelectBlue is a point-of-service plan from Highmark Blue Shield. With SelectBlue, each time you need care, you can choose to receive "coordinated" care at the program’s higher benefit level ... or to "self-refer" at a lower level of benefits.

Like all Highmark Blue Shield network-based programs, SelectBlue uses our broad PremierBlue Shield network. Each family member chooses a Primary Care Physician (PCP) from the PremierBlue Shield network to coordinate his or her care. Benefits are paid at the higher "coordinated" level when care is provided by your PCP or network Ob/Gyn or nurse midwife ... or if care is referred by your PCP or the Blues On Call phone service. If you choose not to receive "coordinated" care, you can self-refer to any provider - in or out of the network. When you do, there’s a deductible, benefits are paid at a lower level and you’ll incur more out-of-pocket expenses.

SelectBlue advantages:
  • Highly qualified providers.
  • Choose from nearly 8,000 PremierBlue Shield physicians and other professional providers.
  • Many network hospitals for your convenience.
  • Your choice of care coordinated through a network PCP or Blues On Call.
  • Direct access to any network Ob/Gyn or nurse midwife at the higher benefit level.
  • Coverage for preventive medical care.
  • Maximum benefits, no claims to file when you choose coordinated care.
  • Self-referrals permitted, with additional cost-sharing.
  • Coverage when you travel anywhere around the world.
  • Employers can choose from a wide variety of prescription drug programs.
  • 24-hour, toll-free Blues On Call health decision support line.
For more information about SelectBlue group coverage, call 1-800-345-3806. If you don't have group coverage, click here for information about Highmark Blue Shield individual programs. 		 
 
 
DirectBlue

DirectBlue is Highmark Blue Shield’s open access program.

Like all Highmark Blue Shield network-based programs, DirectBlue uses our broad PremierBlue Shield network. Each covered family member has direct access to any provider - including specialists - in or out of the PremierBlue Shield network. Care that is received from a network provider is paid at the higher level. Care that is received from an out-of-network provider will be paid at a lower level after the deductible is met. No referrals are needed. Although you are not required to select a Primary Care Physician (PCP), we do recommend that you choose one. This helps you establish an ongoing physician relationship based on knowledge and trust and keeps your care consistent.

DirectBlue advantages:
  • Choose from nearly 8,000 PremierBlue Shield physicians and other professional providers.
  • Many network hospitals for your convenience.
  • Ability to go directly to any specialist - or any other provider - without a referral, even out of the PremierBlue Shield network.
  • Direct access to any network Ob/Gyn at the higher benefit level.
  • Coverage for preventive medical care.
  • Maximum benefits with no claims to file when you use a network provider.
  • Coverage when you travel anywhere around the world.
  • Employers can choose from a wide variety of prescription drug programs.
  • 24-hour, toll-free Blues On Call health decision support line.
For more information about DirectBlue group coverage, call 1-800-345-3806. If you don't have group coverage, click here for information about Highmark Blue Shield individual programs. 		 
 
Central Pennsylvania and the Lehigh Valley include the following counties:
  • Adams
  • Berks
  • Centre
  • Columbia
  • Cumberland
  • Dauphin
  • Franklin
  • Fulton
  • Juniata
  • Lancaster
  • Lebanon
  • Lehigh
  • Mifflin
  • Montour
  • Northampton
  • Northumberland
  • Perry
  • Schuylkill
  • Snyder
  • Union
  • York
    •  
    BlueAccount
     
    BlueAccount: A Consumer-Centered Healthcare Savings Program
     
    BlueAccount is a new approach to health care coverage. This approach gives you greater control over your choice of care and care providers. It allows you to make your own care decisions and provides you with the resources to be an informed health care "consumer."
     
    BlueAccount is made up of three components:
     
  • A health care savings account funded by your employer. It lets you decide how your health care dollars are spent. This account is used to cover a portion of your deductible and unused account dollars can carry over to the following year.

  • PPO plan coverage provides savings through network providers even when you are using your health care account. And preventive care is covered from the first dollar of care. Once your deductible is met, you get a higher level of coverage when you receive care through a PPO network provider. This network includes thousands of physicians and hospitals in central Pennsylvania, across the state, and around the world.

  • A wide range of member health resources to help you make informed health care decisions. Just log onto My Shield Online to contact a Blues On Callsm health coach and to access thousands of pages of medical information on all kinds of health topics through the colorful, illustrated Health Encyclopedia and the comprehensive Healthwise Knowledgebase.
    		•
     
    BlueAccount also makes your health care coverage convenient. You may be able to enroll in BlueAccount, track your account, and submit claims… all online!
     
    Click here to check out BlueAccount Highlights
    		 

    Back to Top