Who can I contact at Highmark with questions about my benefits or insurance coverage?

Call the telephone number on the back of your insurance card for Member Services. This number is specific to your plan and benefits, and it helps you receive the right answers faster.

Is Coronavirus testing covered by my plan and what will it cost me?

Yes, coronavirus testing will be covered with no additional costs when recommended by a medical professional. While this coverage applies to most Highmark members, every plan is a little different. If you have questions on coverage, costs, or anything else, call Member Service at the number on the back of your card.*Exclusions may apply. This waiver continues through December 31, 2021.

In order for a COVID-19 test to be eligible for coverage under your health plan, there’s some important criteria that must be met. In fact, ALL of the following must be confirmed before a test can be approved.

First and foremost, all tests must be ordered by a licensed health care professional unless the test is being ordered prior to an elective surgery. If deemed clinically appropriate, your physician must come to the conclusion that you’re showing signs and symptoms typically associated with COVID-19 — fever, cough, shortness of breath. In the event that you’re asymptomatic, a health care provider must determine that you’ve had known or suspected recent exposure to someone with the virus before a test can be performed.

If the order for a test meets the coverage criteria above, the sample must be collected by authorized health care personnel, or by a self-collect kit used at home when a health care provider deems it appropriate.

Acceptable COVID-19 diagnostic tests may include:

  • Tests approved by the FDA
  • Tests authorized by the FDA under an emergency use authorization (EUA)
  • Tests for which the developer of the test has requested or intends to request EUA (until the request is denied or the developer does not submit the request within a reasonable time)
  • Tests that are developed in or authorized by a State
  • Tests that are determined to be appropriate by the secretary of Health and Human Services (HHS)

As of now, COVID-19 diagnostic testing remains limited to tests which meet the above guidelines. In the event that an employer requires a test that is not medically necessary — for instance, as part of a return-to-work protocol — costs will not be covered.

Is Coronavirus treatment covered by my plan?*

Most plans will cover coronavirus treatment when admitted to an in-network hospital. Our number one priority is your health and making sure you receive the care you need. That’s why we are waiving all costs of care if you are in the hospital being treated for Coronavirus. This includes testing when recommended by a medical professional and care once you are admitted. While this coverage applies to most Highmark members, every plan is a little different. This waiver continues through December 31, 2021.

*Exclusions may apply. If you have questions on coverage, costs, or anything else, call Member Service at the number on the back of your card.

Does my insurance cover me if I get sick when I travel?

Yes, see coverage options at your member website or your plan app or call Member Services at the number on the back of your insurance card. This number is specific to your plan and benefits, and it helps you receive the right answers faster.

Will it be covered if I am stuck in a hospital in a different city for a long time?

Yes, most plans cover you while traveling. Copays, deductibles and coinsurance may still apply. Review your coverage options at your member website or your plan app or call Member Services at the number on the back of your insurance card. This number is specific to your plan and benefits, and it helps you receive the right answers faster.

What if I can’t pay my premium due to furlough?

If you have questions about a grace period  call the number on the back of your card.