Medicare Advantage Member Evidence of Coverage Booklets

An Evidence of Coverage explains how members get their health care and drug coverage through Highmark's Plans.

An Evidence of Coverage, together with a member's enrollment form, riders (including optional supplemental benefit brochures), Annual Notice of Change (ANOC), formulary, and amendments that we may send to them, is our contract with the member. It explains their rights, benefits, and responsibilities as a member of our Plan. The information in each yearly Evidence of Coverage is in effect for the time period during which the member is eligible.

Freedom Blue PPO Plans

The service area for Freedom Blue PPO plans includes Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Fayette, Forest, Greene, Huntingdon, Indiana, Jefferson, Lawrence, McKean, Mercer, Potter, Somerset, Venango, Warren, Washington, and Westmoreland counties.

• 2020 Freedom Blue PPO Classic
• 2020 Freedom Blue PPO Select
• 2020 Freedom Blue PPO ValueRx

Community Blue Medicare HMO Plans

• 2020 Community Blue Medicare HMO Prestige - service area includes Allegheny, Armstrong, Beaver, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Washington, and Westmoreland counties.
• 2020 Community Blue Medicare HMO Signature – service area includes Allegheny, Armstrong, Beaver, Bedford, Butler, Cambria, Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Fayette, Forest, Greene, Huntingdon, Indiana, Jefferson, Lawrence, McKean, Mercer, Somerset, Venango, Warren, Washington, and Westmoreland counties.

Community Blue Medicare PPO Plans

• 2020 Community Blue Medicare PPO Signature – service area includes Crawford, Erie, Forest, Lawrence, McKean, Mercer, Potter, Venango, and Warren counties.
• 2020 Community Blue Medicare PPO Distinct – service area includes Allegheny, Armstrong, Beaver, Bedford, Butler, Cambria, Cameron, Clarion, Clearfield, Elk, Fayette, Greene, Huntingdon, Indiana, Jefferson, Somerset, Washington, and Westmoreland counties.
• 2020 Community Blue Medicare PPO Distinct - service area includes Crawford, Erie, Forest, Lawrence, McKean, Mercer, Potter, Venango, and Warren counties.

Security Blue HMO-POS Plans

• The service area for the Security Blue HMO-POS Basic, Deluxe, and Standard plans includes the following counties in western Pennsylvania: Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Fayette, Forest, Greene, Huntingdon, Indiana, Jefferson, Lawrence, McKean, Mercer, Potter, Somerset, Venango, Warren, Washington, and Westmoreland.
  
  • 2020 Security Blue HMO-POS Basic
  • 2020 Security Blue HMO-POS Deluxe
  • 2020 Security Blue HMO-POS Standard

• Security Blue HMO-POS Southwestern PA Region: includes Allegheny, Armstrong, Beaver, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Washington, and Westmoreland counties.
  
  • 2019 Security Blue HMO-POS ValueRx
• Security Blue HMO West Central PA Region: includes Bedford, Blair, Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Huntingdon, Jefferson, McKean, Mercer, Potter, Somerset, Venango, and Warren counties.
  
  • 2019 Security Blue HMO-POS ValueRx

Blue Rx Medicare Prescription Drug Plans (PDPs)

• 2019 Blue Rx PDP Complete
• 2019 Blue Rx PDP Plus