Legal Information

Highmark Health Options Duals has a contract with the West Virginia Department of Human Services (DoHS). We are able to select a group of health care providers to form a provider network of doctors and specialists, hospitals, and other health care providers. 

If you cannot see or read this website, your Member Handbook, letters, and other written material that Highmark Health Options Duals shares with you, we can communicate with you in a different way, including large print, audio, electronically, or in Braille. We can also give you information in a different language.

 

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We need help from our members and providers to find fraud, waste, and abuse and stop it as soon as possible. 

 

FILE REPORT

The Interoperability and Patient Access Rule requires Medicaid plans, like Highmark Health Options Duals, to give members online access to their medical record.  

 

GET DETAILS

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. 

 

SEND APPEAL

Review the Summary of Various Nonquantitative Treatment Limitations as of Jan. 1, 2023.

 

KNOW MORE

Highmark Health Options Duals 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. 

 

REVIEW NOTICE

 

Our Online Privacy Statement discloses the practices of Highmark Health Options Duals regarding information gathering and disclosure from the Highmark Health Options Duals website. 

 

GET DETAILS

Tell us right away if you think a caregiver has done something wrong.

 

REPORT INCIDENT

Our SMS Texting Terms of Use (“SMS Texting TOU”) set forth the terms and conditions applicable to your participation in Texting with Highmark Health Options Duals.

 

REVIEW TERMS

We’re here for you

Check your Medicare D-SNP benefits documents or Medicaid or WVCHIP Member Handbook  

Call a Member Services Representative, 1-833-957-0025, Monday-Friday, 8 a.m.-5 p.m.  

To find an in-network provider, search your Medicare D-SNP Provider Directory or Medicaid Provider Directory.