Highmark Health Options is a managed care organization serving people who qualify for Medicaid and Medicare D-SNP.
We help each of our more than 154,000 members get the care and services they need to live healthier and more independent lives, and we collaborate with providers and regulators to improve health outcomes, simplify the health care experience, and ensure affordability.
Highmark is committed to providing an inclusive and accessible website. We strive to implement, maintain, and improve the accessibility of our digital experience by following accessibility standards and guidelines. We know that accessibility is an ongoing process, and that standards and guidelines are subject to change.
Fraud, waste, and abuse hurts everyone. It can even raise the cost of getting health care services. This is why we need help from our members and providers to find fraud, waste, and abuse and stop it as soon as possible. As our member, you play an important role in helping us find fraud, waste, and abuse. If you feel that it might be happening, report it as soon as you can.
Because we have smartphones and other devices, we can look up almost anything online. And now, you’ll be able to find your own medical record online, too.
We want you to be happy with the health care and service you get. Let us know if a doctor, hospital, or we do something that you’re unhappy about. We will try to fix any problems over the phone. If you do not like something or we cannot fix your problem, you can file a grievance or an appeal.
Learn about choosing an authorized representative, how to file appeals or grievances with Highmark, how to file a complaint with Medicare and more.
Review the Summary of Various Nonquantitative Treatment Limitations as of Jan. 1, 2023.
Highmark Health Options complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, creed, religious affiliation, ancestry, sex, gender, gender identity or expression, or sexual orientation. Highmark Health Options does not exclude people or treat them differently because of their race, color, national origin, age, disability, creed, religious affiliation, ancestry, sex, gender, gender identity or expression, or sexual orientation.
This Online Privacy Statement discloses the practices of Highmark Health Options regarding information gathering and disclosure from the Highmark Health Options website.
Mistreatment could include actions that cause physical, mental, or financial harm. These situations are called critical incidents. They raise serious red flags about whether a Highmark Health Options member is being treated fairly and safely. Tell us right away if you think doctor or paid caregiver is involved in a critical incident and has mistreated a Highmark Health Options member.
Highmark Health Options offers its Members the option of receiving certain information by Short Message Service (SMS) or texting services ("Text(s)"). These SMS Texting Terms of Use (“SMS Texting TOU”) set forth the terms and conditions applicable to your participation in Texting with Highmark Health Options.
