Highmark Blue Cross Blue Shield
New York • Traditional Indemnity, High-Deductible Health Plan (HDHP), HMO
This is a traditional indemnity prefix. Unlike managed care plans (HMO, PPO, EPO), indemnity plans do not use provider networks. There are no referral requirements and no restrictions on which providers the member can see. Submit claims to the payer listed above for reimbursement at the plan's allowed rate.
HDHP coverage under this prefix means the member carries a higher annual deductible in exchange for lower monthly premiums. Claims are processed normally but the member's cost-sharing will be higher than standard plans until the deductible is met. Preventive services are typically the exception and are covered at no cost to the member.
This prefix is linked to an HMO plan. Health Maintenance Organization coverage requires members to use in-network providers and coordinate care through a designated primary care physician. Referrals are typically required for specialist visits. Claims submitted without proper referral documentation may be denied.
Highmark Inc. providing commercial, Medicare and Medicaid plans in Pennsylvania.