Frequently Asked Questions

Health insurance questions and answers. Learn about Highmark products and services and how to choose health insurance.

Read questions about health insurance including ACA, COVID, Highmark Healthy Kids, home delivery prescriptions and more. Learn how to choose health insurance, find options to get care and read health insurance definitions in the glossary.

Popular health insurance questions and answers

ACA - Affordable Care Act Coverage

Yes. By law, all ACA plans cover preexisting conditions, with no annual or lifetime limits.

The annual Open Enrollment Period for individual and family plans varies by state.

  • PA, DE, and WV: November 1 — January 15
  • NY: November 16 — January 31

Anyone who qualifies for an ACA plan may enroll during this time period.

When you experience a major life event — like the birth of a child, the loss of a job, or a move to a new ZIP code — you may qualify for a Special Enrollment Period (SEP). An SEP typically gives you a 60-day window to enroll in a new individual or family plan and may occur at any time throughout the year.

All Highmark ACA plans cover the 10 Essential Health Benefits:

  • Outpatient care
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care
  • Mental health and substance use disorder services
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including dental and vision care

CHIP - Highmark Healthy Kids FAQ

There are no income limits for CHIP. Your child can be covered on CHIP regardless of household income or employment status.

There aren't any pre-existing condition limits to qualify for CHIP.

You can enroll in CHIP anytime throughout the year.

Home Delivery Prescriptions FAQ

It’s quick and easy to get your prescription delivered right to your home. And, you’ll likely save money. To set up your prescription delivery, grab your Highmark card and call Express Scripts at (800) 282-2881. They are available 24/7 to help switch your prescriptions to home delivery. Or, log in to your Highmark member website and select “Prescriptions.” On the next screen, click “Mail Order Savings” to go to the Express Scripts website. Follow the on-screen prompts to set up your prescription delivery.

Yes, if the prescription is for a 90-day supply. Talk to your doctor to find out if they can change your prescription to a three-month supply.

Depending on your situation, you may be able to get a home delivery of a prescription refill early. Call the Member Services team — the number is on the back of your Highmark Blue Cross Blue Shield card — to learn more.