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  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 Traditional    ClassicBlue Comprehensive

Highmark Blue Shield offers two indemnity health insurance programs for individuals and families who donít have group health coverage and arenít eligible for Medicare. These programs are sometimes referred to as "fee-for-service" plans in that they pay a set amount per health care service performed.
  • ClassicBlue Traditional provides 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. You can choose from two program deductibles.

    Two ClassicBlue Comprehensive options are available for HIPAA eligible individuals to obtain coverage with no pre-existing condition waiting period.
ClassicBlue advantages:
  • Available to all Central Pennsylvania and Lehigh Valley residents, regardless of occupation or health status.
  • Provides a wide choice of Participating doctors and hospitals.
  • Choice is not limited to a managed care network.
  • 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.
For more information, call 1-877-986-4571.
 
 
 
SpecialCare

Special Care is a low-cost program that was initially developed by Highmark Blue Shield for Pennsylvania families and individuals who earn too much to qualify for Medical Assistance and who do not have access to group health insurance.

To qualify, your familyís annual income cannot exceed 185% of the Federal poverty guidelines. Also, you must be a Pennsylvania resident living in one of the 21 counties in Central Pennsylvania and the Lehigh Valley served by Highmark Blue Shield. You may not be enrolled in or eligible for any private or governmental group or individual health care program.

Parents may be eligible for Special Care even though their children are enrolled in BlueCHIP, The Caring Program or the Medical Assistance Healthy Beginnings program.

Special Care advantages:
  • Provides coverage for 21 inpatient hospital days per benefit period, emergency accident and medical treatment, surgery, maternity and newborn care, pediatric preventive services, diagnostic tests, radiation and chemotherapy as well as other services.
  • Covered services are paid in full when performed at a Participating Special Care hospital and/or by a Highmark Blue Shield Participating health care professional.
  • Discounts on prescription drugs at participating pharmacies.
For more information, call 1-877-986-4571.

Special Care is a service mark of Highmark Blue Shield and the other Blue plans in Pennsylvania.

Special Care is not affiliated with "Special Care Inc.," a home health care company.




SpecialCare

MedigapBlue

Choose MedigapBlue - the Medicare Supplemental coverage from Highmark Blue Shield

Medicare was never meant to cover all health care costs. It leaves gaps in the form of deductibles, coinsurance and copayments. Medicare Supplemental insurance, also called Medigap, is a type of health coverage that pays for some or all of the health care costs not covered by Medicare.

You need to be enrolled in both Part A and Part B of Medicare in order to enroll in MedigapBlue or any other Medigap plan.

There are ten standardized Medicare Supplemental policies that can be offered by insurance companies. The standardized benefits included in these ten plans are the same, no matter what insurance company offers them. But Highmark offers special services and programs that you might not get from other companies. Highmark offers six Medicare Supplemental plans: Plans A, B, C, E, H and I.

What you get when you choose MedigapBlue
  • The stability and dependability of an insurance leader: Highmark Blue Shield
  • Wide range of benefits and services covered depending on your needs (6 different plans to choose from)
  • Protection from hospital and medical expenses not covered by Medicare
  • Total freedom of using any doctors, specialists and hospitals you want
  • No referrals needed
  • Coverage when you travel
  • Potential savings with our Prescription Drug Discount - lowest possible cost on most brand name and generic drugs - available with all plans
  • Access to the SilverSneakers Fitness Program - a total health and fitness program designed for older people of all fitness levels. The program is provided through participating, full-service fitness centers throughout your area at no additional cost.
  • Special discounts on vision care with Plan E and Plan I
  • Blues On CallSM health care support resource with Plan E and Plan I - toll-free telephone line that gives you 24-hour-a-day access to a personal health coach who is a Registered Nurse
  Plan A Plan B Plan C* Plan E Plan H* Plan I
STANDARDIZED BENEFITS
Basic Benefits * * * * * *
Medicare Part A Hospital Deductible   * * * * *
Skilled Nursing Facility Coinsurance     * * * *
Medicare Part B Deductible     *      
Foreign Travel Emergency     * * * *
At-Home Recovery           *
Medicare part B Excess Charges           *
Preventive Care       *    
Prescription Drug coverage         * *
HIGHMARK SPECIAL SERVICES
Prescription Drug Discount Program * * * * * *
SilverSneakers Fitness Center Membership® * * * * * *
Vision Discounts       *   *
Blues On CallSM information hotline       *   *

* You must apply within the first six months following your initial enrollment for Medicare Part B Medical Insurance to be eligible for Plan C and Plan H. Plans A, B, E and I are available to all Medicare Beneficiaries at any time. Exceptions do apply, please call us for more information.


Basic Benefits - covered by Plans A, B, C, E, H and I:
  • Medicare charges a $219 per day copayment for days 61-90 in a hospital. MedigapBlue covers this copayment.
  • Medicare charges a $438 per day copayment for days 91-150 in a hospital (lifetime reserve days). MedigapBlue covers this copayment.
  • Medicare does not cover hospital days 151 and on. MedigapBlue will cover up to an additional 365 days at 100% of Medicare-allowable expenses.
  • Medicare requires that you pay for the first 3 pints of blood that you use in a calendar year (unless you replace the blood by donation). MedigapBlue covers the cost of the blood.
  • Medicare generally pays only 80% of covered physician charges, outpatient hospital care and some other medical services that Medicare Part A doesn't cover. MedigapBlue pays the remaining 20% or applicable copayment - doesn't pay the yearly deductible.

Contact Us
The benefits listed here are only a brief overview of MedigapBlue plan benefits. Please call us at
1-800-549-5642, TDD users call 1-800-227-8210 to get more detailed information about plan benefits. We will be happy to send you more information on MedigapBlue.

SM Blues On Call is a service mark of the Blue Cross and Blue Shield Association
® SilverSneakers is a registered trademark of HealthCare Dimensions.


MB-WEB02SHa- (R12-03)
 

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