I have Blue Cross Blue Shield coverage but it isn’t with Highmark, and I live in Western PA. Will I be affected by the end of the Consent Decree?
Yes, the end of the Consent Decree will impact you. After July 1, 2019 certain UPMC providers and facilities will be out-of-network with some exceptions.
If you choose to see an out-of-network provider and your plan has an out-of-network benefit, you will be required to follow the provider and insurance plan’s out-of-network processes. For example, UPMC has announced its intent to require payment upfront from Highmark Medicare Advantage members. Please refer to your benefit plan document for more information.
If you currently see a UPMC doctor, call the Customer Service number on the back of your insurance card for assistance in switching to a network doctor by June 30, 2019.
*This answer is applicable to Commercial and ACA plans only. For questions about how the end of the Consent Decree impacts Medicare Advantage plans, please call the number on the back of your member identification card.