HMO Plans

HMO Plans

HMO members have access to a high quality network of community and specialty hospitals and physicians.

This product is different because it’s an HMO, which means there are no out-of-network benefits and member cost-sharing is the same no matter which HMO providers members choose.

Members are covered for a broad range of care, including:

Routine and Preventive Care

Specialty Care

Hospital Care

Women’s Care

HMO Advantages:

Choose a primary care physician to conduct routine care and exams.
No referrals needed for coverage in network.
Enjoy low deductibles, low copays and 100 percent coverage of most services.
Includes emergency coverage no matter where you are – even out of network.

An HMO may also cover:

Emergency care most anywhere.
Injuries or illnesses that cannot wait for treatment when out of the local service area.
Follow-up care for services that started before members left home.
Care for long-term travelers, separated families or students living away from home.

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are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

Important Legal Information: Health benefits or health benefit administration may be provided by or through Highmark Blue Shield or one of its affiliated Blue companies, which are independent licensees of the Blue Cross Blue Shield Association. Highmark Inc. d/b/a Highmark Blue Shield and certain of its affiliated Blue companies serve Blue Shield members in the 21 counties of central Pennsylvania. As a partner in joint operating agreements, Highmark Blue Shield also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Inc. or certain of its affiliated Blue companies serve Blue Cross Blue Shield members in the 29 counties of western Pennsylvania, 13 counties in northeast Pennsylvania, the state of West Virginia plus Washington County, Ohio, and the entire state of Delaware. Information on this website is issued by Highmark Blue Shield on behalf of its affiliated Blue companies.

We are committed to providing outstanding services to our applicants and members. If you require special assistance, including accommodations for disabilities or limited English proficiency, please call us at 1-800-876-7639 or TTY at #711 to receive assistance free of charge.

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The information contained on this website regarding the Patient Protection and Affordable Care Act of 2010 (“PPACA”), as amended, and/or any other law, does not constitute legal or tax advice and is subject to change based upon the issuance of new guidance and/or change in laws.

The information provided is intended to provide general information only and does not attempt to give you advice that relates to your specific circumstances. State laws and regulations governing health insurance and health plans may vary from state to state. Further, any information regarding any health plan will be subject to the terms of its particular health plan benefit agreement and some health plans may not be available in every region or state.