If you are new to Highmark and in your second or third trimester of pregnancy on July 1, 2019, you can continue your maternity care through completion of postpartum care with your out-of-network physician. After completion of postpartum care, you will need to transition your care in-network to remain at an in-network cost level.
If I need other care that is not available in Highmark’s network after June 30, 2019, am I able to go to an out-of-network physician or facility on an in-network basis?
If I am under care following a transplant of a physician who will be out-of-network after June 30, 2019, when do I have to transition my care to an in-network physician?
If I am in the process of receiving a stem cell transplant and my physician will be considered out-of-network on July 1, 2019, will I need to transition my care to an in-network physician by July 1, 2019 to remain at an in-network cost level?
If I am participating in a clinical research trial, observational study or pharmaceutical trial, with a physician managing my trial that will be considered out-of-network on July 1, 2019, how will my care be handled after June 30, 2019?
Can my kids get cancer care from Children’s Hospital of Pittsburgh after June 30, 2019?
Medicare Members and the Consent Decree