Medical for Blue Cross 50%, 60%, 70%, & 80%
All four Blue Cross Blue Shield plans cover the same services and prescription medications, but the amount you pay when you receive services and the amount you pay in contributions depend on the option you choose:
- 50% option with copays
- 60% option with a health savings account (HSA)
- 70% option with copays
- 80% option with copays
Some areas of the country also have an HMO option available. This information will display for you during enrollment if you are eligible. See the “Other Medical Carriers” page for more details.
Important Medical Benefit Definitions
Annual Deductible
The amount you pay for covered health care expenses before the plan begins to pay
Copay
A flat dollar amount that you pay for certain doctor’s office visits and prescriptions
Coinsurance
The amount you pay for covered health care after you meet your deductible
Out of Pocket
A cap or limit on the amount of money you pay for covered health care services in a plan year
Highmark Clarity Team
If you enroll in a Blue Cross 50%, 60%, 70%, or 80% medical option, your plan includes the Highmark Clarity Team, your single point of contact for everything related to your health care and prescription drug benefits.
Your Clarity Advocate is just a phone call away, ready to:
- Help you resolve claim problems and billing issues
- Find providers and schedule services
- Pre-certify you for services to make sure you are covered
- Listen to your concerns and offer guidance on living a healthier life
The Highmark Clarity Team helps you understand and get the greatest value from your medical and prescription drug benefits. The Clarity Advocate can help you save money or put you in touch with Included Health if you want an expert medical opinion or need treatment decision support.
MyHighmark App
Access all that your Clarity team has to offer by downloading the MyHighmark app.
Visit MyHighmark.com or watch this video for more information.
Prescription Drugs
Your prescription drug coverage is administered by Express Scripts.
Express Scripts
To view and manage your current prescriptions or explore home delivery, please use the link below and use your Express Scripts login/password. If you have not registered, you can register using an email address and answering some questions about you!
Preventive Medications on the 60% with HSA Plan
This list provides examples of commonly prescribed preventive medications that do not apply to the deductible for the 60% plan.
Drug Cost Estimator
The following link will take you to our drug cost estimator, which estimates drug costs based on each of the plans offered and the pharmacies in your area.
Specialty Medications
Express Scripts’ specialty medication company is Accredo, and SaveOnSP is the copay savings program. The links below will take you to a list of specialty medications, more info on SaveOnSP and how to enroll in the program.
National Preferred Formulary
The following is a list of commonly prescribed drugs. It is not all-inclusive and does not guarantee coverage. You are also encouraged to ask your doctor to prescribe generic drugs, when available.
Blue Cross 50%, 60%, 70%, and 80% plan participants have access to many additional medical benefits for surgeries, diabetes management, mental health, fertility, physical therapy and more.
