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2022 Resources

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Medicare Centers

Meet with an experienced local benefit consultant at one of our new, conveniently located Highmark Blue Shield of Northeastern NY Medicare Centers in Malta and Guilderland.

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Stay Healthy with Blue Shield

Our health plans provide many services and programs designed to support you in living a healthy lifestyle, including preventive services and vaccines, fitness memberships, health coaches and more. 

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Medicare and HIPAA Forms

Find all the resources you need to manage your health care. These forms are useful for your Medicare membership, including subscriber claims forms, coverage determination, Health Insurance Portability and Accountability Act (HIPAA) information, and much more. 

Medicare Questions?

We're here to help.

1-833-735-4512 (TTY 711)
Oct. 1 - March 31, 8 a.m. - 8 p.m., 7 days a week
April 1 - Sept. 30, 8 a.m. - 8 p.m., Monday - Friday

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Prescription Drug Information

Search for a pharmacy, review the Medicare Formulary, Quantity Limits, Step Therapy, Medication Therapy Management guidelines and more.

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Over-the-counter (OTC) Drugs and Supplies

Select plans offer an OTC benefit, which provides you an allowance every three months. Ordering is quick and easy with four different options — online, mail-in order form, mobile app, or by phone.

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Telemedicine, hosted by Doctor On Demand®

Convenient 24/7 access to virtual visits with a board certified physician from your smartphone, tablet or computer. 

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Summary of Benefits

The Summary of Benefits provides a look at what we cover and what you are responsible for paying with each Medicare Advantage plan option. 

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Evidence of Coverage

The evidence of coverage booklet explains your member rights and responsibilities, what is covered, and what you pay as a member of one of our Medicare Advantage plans.

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Out-of-Network Coverage Rules

Learn how choosing between in-network and out-of-network doctors and facilities can affect how much you pay for your health care services.

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Exceptions and Appeals

If you want to request a coverage decision or make an appeal related to benefits and coverage for medical services and prescription drugs, including problems related to payment, this guide will walk you through the process. 

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Eligibility Requirements

To enroll in one of our Medicare Advantage plans, you must meet certain criteria. 

Highmark Blue Shield of Northeastern New York (Highmark BSNENY) is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. Highmark BSNENY is a Medicare Advantage plan with a Medicare contract and enrollment depends on contract renewal. Highmark BSNENY complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-833-735-4515 (TTY 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-833-735-4515 (TTY 711).

Content last updated: October 1, 2021