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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.

  • 2020 Freedom Blue PPO Standard – service area includes the following counties in West Virginia: Barbour, Berkeley, Brooke, Cabell, Doddridge, Fayette, Greenbrier, Hampshire, Hardy, Harrison, Jackson, Jefferson, Kanawha, Lewis, Marion, Mason, Mercer, Mingo, Monongalia, Nicholas, Ohio, Pendleton, Putnam, Ritchie, Summers, Taylor, Tucker, Tyler, Upshur, Wetzel, Wirt, Wood, and Wyoming. 
  • 2020 Freedom Blue PPO Distinct - service area includes the following counties in West Virginia: Berkeley, Cabell, Harrison, Kanawha, Lincoln, Marshall, Mineral, Morgan, Ohio, Wayne, and Wood.
Last updated on 12/11/2019 3:23:38 PM

 

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The following entities, which serve the noted regions, are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.

All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.