Highmark Blue Shield of Northeastern New York and Highmark Health have received regulatory approval to form a strategic affiliation. With this affiliation, we begin our path forward to enhance customer and clinician engagement, create better health outcomes, control costs and improve affordability for members in Northeastern New York.
While integrating our two companies will take time, we are committed to keeping you informed throughout this process.
One of America's leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. and its affiliated health plans work passionately to deliver high-quality, accessible, understandable, and affordable experiences, outcomes, and solutions to customers. As the fourth-largest overall Blue Cross Blue Shield-affiliated organization in membership, Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of more than 5.6 million members in Pennsylvania, Delaware, and West Virginia. Its diversified businesses serve group customer and individual needs across the United States through dental insurance and other related businesses.
March 1, 2021 | Source: BSNENY
Frequently Asked Questions (FAQs)
Will members receive a new ID Card?
Yes, members will receive a new member ID card from Highmark.
Why is the member name cut off on their ID card?
There is a system limitation on the number of characters on member ID cards. This will have no bearing on member coverage.
Members in the EX plan received ID cards with “HMO POS 200” as the network. Is this correct?
Yes. HMO POS 200 is the name of the network the EX products use when members receive services in the local service area.
Will members have access to the same doctors, providers, and pharmacies?
Yes, members will have access to the same doctors, providers, and pharmacies.
What is the website for Highmark?
Do members need to create a new login and password on the Highmark website?
Yes, members should use their new member ID card to login for the first time and follow the prompts to create a new login and password.
Alternately, members will also be able to use their social security number to log in.
Is there a new mobile app to download for Highmark?
Yes, members can download the Highmark Plan mobile app. Members can view their plan information on the go and obtain their virtual Member ID card. There is no cost to download the mobile app through Google Play or the Apple Store.
Can members still use Express Scripts Home Delivery Pharmacy for mail order prescriptions?
Yes, Highmark still partners with Express Scripts home delivery pharmacy for mail order prescriptions.
Express Scripts can be reached at 1-866-264-4685, Monday – Friday: 24 hours, 7 days a week.
Do members need to create a new login and password for the Express Scripts website?
Current members who have already created a username and password on the Express Scripts website will not need to create a new login. All historical prescription information will remain in place for the member, including active prescriptions on file.
Can members still use Accredo for my specialty medications?
Yes, Highmark uses Accredo for their preferred specialty pharmacy.
Accredo can be reached at 1-800-803-2523, Monday-Friday 8am – 11pm EST and Saturday 8am-5pm EST. An Accredo pharmacist is available 24 hours a day, 7 days a week.
Do members need to create a new login and password for the Accredo website?
Current members who have already created a username and password on the Accredo website will not need to create a new login. All historical prescription information will remain in place for the member, including active prescriptions on file.
Is the drug formulary (a list of drugs covered by my plan) changing?
From time to time, there are changes to the drug formulary. While many of your pharmacy benefits will remain the same, the drug formulary, a list of drugs covered by tier status for your plan, is changing slightly, and can be found online here.
Employer Portal and eBilling
How do I access information about my plan?
The Highmark employer portal houses information about your plan and benefits, as well as member ID cards and eBilling information. You can also view your group structure, including Client ID and applicable Group Numbers.
How do I access the Highmark employer portal?
You will receive a separate email that provides instructions on how to set up your employer portal.
I logged into the Highmark employer portal, but I don’t see eBilling. How can I access my invoice?
The eBilling platform will become active once the first month’s invoice is generated.
I had autopay set up on my previous account. Will that carry over?
If you previously used autopay, you will have to set this up in the eBilling system on the Highmark employer portal.
How do I make a payment to Highmark?
Payments can be made online using the eBilling platform on your Highmark employer portal
Alternatively, payments can be mailed to:
PO Box 640966
Pittsburgh, PA 15264-0966
I have a member with an enrollment/eligibility change that dates back prior to my migration date. How will this process?
When submitting the enrollment/eligibility change, please note on the form that this is for a migration client. Adding this note will allow for more seamless processing and ensure that the change is captured for both pre- and post-migration claims.
Who can I contact with additional questions?
For questions related to billing and enrollment, please contact firstname.lastname@example.org.
For questions about your plan and benefits, refer to your employer portal or contact your Client Manager.
Will members receive a new wellness card this year?
Yes. Members will receive a new wellness card.
Will dependents receive cards as well?
If the plan includes a covered spouse or domestic partner, a second card will be sent.
When will members receive their wellness card?
Cards should arrive 7-10 business days from the enrollment date. It’ll be mailed to the same address listed on the health plan. If a spouse is covered under the plan, they’ll receive their own card, too.
How does a member activate their card?
Members will need to activate their card before using it. Here’s how:
- Over the phone – Members can call the number on the sticker on the front of the card
- On the member website – Members can log in at member.highmark.com and click Manage under Spending Account Balance to access their personal dashboard. From there, they can click on their name at the top right corner and select Debit Cards. Find Wellness Card and click Activate.
Does a member need a PIN or security code to use the card?
Nope. Members should make sure to choose “credit” when using their card at checkout (no PIN necessary).
What should a member do if they have trouble using their card at a preapproved location?
If a member’s card is not accepted at a preapproved location, they can submit their receipt for reimbursement from the wellness card vendor, Alegeus.
Please note, wellness card guidelines were updated for 2022, and acupuncture, massage therapy, and chiropractic services are no longer accepted.
Wellness Card Reimbursement Process
If members have a separate spending account in addition to the wellness card, will they receive a separate card?
Highmark’s wellness cards and spending account cards are administered by the same company – Alegeus. If a member has a wellness card and another spending account (health reimbursement account, flexible spending account, etc.), accounts will be linked under the same card. Members will not have a separate card if both accounts are with Highmark. Wellness funds and HSA/FSA funds will be on the same card.
If accounts are linked under the same card, how will a vendor know which account to access?
The benefits card automatically categorizes purchases and links them to the appropriate account, using either wellness card or HSA/FSA funds.
What if a member has additional questions?
Members who have questions can call the Alegeus member service number on the back of their Alegeus wellness card for assistance or benefit information.
Alegeus Account Member Service is (844) 946-6261
To learn more about the wellness card, read through our user guide.
Getting started with your Highmark Employer Portal
For password resets or technical assistance with your Highmark Employer Portal, call 1-877-298-3918