Why Highmark Wholecare

When it comes to Medicare, you have a lot of options. With Highmark Wholecare, you don't just get more coverage, you get better coverage. For 25 years, we have provided affordable, accessible healthcare to those who need it most.

Medicare Assured by the Numbers:

  • Located throughout 58 counties in Pennsylvania
  • Accepted by thousands of board certified doctors and other healthcare providers
  • Accepted by hundreds of hospitals

We believe in one very important thing: You aren’t your medical condition. You are a living, breathing individual with hopes and dreams. You're a valuable person with friends and family members. And, we believe you deserve a complete care plan that fits your life and budget - a plan that you can truly count on.

Our Medicare Advantage Prescription Drug Plans (MAPDs)

  • A Medicare Advantage Prescription Drug Plan (MAPD) is a health plan for Medicare beneficiaries who only have Medicare and no other qualifying conditions or income levels. 
  • To become a member of one of our MAPD plans, you must live in the Medicare Assured service area and be on Medicare. No supplement plan is needed for the MAPD Plans. 
  • MAPD Plans offer benefits to help those on Medicare live an active and healthy lifestyle.

Our Special Needs Plans (SNPs)

  • Dual Eligible Special Needs Plans (D-SNP)
  • Dual Eligible (D-SNP) plans are for Medicare beneficiaries who also qualify for Medicaid or receive assistance from the State.

Free Health & Wellness Programs Right at Your Fingertips

As a member, you can take advantage of a variety of fantastic programs. Give us a call to discover everything that Highmark Wholecare can do for you today, such as:

  • Get personalized help over the phone with our Wellness Coaching program.
  • Expectant mothers can get a helping hand with MOM Matters
  • Participate in the Goodness Rewards program, and so much more!

Health and Wellness Education

As a member, you have access to health and wellness programs as part of your coverage. Whether you're trying to get healthy, stay healthy or live with a chronic illness, Highmark Wholecare gives you the tools to improve your overall health and well-being.

Prospective Care Management (PCM®)

Highmark Wholecare looks at the whole member, not just their health condition. Our Case Management staff provides disease specific education and instruction in self-care and helps you locate referrals to community-based services and programs to address specific needs. We collaborate with physicians and community organizations while actively engaging you and your caregivers

This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 14 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

Health benefits or health benefit administration may be provided by or through Highmark Wholecare, coverage by Gateway Health Plan, an independent licensee of the Blue Cross Blue Shield Association (“Highmark Wholecare”). Highmark Wholecare offers HMO plans with a Medicare Contract. Enrollment in these plans depends on contract renewal.


Copyright 2023 by Highmark WholecareSM