Network Sharing for Freedom Blue PPO and Community Blue Medicare PPO Members

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Nationwide partnerships for feels-like-home coverage.

Medicare Advantage PPO Network Access

Participating network availableNo participating network available

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We’ve made it easy for you to find a participating Blue Cross and Blue Shield Medicare Advantage PPO network in a few simple clicks:

1. Visit provider.bcbs.com.

2. Click select a plan.

3. Enter the first three letters of your member ID number.

- OR -

Click browse a list of plans. From there, choose Medicare Advantage PPO and

scroll down to choose Pennsylvania, Highmark Blue Shield.

4. In the your location field, enter your current location.

5. In the search field, enter the doctor or service you’re looking for and click the search icon.

6. From there, click on the search results and within Insurance Details, make sure Medicare

Advantage PPO is listed. If it is, that means you found a participating network provider and

you’re good to go! If not, check out the next page for more details.

Not into searching? That’s okay, too. Give Member Service a call and they’ll gladly assist you. You can find their number on your member ID card.

With Network Sharing, you have access to the coverage you love, wherever you roam, nationwide. When you need care, find an in-network doctor or location that’s willing to “share your care” — or any Medicare-eligible doctor or location — and you’re all set.

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Network Sharing Counties by StateThe following 43 states and Puerto Rico include participating Blue Cross and/or Blue Shield Medicare Advantage PPO providers only in the counties listed:

State CountyAL AUTAUGA AL BALDWIN AL BARBOUR AL BIBB AL BLOUNT AL BULLOCK AL BUTLER AL CALHOUN AL CHAMBERS AL CHEROKEE AL CHILTON AL CHOCTAW AL CLARKE AL CLAY AL CLEBURNE AL COFFEE AL COLBERT AL CONECUH AL COOSA AL COVINGTON AL CRENSHAW AL CULLMAN AL DALE AL DALLAS AL DEKALB AL ELMORE AL ESCAMBIA AL ETOWAH AL FAYETTE AL FRANKLIN AL GENEVA

State CountyAL GREENE AL HALE AL HENRY AL HOUSTON AL JACKSON AL JEFFERSON AL LAMAR AL LAUDERDALE AL LAWRENCE AL LEE AL LIMESTONE AL LOWNDES AL MACON AL MADISON AL MARENGO AL MARION AL MARSHALL AL MOBILE AL MONROE AL MONTGOMERY AL MORGAN AL PERRY AL PICKENS AL PIKE AL RANDOLPH AL RUSSELL AL SAINT CLAIR AL SHELBY AL SUMTER AL TALLADEGA AL TALLAPOOSA

State CountyAL TUSCALOOSA AL WALKER AL WASHINGTON AL WILCOX AL WINSTON AR BAXTERAR BENTONAR BOONEAR CARROLLAR CLARKAR CLAYAR CLEBURNEAR CONWAYAR CRAIGHEADAR CRAWFORDAR CRITTENDENAR CROSSAR FAULKNERAR FRANKLINAR FULTONAR GARLANDAR GRANTAR GREENEAR HOT SPRINGAR INDEPENDENCEAR IZARDAR JEFFERSONAR JOHNSONAR LAWRENCEAR LOGANAR LONOKE

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State CountyAR MADISONAR MARIONAR MISSISSIPPIAR NEWTONAR OUACHITAAR PERRYAR POINSETTAR POLKAR POPEAR PULASKIAR RANDOLPHAR SALINEAR SCOTTAR SEARCYAR SEBASTIANAR ST. FRANCISAR VAN BURENAR WASHINGTONAR WHITEAR WOODRUFFAR YELLAZ MARICOPAAZ PIMACA ALAMEDACA ALPINECA AMADORCA BUTTECA CALAVERASCA COLUSACA CONTRA COSTACA EL DORADOCA FRESNO CA GLENNCA HUMBOLDTCA IMPERIALCA INYOCA KERNCA KINGSCA LAKECA LASSENCA LOS ANGELES CA MADERA CA MARINCA MARIPOSACA MENDOCINOCA MERCED

State CountyCA MONOCA MONTEREYCA NAPACA NEVADACA ORANGECA PLACERCA PLUMASCA RIVERSIDE CA SACRAMENTO CA SAN BENITOCA SAN BERNARDINO CA SAN DIEGOCA SAN FRANCISCO CA SAN JOAQUINCA SAN LUIS OBISPOCA SAN MATEOCA SANTA CLARACA SANTA CRUZCA SHASTACA SIERRACA SISKIYOUCA SOLANOCA SONOMACA STANISLAUSCA SUTTERCA TEHAMACA TRINITYCA TULARE CA TUOLUMNECA VENTURA CA YOLO CA YUBACO ADAMS CO ARAPAHOECO BENTCO BOULDERCO BROOMFIELDCO CHAFFEECO CLEAR CREEKCO CONEJOSCO COSTILLACO CROWLEYCO CUSTERCO DELTACO DENVERCO DOLORES

State CountyCO DOUGLASCO EAGLECO EL PASOCO ELBERTCO FREMONTCO GARFIELDCO GILPINCO GRAND CO GUNNISONCO HINSDALECO HUERFANOCO JACKSONCO JEFFERSON CO LAKECO LARIMERCO LAS ANIMASCO LINCOLN CO MESACO MINERALCO MOFFATCO MONTROSECO MORGANCO OTEROCO OURAYCO PARKCO PITKINCO PUEBLOCO RIO BLANCOCO ROUTTCO SAGUACHECO SAN JUAN CO SAN MIGUELCO SUMMIT CO TELLERCO WASHINGTONCO WELDCT FAIRFIELDCT HARTFORDCT LITCHFIELDCT MIDDLESEX CT NEW HAVENCT NEW LONDONCT TOLLANDCT WINDHAMFL ALACHUAFL BAKER

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State CountyFL BAYFL BRADFORDFL BREVARDFL BROWARD FL CALHOUNFL CHARLOTTEFL CITRUSFL CLAY FL COLLIERFL COLUMBIAFL DESOTOFL DIXIEFL DUVALFL ESCAMBIA FL FLAGLERFL FRANKLIN FL GADSDENFL GILCHRISTFL GLADESFL GULFFL HAMILTONFL HARDEEFL HENDRYFL HERNANDOFL HIGHLANDSFL HILLSBOROUGH FL HOLMESFL INDIAN RIVERFL JACKSONFL JEFFERSON FL LAFAYETTEFL LAKE FL LEE FL LEONFL LEVYFL LIBERTYFL MADISON FL MANATEE FL MARION FL MARTINFL MIAMI-DADEFL MONROE FL NASSAUFL OKALOOSAFL OKEECHOBEEFL ORANGE

State CountyFL OSCEOLA FL PALM BEACH FL PASCO FL PINELLAS FL POLK FL PUTNAM FL SAINT JOHNSFL SANTA ROSAFL SARASOTA FL SEMINOLEFL ST. LUCIEFL SUMTER FL SUWANNEEFL TAYLORFL UNION FL VOLUSIAFL WAKULLAFL WALTONFL WASHINGTONGA APPLINGGA ATKINSONGA BACONGA BAKERGA BALDWINGA BANKSGA BARROWGA BARTOWGA BEN HILLGA BERRIENGA BIBB GA BLECKLEYGA BRANTLEYGA BROOKSGA BRYANGA BULLOCHGA BURKEGA BUTTS GA CALHOUNGA CANDLERGA CHATHAMGA CHATTAHOOCHEEGA CHATTOOGAGA CHEROKEE GA CLARKE GA CLAYGA CLAYTON

State CountyGA CLINCHGA COBBGA COFFEE GA COLQUITTGA COLUMBIAGA COOKGA COWETAGA CRAWFORD GA CRISPGA DADEGA DAWSONGA DECATUR GA DEKALBGA DODGEGA DOOLYGA DOUGLASGA ECHOLSGA EFFINGHAMGA ELBERTGA EMANUELGA EVANSGA FANNINGA FAYETTE GA FLOYD GA FORSYTHGA FRANKLIN GA FULTON GA GILMERGA GLASCOCKGA GORDONGA GRADYGA GREENE GA GWINNETTGA HABERSHAMGA HANCOCK GA HARALSONGA HARRIS GA HARTGA HEARDGA HENRY GA HOUSTON GA IRWINGA JACKSONGA JASPER GA JEFF DAVISGA JEFFERSON

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State CountyGA JENKINSGA JOHNSON GA JONES GA LAMARGA LANIERGA LAURENSGA LEEGA LIBERTYGA LINCOLNGA LONGGA LUMPKINGA MACONGA MADISON GA MARION GA MCDUFFIEGA MCINTOSHGA MERIWETHERGA MILLERGA MITCHELLGA MONROE GA MONTGOMERY GA MORGANGA MURRAYGA MUSCOGEEGA NEWTON GA OCONEEGA OGLETHORPEGA PAULDINGGA PEACH GA PICKENS GA PIERCEGA PIKE GA POLK GA PULASKI GA PUTNAM GA QUITMANGA RABUNGA RANDOLPH GA RICHMONDGA ROCKDALEGA SCHLEYGA SCREVENGA SEMINOLEGA SPALDINGGA STEPHENSGA STEWART

State CountyGA SUMTER GA TALBOTGA TALIAFERROGA TATTNALLGA TAYLORGA TELFAIRGA TERRELLGA THOMASGA TIFTGA TOOMBSGA TOWNSGA TREUTLENGA TROUPGA TURNERGA TWIGGS GA UNION GA UPSONGA WALKER GA WALTONGA WAREGA WARREN GA WASHINGTON GA WAYNE GA WEBSTER GA WHEELERGA WHITE GA WILCOX GA WILKESGA WILKINSONGA WORTHHI HAWAIIHI HONOLULUHI KALAWAOHI KAUAIHI MAUIID ADA ID ADAMSID BANNOCKID BENEWAHID BINGHAMID BOISE ID BONNER ID BONNEVILLE ID BOUNDARYID CANYON ID CASSIA

State CountyID CLARK ID ELMORE ID FREMONTID GEM ID GOODINGID JEFFERSON ID JEROMEID KOOTENAI ID LATAH ID MADISON ID MINIDOKA ID NEZ PERCE ID OWYHEE ID PAYETTE ID POWER ID SHOSHONEID TWIN FALLS ID VALLEYID WASHINGTONIL CHRISTIANIL COOKIL DEWITTIL DUPAGEIL KANEIL LOGANIL MACONIL MASONIL MCHENRYIL MENARDIL MONTGOMERYIL MORGANIL MOULTRIEIL PIATTIL SANGAMONIL SHELBYIL WILLIN ADAMSIN ALLEN IN BARTHOLOMEW IN BENTONIN BLACKFORD IN BOONE IN BROWN IN CARROLL IN CASS IN CLARK

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State CountyIN CLAY IN CLINTON IN CRAWFORDIN DAVIESS IN DEKALB IN DEARBORN IN DECATUR IN DELAWARE IN DUBOISIN ELKHART IN FAYETTE IN FLOYD IN FOUNTAININ FRANKLIN IN FULTON IN GIBSON IN GRANT IN GREENE IN HAMILTON IN HANCOCK IN HARRISON IN HENDRICKS IN HENRY IN HOWARD IN HUNTINGTON IN JACKSON IN JASPER IN JAY IN JEFFERSON IN JENNINGS IN JOHNSON IN KNOX IN KOSCIUSKO IN LAGRANGE IN LAKE IN LAPORTE IN LAWRENCE IN MADISON IN MARION IN MARSHALL IN MARTIN IN MIAMI IN MONROE IN MONTGOMERY IN MORGAN IN NEWTON

State CountyIN NOBLE IN OHIO IN ORANGE IN OWEN IN PARKE IN PERRY IN PIKE IN PORTER IN POSEY IN PULASKI IN PUTNAM IN RANDOLPH IN RIPLEY IN RUSH IN SCOTT IN SHELBY IN SPENCER IN ST JOSEPH IN STARKE IN STEUBEN IN SULLIVAN IN SWITZERLAND IN TIPPECANOE IN TIPTON IN UNION IN VANDERBURGH IN VERMILLION IN VIGO IN WABASH IN WARREN IN WARRICK IN WASHINGTON IN WAYNE IN WELLS IN WHITE IN WHITLEY KS BUTLER KS COWLEYKS DOUGLASKS HARVEYKS JACKSONKS JEFFERSONKS JOHNSONKS KINGMANKS OSAGEKS POTTAWATOMIE

State CountyKS RENOKS SEDGWICKKS SHAWNEEKS SUMNERKS WABAUNSEEKS WYANDOTTEKY ADAIR KY ALLEN KY ANDERSON KY BALLARD KY BARREN KY BATH KY BELL KY BOONE KY BOURBON KY BOYD KY BOYLE KY BRACKEN KY BREATHITT KY BRECKINRIDGEKY BULLITT KY BUTLER KY CALDWELL KY CALLOWAY KY CAMPBELL KY CARLISLE KY CARROLL KY CARTERKY CASEY KY CHRISTIAN KY CLARK KY CLAY KY CLINTON KY CRITTENDEN KY CUMBERLAND KY DAVIESS KY EDMONSON KY ELLIOTTKY ESTILLKY FAYETTE KY FLEMING KY FLOYD KY FRANKLIN KY FULTON KY GALLATIN KY GARRARD

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State CountyKY GRANT KY GRAVES KY GRAYSON KY GREEN KY GREENUP KY HANCOCK KY HARDINKY HARLAN KY HARRISON KY HART KY HENDERSON KY HENRY KY HICKMAN KY HOPKINSKY JACKSONKY JEFFERSON KY JESSAMINE KY JOHNSON KY KENTON KY KNOTT KY KNOX KY LARUE KY LAUREL KY LAWRENCE KY LEEKY LESLIE KY LETCHER KY LEWISKY LINCOLN KY LIVINGSTON KY LOGAN KY LYON KY MADISON KY MAGOFFIN KY MARION KY MARSHALL KY MARTIN KY MASON KY MCCRACKEN KY MCCREARYKY MCLEAN KY MEADEKY MENIFEE KY MERCER KY METCALFEKY MONROE

State CountyKY MONTGOMERY KY MORGAN KY MUHLENBERG KY NELSON KY NICHOLAS KY OHIO KY OLDHAM KY OWEN KY OWSLEYKY PENDLETON KY PERRY KY PIKE KY POWELL KY PULASKI KY ROBERTSON KY ROCKCASTLEKY ROWAN KY RUSSELL KY SCOTT KY SHELBY KY SIMPSON KY SPENCER KY TAYLOR KY TODD KY TRIGGKY TRIMBLE KY UNION KY WARREN KY WASHINGTON KY WAYNE KY WEBSTER KY WHITLEY KY WOLFE KY WOODFORD LA ACADIALA ALLEN LA ASCENSIONLA ASSUMPTIONLA AVOYELLESLA BEAUREGARDLA BIENVILLELA BOSSIERLA CADDOLA CALCASIEULA CALDWELL LA CAMERON

State CountyLA CATAHOULALA CLAIBORNELA CONCORDIALA DE SOTOLA EAST BATON ROUGELA EAST CARROLLLA EAST FELICIANALA EVANGELINELA FRANKLIN LA GRANT LA IBERIALA IBERVILLELA JACKSONLA JEFFERSON LA JEFFERSON DAVISLA LA SALLELA LAFAYETTELA LAFOURCHELA LINCOLN LA LIVINGSTONLA MADISON LA MOREHOUSELA NATCHITOCHESLA ORLEANSLA OUACHITALA PLAQUEMINESLA POINTE COUPEELA RAPIDESLA RED RIVERLA RICHLANDLA SABINELA ST BERNARDLA ST CHARLESLA ST HELENALA ST JAMESLA ST JOHN THE BAPTISTLA ST LANDRYLA ST MARTINLA ST MARYLA ST TAMMANYLA TANGIPAHOALA TENSASLA TERREBONNELA UNION LA VERMILIONLA VERNON

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State CountyLA WASHINGTON LA WEBSTER LA WEST BATON ROUGELA WEST CARROLLLA WEST FELICIANALA WINNMA BARNSTABLE MA BRISTOL MA ESSEX MA FRANKLIN MA HAMPDEN MA HAMPSHIRE MA MIDDLESEX MA NORFOLK MA PLYMOUTH MA SUFFOLK MA WORCESTER ME ANDROSCOGGINME AROOSTOOKME CUMBERLAND ME FRANKLIN ME HANCOCK ME KENNEBECME KNOX ME LINCOLN ME OXFORD ME PENOBSCOTME PISCATAQUIS ME SAGADAHOC ME SOMERSET ME WALDO ME WASHINGTON ME YORKMI ALCONAMI ALGERMI ALLEGANMI ALPENAMI ANTRIMMI ARENACMI BARAGAMI BARRYMI BAYMI BENZIEMI BERRIENMI BRANCHMI CALHOUN

State CountyMI CASSMI CHARLEVOIXMI CHEBOYGANMI CHIPPEWAMI CLAREMI CLINTONMI CRAWFORDMI DELTAMI DICKINSONMI EATONMI EMMETMI GENESEEMI GLADWINMI GOGEBICMI GRAND TRAVERSEMI GRATIOTMI HILLSDALEMI HOUGHTONMI HURONMI INGHAMMI IONIAMI IOSCOMI IRONMI ISABELLAMI JACKSONMI KALAMAZOOMI KALKASKAMI KENTMI KEWEENAWMI LAKEMI LAPEERMI LEELANAU MI LENAWEEMI LIVINGSTONMI LUCEMI MACKINACMI MACOMBMI MANISTEEMI MARQUETTEMI MASONMI MECOSTAMI MENOMINEEMI MIDLANDMI MISSAUKEEMI MONROEMI MONTCALM

State CountyMI MONTMORENCYMI MUSKEGONMI NEWAYGOMI OAKLANDMI OCEANAMI OGEMAWMI ONTONAGONMI OSCEOLAMI OSCODAMI OTSEGOMI OTTAWAMI PRESQUE ISLEMI ROSCOMMONMI SAGINAWMI SAINT CLAIRMI SAINT JOSEPHMI SANILACMI SCHOOLCRAFTMI SHIAWASSEEMI TUSCOLAMI VAN BURENMI WASHTENAWMI WAYNEMI WEXFORDMN AITKINMN ANOKAMN BECKERMN BELTRAMIMN BENTONMN BIG STONEMN BLUE EARTHMN BROWNMN CARLTONMN CARVERMN CASSMN CHIPPEWAMN CHISAGOMN CLAYMN CLEARWATERMN COOKMN COTTONWOODMN CROW WINGMN DAKOTAMN DODGEMN DOUGLASMN FARIBAULT

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State CountyMN FILLMOREMN FREEBORNMN GOODHUEMN GRANTMN HENNEPINMN HOUSTONMN HUBBARDMN ISANTIMN ITASCAMN JACKSONMN KANABECMN KANDIYOHIMN KITTSONMN KOOCHICHINGMN LAC QUI PARLEMN LAKEMN LAKE OF THE WOODSMN LE SUEURMN LINCOLNMN LYONMN MAHNOMENMN MARSHALLMN MARTINMN MCLEODMN MEEKERMN MILLE LACSMN MORRISONMN MOWERMN MURRAYMN NICOLLETMN NOBLESMN NORMANMN OLMSTEDMN OTTER TAILMN PENNINGTONMN PINEMN PIPESTONEMN POLKMN POPEMN RAMSEYMN RED LAKEMN REDWOODMN RENVILLEMN RICEMN ROCKMN ROSEAU

State CountyMN SCOTTMN SHERBURNEMN SIBLEYMN ST. LOUISMN STEARNSMN STEELEMN STEVENSMN SWIFTMN TODDMN TRAVERSEMN WABASHAMN WADENAMN WASECAMN WASHINGTONMN WATONWANMN WILKINMN WINONAMN WRIGHTMN YELLOW MEDICINEMO ADAIR MO AUDRAINMO BARRYMO BARTONMO BOLLINGERMO BOONEMO BUCHANANMO BUTLER MO CALLAWAYMO CAMDENMO CAPE GIRARDEAUMO CARTERMO CASSMO CEDARMO CHARITONMO CHRISTIAN MO CLARKMO CLAY MO CLINTONMO COLEMO COOPERMO CRAWFORDMO DADEMO DALLASMO DENTMO DOUGLAS MO FRANKLIN

State CountyMO GASCONADEMO GREENE MO HICKORYMO HOWARD MO HOWELLMO IRONMO JACKSONMO JASPERMO JEFFERSONMO KNOXMO LACLEDEMO LAFAYETTEMO LAWRENCE MO LEWISMO LINCOLN MO LINNMO MACONMO MADISONMO MARIESMO MARION MO MCDONALDMO MILLERMO MISSISSIPPIMO MONITEAUMO MONROEMO MONTGOMERY MO MORGANMO NEW MADRIDMO NEWTON MO OREGONMO OSAGEMO OZARKMO PEMISCOTMO PERRY MO PHELPSMO PIKE MO PLATTEMO POLK MO PULASKIMO PUTNAMMO RALLSMO RANDOLPH MO RAYMO REYNOLDSMO SAINT CHARLESMO SAINT FRANCOIS

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State CountyMO SAINT LOUIS MO SAINT LOUIS CITY MO SCOTLANDMO SCOTTMO SHANNONMO SHELBYMO STE GENEVIEVEMO STODDARDMO STONE MO SULLIVANMO TANEY MO TEXASMO WARREN MO WASHINGTON MO WAYNEMO WEBSTER MO WRIGHTMT CASCADEMT FLATHEADMT GALLATINMT LAKEMT LEWIS AND CLARKMT LINCOLNMT MISSOULAMT RAVALLIMT YELLOWSTONENC ALAMANCE NC ALEXANDER NC ANSONNC BEAUFORTNC BERTIENC BLADENNC BRUNSWICKNC BUNCOMBENC CABARRUS NC CALDWELL NC CASWELL NC CATAWBA NC CHATHAM NC CHOWANNC CLEVELANDNC COLUMBUSNC CUMBERLAND NC DAVIDSON NC DUPLINNC DURHAM

State CountyNC EDGECOMBENC FORSYTH NC FRANKLIN NC GASTON NC GATESNC GUILFORD NC HARNETTNC HAYWOODNC HENDERSON NC HERTFORDNC HOKE NC IREDELL NC JOHNSTON NC JONESNC LEE NC MADISONNC MARTIN NC MCDOWELLNC MECKLENBURG NC MITCHELLNC MOORENC NASH NC NEW HANOVERNC ORANGE NC PERSON NC PITTNC POLK NC RANDOLPH NC RICHMOND NC ROBESONNC ROCKINGHAM NC ROWAN NC SAMPSONNC SCOTLANDNC STOKES NC SURRY NC TRANSYLVANIANC WAKE NC WARREN NC WASHINGTON NC WATAUGA NC WAYNENC WILKES NC WILSONNC YANCEYND BURLEIGH

State CountyND CASSND MORTONND RICHLANDND STUTSMANNE ADAMSNE ANTELOPENE ARTHURNE BLAINENE BOONENE BUFFALONE BURTNE BUTLER NE CASSNE CHASENE CLAY NE COLFAXNE CUMINGNE CUSTERNE DAWSONNE DODGENE DOUGLASNE FILLMORENE FRANKLINNE FRONTIERNE FURNASNE GAGENE GARFIELDNE GOSPERNE GRANT NE GREELEYNE HALLNE HAMILTON NE HARLANNE HAYESNE HITCHCOCKNE HOOKERNE HOWARDNE JEFFERSONNE JOHNSONNE KEARNEYNE KEITHNE KNOX NE LANCASTERNE LINCOLNNE LOGAN NE MADISON

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State CountyNE MCPHERSONNE MERRICKNE NANCENE NEMAHANE NUCKOLLSNE OTOENE PAWNEENE PERKINSNE PHELPSNE PIERCENE PLATTENE POLKNE SALINENE SARPYNE SAUNDERSNE SEWARDNE SHERMANNE STANTONNE THAYERNE THOMASNE VALLEYNE WASHINGTONNE WAYNENE WEBSTERNE WHEELERNE YORKNH BELKNAPNH CARROLL NH CHESHIRENH COOSNH GRAFTONNH HILLSBOROUGHNH MERRIMACKNH ROCKINGHAMNH STRAFFORDNH SULLIVANNJ ATLANTICNJ BERGENNJ BURLINGTONNJ CAMDENNJ CAPE MAYNJ CUMBERLAND NJ ESSEXNJ GLOUCESTERNJ HUDSONNJ HUNTERDON

State CountyNJ MERCER NJ MIDDLESEXNJ MONMOUTHNJ MORRISNJ OCEANNJ PASSAICNJ SALEMNJ SOMERSETNJ SUSSEXNJ UNION NJ WARREN NM BERNALILLONM SANDOVALNM SANTA FENM TORRANCENM VALENCIANV CARSON CITYNV CHURCHILL NV CLARK NV DOUGLAS NV LYONNV MINERALNV NYENV STOREYNV WASHOE NY ALBANY NY ALLEGANY NY BRONX NY BROOMENY CATTARAUGUS NY CAYUGANY CHAUTAUQUA NY CHEMUNGNY CHENANGONY CLINTONNY COLUMBIA NY CORTLANDNY DELAWARE NY DUTCHESSNY ERIE NY ESSEXNY FRANKLINNY FULTONNY GENESEE NY GREENE NY HAMILTON

State CountyNY HERKIMERNY JEFFERSONNY KINGS NY LEWISNY LIVINGSTONNY MADISONNY MONROENY MONTGOMERYNY NASSAU NY NEW YORK NY NIAGARA NY ONEIDANY ONONDAGANY ONTARIONY ORANGENY ORLEANS NY OSWEGONY OTSEGONY PUTNAMNY QUEENS NY RENSSELAER NY RICHMOND NY ROCKLAND NY SAINT LAWRENCENY SARATOGA NY SCHENECTADY NY SCHOHARIENY SCHUYLERNY SENECANY STEUBENNY SUFFOLK NY SULLIVANNY TIOGANY TOMPKINSNY ULSTERNY WARREN NY WASHINGTON NY WAYNENY WESTCHESTER NY WYOMING NY YATESOH ADAMS OH ALLEN OH ASHLAND OH ASHTABULAOH ATHENS

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State CountyOH AUGLAIZE OH BELMONTOH BROWN OH BUTLER OH CARROLL OH CHAMPAIGN OH CLARK OH CLERMONT OH CLINTON OH COLUMBIANA OH COSHOCTONOH CRAWFORD OH CUYAHOGA OH DARKE OH DEFIANCE OH DELAWARE OH ERIE OH FAIRFIELD OH FAYETTE OH FRANKLIN OH FULTON OH GALLIAOH GEAUGA OH GREENE OH GUERNSEY OH HAMILTON OH HANCOCK OH HARDIN OH HARRISON OH HENRY OH HIGHLANDOH HOCKING OH HOLMES OH HURON OH JACKSONOH JEFFERSON OH KNOX OH LAKE OH LAWRENCE OH LICKING OH LOGAN OH LORAIN OH LUCAS OH MADISON OH MAHONING OH MARION

State CountyOH MEDINA OH MEIGSOH MERCER OH MIAMI OH MONROE OH MONTGOMERY OH MORGANOH MORROW OH MUSKINGUM OH NOBLE OH OTTAWA OH PAULDING OH PERRY OH PICKAWAY OH PIKE OH PORTAGE OH PREBLE OH PUTNAM OH RICHLANDOH ROSSOH SANDUSKY OH SCIOTOOH SENECA OH SHELBY OH STARK OH SUMMIT OH TRUMBULL OH TUSCARAWAS OH UNION OH VAN WERT OH VINTONOH WARREN OH WASHINGTON OH WAYNE OH WILLIAMS OH WOOD OH WYANDOT OK ALFALFAOK BLAINEOK CADDOOK CANADIANOK CLEVELANDOK COMANCHEOK COTTONOK CRAIGOK CREEK

State CountyOK DEWEYOK GARFIELDOK GARVINOK GRADYOK GRANTOK GREEROK HARMONOK HUGHESOK JEFFERSONOK KINGFISHEROK KIOWAOK LINCOLNOK LOGANOK MAJOROK MAYESOK MCCLAINOK MCINTOSHOK MUSKOGEEOK NOBLEOK NOWATAOK OKFUSKEEOK OKLAHOMAOK OKMULGEEOK OSAGEOK PAWNEEOK PAYNEOK POTTAWATOMIEOK ROGERSOK SEMINOLEOK STEPHENSOK TILLMANOK TULSAOK WOODSOR BENTONOR CLACKAMASOR COLUMBIAOR COOSOR CURRYOR DOUGLASOR JACKSONOR JOSEPHINEOR LANEOR LINCOLNOR LINNOR MARION OR MULTNOMAH

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State CountyOR POLKOR WASHINGTON OR YAMHILLPA ADAMS PA ALLEGHENY PA ARMSTRONG PA BEAVER PA BEDFORD PA BERKS PA BLAIR PA BRADFORD PA BUCKSPA BUTLER PA CAMBRIA PA CAMERON PA CARBON PA CENTRE PA CHESTERPA CLARION PA CLEARFIELD PA CLINTON PA COLUMBIA PA CRAWFORD PA CUMBERLAND PA DAUPHIN PA DELAWARE PA ELK PA ERIE PA FAYETTE PA FOREST PA FRANKLIN PA FULTON PA GREENE PA HUNTINGDON PA INDIANA PA JEFFERSON PA JUNIATA PA LACKAWANNA PA LANCASTER PA LAWRENCE PA LEBANON PA LEHIGH PA LUZERNE PA LYCOMING PA MCKEAN PA MERCER

State CountyPA MIFFLIN PA MONROE PA MONTGOMERY PA MONTOUR PA NORTHAMPTON PA NORTHUMBERLAND PA PERRY PA PHILADELPHIAPA PIKE PA POTTER PA SCHUYLKILL PA SNYDER PA SOMERSET PA SULLIVAN PA SUSQUEHANNA PA TIOGA PA UNION PA VENANGO PA WARREN PA WASHINGTON PA WAYNE PA WESTMORELAND PA WYOMING PA YORK PR ADJUNTAS PR AGUAS BUENAS PR AIBONITO PR ANASCO PR ARECIBO PR ARROYO PR BARCELONETA PR BARRANQUITAS PR BAYAMON PR CABO ROJO PR CAGUAS PR CAMUY PR CANOVANAS PR CAROLINA PR CAYEY PR CEIBA PR CIALES PR CIDRA PR COAMO PR COMERIO PR COROZAL PR CULEBRA

State CountyPR DORADO PR FAJARDO PR FLORIDA PR GUANICA PR GUAYAMA PR GUAYANILLA PR GUAYNABO PR GURABO PR HATILLO PR HUMACAO PR ISABELA PR JAYUYA PR JUANA DIAZ PR JUNCOS PR LAJAS PR LARES PR LAS MARIAS PR LAS PIEDRAS PR LOIZA PR LUQUILLO PR MANATI PR MARICAO PR MAUNABO PR MOCA PR MOROVIS PR NAGUABO PR NARANJITO PR OROCOVIS PR PATILLAS PR PENUELAS PR PONCE PR RIO GRANDE PR SABANA GRANDE PR SALINAS PR SAN GERMAN PR SAN LORENZO PR SAN SEBASTIAN PR SANTA ISABEL PR TOA ALTA PR TOA BAJA PR TRUJILLO ALTO PR UTUADO PR VEGA ALTA PR VEGA BAJA PR VIEQUES PR VILLALBA

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State CountyPR YABUCOA PR YAUCO RI BRISTOLRI KENTRI NEWPORTRI PROVIDENCERI WASHINGTONSC AIKEN SC ANDERSON SC BEAUFORT SC BERKELEY SC CALHOUN SC CHARLESTON SC CHEROKEE SC CHESTERFIELDSC DILLONSC DORCHESTER SC FAIRFIELD SC FLORENCE SC GEORGETOWN SC GREENVILLE SC HORRY SC KERSHAW SC LEXINGTON SC MARION SC MARLBOROSC OCONEE SC ORANGEBURG SC PICKENS SC RICHLAND SC SALUDA SC SPARTANBURG SC SUMTER SC YORK TN ANDERSON TN BEDFORD TN BENTONTN BLEDSOETN BLOUNTTN BRADLEYTN CAMPBELL TN CANNONTN CARROLL TN CARTERTN CHEATHAMTN CHESTER

State CountyTN CLAIBORNETN CLAY TN COCKETN COFFEETN CROCKETTTN CUMBERLAND TN DAVIDSONTN DECATURTN DEKALBTN DICKSONTN DYERTN FAYETTE TN FENTRESSTN FRANKLIN TN GIBSONTN GILESTN GRAINGERTN GREENE TN GRUNDYTN HAMBLENTN HAMILTONTN HANCOCK TN HARDEMANTN HARDINTN HAWKINSTN HAYWOODTN HENDERSONTN HENRYTN HICKMANTN HOUSTONTN HUMPHREYSTN JACKSONTN JEFFERSON TN JOHNSONTN KNOX TN LAKETN LAUDERDALETN LAWRENCE TN LEWIS TN LINCOLN TN LOUDON TN MACONTN MADISONTN MARION TN MARSHALL TN MAURY

State CountyTN MCMINNTN MCNAIRYTN MEIGSTN MONROE TN MONTGOMERY TN MOORETN MORGAN TN OBIONTN OVERTONTN PERRYTN PICKETTTN POLK TN PUTNAMTN RHEATN ROANETN ROBERTSONTN RUTHERFORDTN SCOTTTN SEQUATCHIETN SEVIER TN SHELBY TN SMITHTN STEWARTTN SULLIVANTN SUMNERTN TIPTONTN TROUSDALETN UNICOITN UNION TN VAN BURENTN WARRENTN WASHINGTONTN WAYNE TN WEAKLEYTN WHITETN WILLIAMSONTN WILSONTX ATASCOSATX BANDERATX BASTROPTX BEXARTX BURNETTX CALDWELLTX CAMERONTX CHAMBERSTX COLLIN

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State CountyTX COLORADOTX COMALTX COOKETX DALLASTX DENTONTX EL PASOTX FANNINTX FAYETTETX FORT BENDTX GALVESTONTX GONZALESTX GUADALUPETX HARDINTX HARRISTX HAYSTX HIDALGOTX HILLTX HOODTX JEFFERSONTX JOHNSONTX KENDALLTX LAMPASASTX LEE TX LIBERTYTX LLANOTX MATAGORDATX MCMULLENTX MEDINATX MILAMTX MONTGOMERY TX NAVARROTX REALTX ROCKWALLTX TARRANTTX TRAVISTX WHARTONTX WILLACYTX WILLIAMSONTX WILSONTX WISEUT BOX ELDERUT CACHEUT DAVISUT IRONUT MORGANUT SALT LAKE

State CountyUT SUMMIT UT TOOELEUT UTAHUT WASATCHUT WASHINGTONUT WEBERVA ALBEMARLEVA ALEXANDRIA CITYVA ALLEGHANY VA AMELIAVA AMHERSTVA APPOMATTOXVA ARLINGTONVA AUGUSTAVA BATH VA BEDFORD VA BLANDVA BOTETOURTVA BRISTOL CITYVA BRUNSWICKVA BUCHANANVA BUCKINGHAMVA BUENA VISTAVA CAMPBELL VA CAROLINEVA CARROLL VA CHARLES CITYVA CHARLOTTEVA CHARLOTTESVILLEVA CHESAPEAKE CITYVA CHESTERFIELDVA CLARKEVA COLONIAL HEIGHTS CITYVA COVINGTON CITYVA CRAIGVA CULPEPERVA CUMBERLAND VA DANVILLE CITYVA DICKENSONVA DINWIDDIEVA EMPORIA CITYVA ESSEX VA FAIRFAXVA FAIRFAX CITYVA FALLS CHURCH CITYVA FAUQUIER

State CountyVA FLOYDVA FLUVANNAVA FRANKLINVA FRANKLIN CITYVA FREDERICKVA FREDERICKSBURG CITYVA GALAX CITY VA GILESVA GLOUCESTERVA GOOCHLANDVA GRAYSONVA GREENE VA GREENSVILLE VA HALIFAXVA HAMPTON CITYVA HANOVERVA HARRISONBURG CITYVA HENRICOVA HENRYVA HIGHLANDVA HOPEWELL CITYVA ISLE OF WIGHTVA JAMES CITY COUNTYVA KING AND QUEENVA KING GEORGEVA KING WILLIAMVA LANCASTERVA LEEVA LEXINGTON CITY VA LOUDOUNVA LOUISAVA LUNENBURGVA LYNCHBURG CITYVA MADISONVA MANASSAS CITYVA MANASSAS PARK CITYVA MARTINSVILLE CITYVA MATHEWSVA MECKLENBURGVA MIDDLESEXVA MONTGOMERY VA NELSONVA NEW KENTVA NEWPORT NEWS CITYVA NORFOLK CITYVA NORTHAMPTON

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State CountyVA NORTHUMBERLANDVA NORTON CITYVA NOTTOWAYVA ORANGEVA PAGEVA PATRICKVA PETERSBURG CITYVA PITTSYLVANIAVA POQUOSON CITYVA PORTSMOUTH CITYVA POWHATANVA PRINCE EDWARDVA PRINCE GEORGEVA PRINCE WILLIAMVA PULASKIVA RADFORD CITYVA RAPPAHANNOCKVA RICHMONDVA RICHMOND CITYVA ROANOKEVA ROANOKE CITYVA ROCKBRIDGEVA ROCKINGHAMVA RUSSELLVA SALEM CITYVA SCOTTVA SHENANDOAHVA SMYTHVA SOUTHAMPTONVA SPOTSYLVANIAVA STAFFORDVA STAUNTON CITYVA SUFFOLK CITYVA SURRYVA SUSSEXVA TAZEWELLVA VIRGINIA BEACH CITYVA WARRENVA WASHINGTONVA WAYNESBORO CITYVA WESTMORELAND VA WILLIAMSBURG CITYVA WINCHESTER CITYVA WISEVA WYTHEVA YORK

State CountyVT ADDISONVT BENNINGTONVT CALEDONIAVT CHITTENDENVT ESSEX VT FRANKLINVT GRAND ISLEVT LAMOILLEVT ORANGEVT ORLEANSVT RUTLANDVT WASHINGTONVT WINDHAMVT WINDSORWA ASOTINWA CLALLAMWA CLARKWA COLUMBIA WA COWLITZWA GRAYS HARBORWA ISLANDWA JEFFERSONWA KINGWA KITSAPWA LEWIS WA MASONWA PIERCEWA SNOHOMISHWA THURSTONWA WAHKIAKUMWA WALLA WALLAWA YAKIMAWI ADAMS WI ASHLAND WI BAYFIELDWI BROWNWI BURNETTWI CALUMETWI CLARKWI COLUMBIAWI DANEWI DODGEWI DOORWI DOUGLASWI DUNNWI FLORENCE

State CountyWI FOND DU LACWI FORESTWI GREENWI GREEN LAKEWI IOWAWI IRONWI JACKSONWI JEFFERSONWI JUNEAUWI KENOSHAWI KEWAUNEEWI LAFAYETTEWI LANGLADEWI LINCOLNWI MANITOWOCWI MARATHONWI MARINETTEWI MARQUETTEWI MENOMINEEWI MILWAUKEEWI OCONTOWI ONEIDAWI OUTAGAMIEWI OZAUKEEWI POLKWI PORTAGEWI PRICEWI RACINEWI RICHLANDWI ROCKWI RUSKWI SAUKWI SHAWANOWI SHEBOYGANWI TAYLORWI VILASWI WALWORTHWI WASHBURNWI WASHINGTONWI WAUKESHAWI WAUPACAWI WAUSHARAWI WINNEBAGOWI WOODWV BARBOUR WV BERKELEY

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State CountyWV BRAXTON WV BROOKE WV CABELL WV CALHOUN WV CLAY WV DODDRIDGE WV FAYETTE WV GILMER WV GRANT WV GREENBRIER WV HAMPSHIRE WV HANCOCK WV HARDY WV HARRISON WV JACKSON WV JEFFERSON WV KANAWHA WV LEWIS WV LINCOLN WV LOGAN WV MARION WV MARSHALL WV MASON WV MCDOWELL WV MERCER WV MINERAL WV MINGO WV MONONGALIA WV MONROE WV MORGAN WV NICHOLAS WV OHIO WV PENDLETON WV PLEASANTS WV POCAHONTAS WV PRESTON WV PUTNAM WV RALEIGH WV RANDOLPH WV RITCHIE WV SUMMERS WV TAYLOR WV TUCKER WV TYLER WV UPSHUR WV WAYNE

State CountyWV WETZEL WV WIRT WV WOOD WV WYOMING

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Search complete? Decision made?

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Here’s what’s next. If you found a local participating network…Great. You’ll have full coverage after your usual copayment or coinsurance.

If there were no participating networks near you…Not to worry, you still have options. Go to any Medicare-eligible doctor or location and you’ll have full coverage after your in-network copayment or coinsurance.

Please confirm that the provider is Medicare-eligible before receiving care. Highmark will not cover services if the provider has opted out of the Medicare program.

If there was a participating network near you, but you’ve chosen a non-participating option…In that case, you’ll be covered at your lower, out-of-network level once you pay your annual deductible.

If you had no time to search because it was an emergency…No problem. Emergency and urgent care are always the exceptions to the rule. You’ll be covered at the higher, in-network level, regardless of where you receive care.

When you hit the road, you can count on the suitcase. The Medicare Advantage suitcase symbol on your card grants you coverage away from home. Simply present the card, and we’ll take it from there.

Your search results AND your choice in provider or location will determine your coverage, and ultimately your payment.

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Understanding costs is key. That’s why we’ve outlined a few examples. EXAMPLE 1: You’re in a Network Sharing county and need care. You’ve searched for a participating provider nearby — and great news — you’ve found one.

The participating provider charges: $150

The negotiated plan rate covers: $130

Freedom Blue PPO or Community Blue Medicare PPO pays remaining amount up to negotiated local Blue Cross and/or Blue Shield Plan contracted rate

$130

Your total payment:0% of the negotiated rate*

In this example, the plan will cover 100% of the costs, minus any standard copays, coinsurance, or deductibles.

EXAMPLE 2: You’re in a Network Sharing county and need care, but after searching, there were no participating providers nearby.

The in-network charges: $150

The negotiated plan rate covers: $130

Freedom Blue PPO or Community Blue Medicare PPO pays remaining amount up to negotiated local Blue Cross and/or Blue Shield Plan contracted rate

$130

Your total payment: $0

In this example, as long as you visit a doctor who accepts Medicare, your care will be covered at the in-network rate. That means the plan will cover 100% of the costs, minus any standard copays, coinsurance, or deductibles.

EXAMPLE 2A: You’re in a Network Sharing county and need care. While there was a participating provider available, you chose to receive care from a non-participating provider.

The out-of-network charges: $150

The Medicare-approved charge: $130

The plan pays 80% of the Medicare- approved charge:

$124

You pay 20% of the Medicare- approved charge:

$26

Your total payment: $26

In this example, you’ll pay out-of-network rates — including any copays, coinsurance, or deductibles — up to your out-of-network, out-of-pocket maximum.

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EXAMPLE 2B: You’re in a Network Sharing county and need care, but you receive it from a provider who does not accept Medicare.

Out-of-Network provider’s charge for eligible service:

$150

Medicare-approved amount for this service:

$130

The Plan Pays 80%* of Medicare- Approved amount:

$104

The member pays 20%* of Medicare-Approved amount:

$26

Total amount the member pays to the provider:

$26

In this example, this is a limiting charge because the provider doesn’t accept Medicare. If you’ve reached your deductible, you’ll pay 20% of that charge.

DON’T FORGET: Details and costs may vary depending on your specific plan.

An out-of-network provider may not accept a Medicare-approved charge in full. If that’s the case, the provider can receive a limiting charge. You may be billed for the difference between what the plan pays and the limiting charge.

For covered services that require you to pay coinsurance, the amount will be based on either:

- The Medicare allowable amount for the covered services.

- The negotiated provider rate, which may be different than the Medicare allowable amount.

Whether you’re snowbirding to Florida or headed out west, our lawyers want you to have the following handy.

*A member may pay more depending on the specific plan’s network cost-sharing benefit design.

Your health benefits or health benefit administration may be provided by or through Highmark Senior Health Company. Highmark Blue Shield provides post-sale administrative communications for these companies.

Highmark Blue Shield and Highmark Senior Health Company all of which are independent licensees of the Blue Cross and Blue Shield Association.

Highmark Senior Health Company is a PPO plan with a Medicare contract. Enrollment in Highmark Senior Health Company depends on contract renewal.

Out-of-network/non-contracted providers are under no obligation to treat Freedom Blue PPO members and/or Community Blue Medicare PPO members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.

continued on back

Discrimination is Against the LawThe Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. The Plan:

• Provides free aids and services to people with disabilities to communicate effectively with us, such as:

– Qualified sign language interpreters

– Written information in other formats (large print, audio, accessible electronic formats, other formats)

• Provides free language services to people whose primary language is not English, such as:

– Qualified interpreters

– Information written in other languages

If you need these services, contact the Civil Rights Coordinator.

If you believe that the Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Civil Rights Coordinator, P.O. Box 22492, Pittsburgh, PA 15222, Phone: 1-866-286-8295, TTY: 711, Fax: 412-544-2475, email: CivilRightsCoordinator@highmarkhealth.org. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/ portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

EGHP_20_9658_C 10/20 Z MX202397