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Highmark Members Have In-Network Coverage

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Highmark Members Have In-Network Coverage W H AT BLUE MEANS FOR YOU. BIGGEST. HIGH- QUALITY. EASIEST. HE A LT H CARE. THE COLOR BLUE SURROUNDS US, from the sky above our heads to the ocean waves against our shores. It can mean so many things, from the hard working spirit of blue collar workers to a symbol of excellence and distinction. Here at Highmark, Blue means all of that and more … We didn’t select the image of the largest mammal on earth on a whim. It’s our way of putting an exclamation point on a crucial fact: When you’re a Highmark member, you’re part of something really big … THE BLUE CROSS BLUE SHIELD NETWORK. You have access to the largest health care network in the nation. IN-NETWORK ACCESS TO 96%of the nation’s hospitals 93%of the nation’s doctors (According to the Blue Cross Blue Shield Association.) Travel with assurance In western Pennsylvania Because you’re covered nearly anywhere You have access to more than 50 you go — nationally in every state, and hospitals — including seven Allegheny internationally in 190 countries. Not Health Network (AHN) hospitals, every health plan can offer that. Children’s Hospital of Pittsburgh of Plus, emergency care is always UPMC (until 2022), and many high- covered at the in-network benefit quality community hospitals. level at any hospital, near or far. Many are recognized as Blue Distinction Centers®, a Blue Cross Blue Shield Association program that recognizes excellence for delivering superior outcomes in advanced specialty care. IN WESTERN PA YOU HAVE ACCESS TO 7,600+ 2,800+ primary care physicians of those physicians are and specialists. within AHN. YOUR ACCESS TO HIGH- QUALITY CARE Hospitals that have one or more Blue Distinction Center® designations that are in-network: Erie McKean Potter • Allegheny General Hospital • Heritage Valley Sewickley Warren Crawford • Allegheny Valley Hospital • Indiana Regional Medical Center • Armstrong County • Jefferson Hospital Forest Memorial Hospital • Meadville Medical Center Venango Elk Cameron • Bradford Regional Medical Center • Monongahela Valley Hospital Mercer • Canonsburg Hospital • Ohio Valley Hospital • Charles Cole Memorial Hospital • Penn Highlands DuBois Clarion Jeerson • Conemaugh Memorial • Punxsutawney Area Hospital Lawrence Butler Medical Center Clearfield Centre • Saint Vincent Hospital • Conemaugh Nason Medical Center • Sharon Regional Health System Armstrong • Excela Health • St. Clair Hospital Beaver Indiana Westmoreland Hospital • Uniontown Hospital Allegheny • Excela Latrobe Hospital • Warren General Hospital Cambria Blair • Forbes Hospital • West Penn Hospital Huntingdon • Heritage Valley Beaver Westmoreland Bedford Washington Somerset Allegheny Health Fayette Network hospitals Greene Access to Allegheny Health Network (AHN), one of the providers in our network AHN is the highest-rated health system in western PA* for Medical Excellence in Cardiac Care, Stroke Care, and Women’s Health.** Plus, it offers cancer care that’s rated among the top providers nationwide, in addition to its relationship with John Hopkins Sidney Kimmel Cancer Center. AHN is a leader in women’s health Yo u ’ll receive compassionate, personalized health care through all stages of a woman’s life, whether it’s for preventive or more specialized care, such as fertility issues, cardiac care, or breast cancer. Plus, if you’re expecting, rest assured that you’ll have in-network access to Level III Neonatal Intensive Care Units (NICU) located at West Penn and Saint Vincent hospitals and Level II NICUs at Jefferson and Forbes hospitals. For more information about other specialties and research at AHN, please visit AHN.ORG. Map indicates in-network hospitals in western PA. Erie McKean Potter Warren Crawford Forest Venango Elk Cameron Mercer Clarion Jeerson Lawrence Butler Clearfield Centre Armstrong Beaver Indiana Allegheny Cambria Blair Huntingdon Westmoreland Bedford Washington Somerset Allegheny Health Fayette Network hospitals Greene U.S. News & World Report. Thomson Reuters. Health Grades. CareChex®. We’re proud that the hospitals in our network have … TOP MARKS FOR HIGH-QUALITY. But we’re even prouder to offer access to top-quality care that’s close to home. Highmark’s network of hospitals in western PA includes some of the best in the nation. Highmark members have in-network coverage at hospitals which are rated in the top 10% in the nation for Medical Excellence* in: Cardiac Surgery (4) Cardiac Care (4) TOP Heart Attack Care (4) Heart Failure (3) Orthopedic Care (1) Orthopedic Major Surgery (1) 10%in the nation for Medical Excellence* and Organ Transplants (1) (#) numbers of hospitals falling within the top 10% • Women’s Health (5)** TOP 25% • Stroke Care (9) IN THE NATION FOR • Cancer Care (7) MEDICAL EXCELLENCE*: • Pulmonary Care (8) IT’S EASY TO FIT CARE INTO YOUR BUSY LIFE When you choose AHN primary and specialty care providers, you also get these added conveniences: Same-day appointments are available now. Convenient Locations Health+Wellness Pavilions Convenient locations for services that provide one-stop health care at state-of-the art facilities in Wexford, Peters Township, Bethel Park, and Erie West Side, including extended hours for Express Care urgent care services. Same-day Appointments Primary and Specialty Care Call (412) DOCTORS between 7 a.m. and 11 a.m., Monday – Friday, to get same-day appointments for Online Health primary care and over 20 specialties, including heart care, cancer care, Connection and women’s health.† MyChart® Communicate with your doctors, † Some restrictions apply. For more details, visit AHN.ORG/same-day view your medical history and test results, schedule appointments, request prescription renewals, and pay your health bills at any time — online or with the app. Use the MyChart app! It’s super easy. The human body is an incredibly complex system. But the health care you need to take care of yours shouldn’t be complicated to navigate. HIGHMARK WORKS HARD TO MAKE IT EASY FOR YOU. Highmark services make it easier to fit care into your busy life. Highmark members have access to dedicated health advocates through My Care Navigator who can help you find in-network providers, make appointments, and transfer medical records. To get started call 1-844-462-2551 or visit HIGHMARKBCBS.COM. Highmark Direct Stores Meet Dr. Right Visit with a representative in person. Meet with in-network primary care Go to highmarkdirect.com to find a doctors and specialists from the local store near you. community at our Meet Dr. Right events. If you find the right match, make an appointment before you leave. For a list of upcoming events, There are 5 Highmark Direct go to meet-dr-right.com. Stores in western PA! A heritage of care, innovation, and community involvement that proves we’re True Blue. OUR HISTORY BEGAN MORE THAN 75 YEARS AGO. Helping to build healthier, stronger communities. Highmark is committed to improving the quality of life in the communities we serve — to give back, reinvest, and ensure those communities remain as strong and healthy as possible. Our corporate giving benefited hundreds of organizations across our service areas, donating millions of dollars. In addition, Highmark’s signature program — Walk for a Healthy Community — along with Adopt-a-Schools programs initiated by employees in Pittsburgh and Erie, and National Make a Difference Day of volunteering provide significant benefits to individuals and the communities we proudly serve. In 2016 … Over the past 13 years … MORE THAN MORE THAN 6,000 12,000 BUTTERFLIES WERE DECORATED WOMEN HAVE BEEN EMPOWERED with messages of hope for grieving to take control of their health at our children in conjunction with Children’s Fun, Fit & Fabulous health conference. Grief Awareness DayTM. Supporting grieving children The Highmark Caring Place is a program of the Highmark Caring Foundation. For over two decades it has been supporting children who have been devastated by the loss of a loved one. It provides support through various programs at their facilities in Erie, Harrisburg, and Pittsburgh. Thousands of community members are helped each year at no cost through peer support programs, education, consultation, and referral services. Come see why Highmark has been trusted for more than 75 years and insures more than 4.2 million members. Reference * Market claims are based on CareChex® Composite Quality Scores™ and nationally balanced scorecard criteria for health systems servicing the combined statistical area (CSA) of Pittsburgh-New Castle-Weirton. Source: Quantros Inc., CareChex® National Quality Rating Database: FFY 2013, 2014 and 2015. ** Excludes labor & delivery. Access for children Highmark currently is in a long-term contract with Children’s Hospital of Pittsburgh of UPMC, which provides in-network access to both Children’s Hospital of Pittsburgh of UPMC and its pediatricians (CHP) until at least 2022. Highmark has every intention to continue to renew this contract. You will have access to the services provided by Children’s Hospital of Pittsburgh of UPMC and the physicians who practice there. What you need to know about temporary access to UPMC. When UPMC terminated most of its commercial contracts with Highmark, the Governor’s Office facilitated a Consent Decree to allow members limited and temporary access to UPMC in certain circumstances, through June 30, 2019. The specific terms of coverage will be according to the member’s benefit plan and covered claims from UPMC providers may process at a lower level of benefits in certain plans. Oncology/cancer services Members who have been diagnosed with cancer have in-network access to all UPMC services, facilities, doctors, and joint ventures for oncology covered services through June 2019. (When the member’s physician in consultation with the member has determined that the member should be treated by a UPMC oncology provider.) This also includes care for any illnesses/complications resulting from cancer treatment such as endocrinology, orthopedics, and cardiology. Highmark members in the Community Blue Flex and Connect Blue products can access UPMC facilities on an in- network basis at the standard level of benefits for cancer services.
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