Medicare Advantage Member Evidence of Coverage Booklets

An Evidence of Coverage explains how members get their health care and drug coverage through Highmark's Plans.

An Evidence of Coverage, together with a member's enrollment form, riders (including optional supplemental benefit brochures), Annual Notice of Change (ANOC), formulary, and amendments that we may send to them, is our contract with the member. It explains their rights, benefits, and responsibilities as a member of our Plan. The information in each yearly Evidence of Coverage is in effect for the time period during which the member is eligible.

Freedom Blue PPO Plans: service area includes Adams, Berks, Bradford, Carbon, Centre, Clinton, Columbia, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lackawanna, Lancaster, Lebanon, Lehigh, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northampton, Northumberland, Perry, Pike, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne, Wyoming, and York counties.

Community Blue Medicare HMO Signature: service area includes Adams, Berks, Cumberland, Dauphin, Juniata, Lackawanna, Lebanon, Lehigh, Luzerne, Monroe, Northampton, Perry, Schuylkill, Snyder, Susquehanna, Union, Wayne, Wyoming, and York counties.

Community Blue Medicare PPO Signature: service area includes Adams, Berks, Bradford, Carbon, Centre, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lackawanna, Lebanon, Lehigh, Luzerne, Mifflin, Monroe, Northampton, Perry, Pike, Schuylkill, Snyder, Susquehanna, Union, Wayne, Wyoming, and York counties.

Community Blue Medicare HMO and PPO Plans available only to members who reside in Lancaster County.

Community Blue Medicare Plus PPO available only to members who reside in the limited service area, which includes Clinton, Lycoming, Sullivan, and Tioga counties.

Blue Rx Medicare Prescription Drug Plans (PDPs)

Last updated on 1/16/2019

 

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