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Medicare Offerings

Highmark Blue Shield

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HIGHMARK SENIOR MARKETS

 

Special Enrollment Period for PACE and PACENET Members

 

PACE and PACENET offer low-cost prescription assistance for older adults, age 65 and older, who qualify. Members enrolled in either of these programs may choose a SEP once per year, any time during the year, to join a Medicare Advantage plan or Part-D plan for the first time or to change to another Medicare Advantage plan or Part-D plan. However, if a member is automatically enrolled in a Part-D plan by their State Pharmaceutical Assistance Program, they will not have this SEP option. 

Beginning January 1st, 2019, the Commonwealth of Pennsylvania is paying the late enrollment penalty (LEP) in full for members in either of these programs; see additional info below: 

PACE:

  • The Commonwealth will pay a maximum of $35.63 for a member’s Part-D premium and full Part-D LEP for non-low-income subsidy (LIS) individuals.  
  • Individuals that qualify for LIS will receive a subsidy of no more than $35.63 benchmark amount and no Part-D LEP.

PACENET:

  • The Commonwealth will pay full Part-D LEP only for non-LIS individuals.  
  • The Commonwealth will not pay towards any PACENET premiums in 2020.

Special Enrollment Periods (SEP) permit changes to a Medicare Advantage Plan or Medicare prescription drug plan coverage outside of the regular enrollment periods when certain life events occur. Common examples of these events are:

  • Relocation
  • Loss of employer coverage
  • Loss of dual eligibility status
  • PACE/PACENET/LIS

 


High Performance Networks

 

Are you ever caught off guard by a client with a question about a specific network and wish you had a quick reference guide to provide assistance? We have put together the following three lists to assist you with your clients! These lists specifically apply to our Community Blue Medicare HMO and PPO products.
 

Select DME Network
 

High Performance Home Health Network
 

 

High Performance SNF Network


To find participating providers for Freedom Blue PPO and Security Blue HMO; please use the provider search tool located at: Highmark Medicare Provider Search

Please note: Provider Networks are subject to change and should be verified prior to services being rendered.

 

This email was sent from the Highmark Senior Markets Sales team. If you have questions, please contact our Broker Services Team at highmarkseniormarkets@highmark.com or call (800) 652-9459.