Highmark Medigap Blue Plan Review
Highmark Medigap Blue plans are Medicare Supplement Insurance policies from Highmark, an independent licensee of Blue Cross Blue Shield. Read our Medicare plan review to learn more about these plans and how you can compare Medigap plans.
Highmark Inc. is a part of the Blue Cross Blue Shield family of brands, and they offer Highmark Medigap Blue plans in certain parts of the country.
Learn more about Highmark, and find out if Highmark Medigap Blue plans are available near you and how to compare more Medicare Supplement plans.
Highmark is an affiliate of Blue Cross Blue Shield that sells health insurance plans in:
- Delaware (Highmark Blue Cross Blue Shield Delaware)
- New York (Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York)
- Pennsylvania (Highmark Blue Shield and Highmark Blue Cross Blue Shield)
- West Virginia (Highmark Blue Cross Blue Shield West Virginia)
Medigap Blue is a name Highmark uses for the Medicare Supplement Insurance plans they offer. Highmark Medigap Blue plans are available in Delaware, Pennsylvania and West Virginia.
Medicare Supplement Insurance, also called Medigap, provides coverage for many of the out-of-pocket costs that are required by Original Medicare (Part A and Part B). These costs can include Medicare deductibles, copayments, coinsurance and more.
Medicare Supplement Insurance is sold by private insurers like Highmark and other Blue Cross Blue Shield affiliates.
There are 10 different types of standardized Medicare Supplement Insurance plans sold in most states, and each type of plan has benefits that are standardized by the federal government. Medigap Blue offers seven of the 10 available plans, including Medigap Plans A, B, C, D, F, G and N. Medigap Blue also offers a high-deductible Plan F, which offers beneficiaries an opportunity to pay a lower monthly premium for a Medigap plan with a higher deductible.
The benefits of each of the 10 available Medigap plans available are detailed below. Plans K, L and M are the only plans not offered by Medigap Blue.
Not all seven plans are necessarily guaranteed to be available in each of the three states served by Medigap Blue, so contact a licensed insurance agent to discuss the specific plan options available in your area.
|Medicare Supplement Benefits||A||B||C1||D||F1||G||K||L||M||N|
|Part A coinsurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B coinsurance or copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plans C and F are not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Plans F and G also offer a high deductible plan which has an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
3. Plan K has an out-of-pocket yearly limit of $6,220 in 2021. Plan L has an out-of-pocket yearly limit of $3,110 in 2021.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
To be eligible for a Medicare Supplement Insurance plan from Highmark Medigap Blue or any other provider, you must be enrolled in both Medicare Part A and Part B.
Age restrictions for Medicare Supplement Insurance vary by state.
- In Delaware, insurance companies are required to offer Medigap plans to Medicare beneficiaries under the age of 65. However, companies reserve the right to charge higher premiums to those under 65.
- In Pennsylvania, insurers must offer all their available plans to those under 65 and are not allowed to charge higher premiums to those under 65 based on age alone.
- In West Virginia, insurers are not required by law to sell plans to those under 65 but may do so at their own discretion.
No matter your age, you may only apply for a Medigap plan that is available in the area in which you reside.
Technically, you can apply for a Medigap plan at any time. However, the best time to do so is during your Medigap open enrollment period. This period begins the first month that you are enrolled in Medicare Part B and at least 65 years old. Your Medigap open enrollment period lasts for six months.
During this period, you have guaranteed issue rights. That means insurance companies are not allowed to use medical underwriting to determine your Medigap premiums.
If you apply for a Medigap plan outside of your Medigap open enrollment period – or if you apply during any other time that you don’t have guaranteed issue rights – insurance companies can use medical underwriting as part of your application. This means that you could potentially be charged higher premiums or be denied coverage altogether based on your health.
The cost of a Highmark Medigap Blue plan will vary by plan selection and location. The chart below shows some pricing examples of plans in three different counties using Highmark’s online quote estimator.
(The examples below do not reflect the complete selection of plans available in any given area.)
|County||Plan A||Plan F||Plan N|
$117.60 - $209.40
$172.15 - $313.60
$125.20 - $222.60
$92.90 - $255.48
$153.66 - $422.55
$108.49 - $298.33
$121.91 - $207.42
$194.22 - $330.53
$159.87 - $272.30
Highmark offers a benefits package called Whole Health Balance that may be added to a Medigap Blue plan for an additional premium. The Whole Health Balance package includes dental, hearing and vision coverage as well as a SilverSneakers fitness program membership.
A great way to shop for Medigap plans is with the help of a licensed insurance agent. Remember, basic plan benefits are standardized by the federal government, so each plan of the same letter will offer similar coverage no matter which insurance company is selling it.
And because different carriers may offer a different mix of plans in any given area, it’s a good idea to shop around and review all your coverage options before you apply.