Highmark BCBSWNY can help you get the most out of yourMedicaid benefits. Get vision care, dental benefits, prescriptions, mental health services and more! See doctors and pick up prescriptions close to home. Use our 24/7 NurseLine to get reliable medical advice any time, day or night.
A dental benefits vendor had a data breach which impacted certain members. To learn more, please visit hereor call toll free at 888-220-5006.
New to Highmark BCBSWNY?
As a new member, we know you have questions. We also know you’re short on time! Learn the basics about your health plan on the New Member Welcome page.
What you get with Highmark BCBSWNY
Your health is important to us. That’s why you get important care and services like:
- A primary care provider (PCP) to help you get the care you need.
- Prescriptions*.
- Wellness visits and immunizations.
- Specialty physician services.
- Substance use treatment.
- Psychiatric services.
- Disease management for asthma, diabetes and more.
- Smoking cessation.
- Coping, crisis prevention, stress management, and life skills training.
- Family support training.
*Starting April 1, 2023, your prescriptions will not be covered by Highmark BCBSWNY. They will be covered by NYRx, the Medicaid pharmacy program.
Frequently asked questions
How do I get help after my primary care provider’s (PCP) office closes?
Unless it’s a life-threatening emergency, do not go to the emergency room (ER). Instead, call the 24/7 NurseLine at 1-866-231-0847 (TTY 711) to talk to a nurse any time, day or night. Our nurses can answer questions about your health or help you find an urgent care facility near you.
Can I call my specialist’s office directly to set up an appointment?
Your PCP will refer you to a specialist. If you need specialist services you can’t get from a Highmark BCBSWNY plan doctor, we’ll work with your PCP to refer you to an out-of-plan specialist. Your PCP must call Highmark BCBSWNY at 1-866-231-0847 (TTY 711) to request approval for an out-of-plan referral.
My plan has dental benefits. How do I choose a dentist?
If you need to find a dentist, please call Liberty Dental toll free at 1-833-276-0846 (TTY 1-877-855-8039) Monday through Friday from 8 a.m. to 8 p.m. Eastern time. You can also call Member Services at 1-866-231-0847 (TTY 711). When you visit your dentist, you should show your plan ID card.
How do I get a copy of the Highmark BCBSWNY provider directory?
Please call Member Services at 1-866-231-0847 (TTY 711) and request one. You can also view our provider directory online.
How do I see a doctor who is not a Highmark BCBSWNY plan doctor?
Please call Member Services at 1-866-231-0847 (TTY 711) Monday through Friday from 8:30 a.m. to 6 p.m. Eastern time with questions.
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Can I call my specialist’s office directly to set up an appointment?
You need a referral from your PCP to see a specialist.Learn more about how to get specialty care and referrals.
Extra Benefits
Get what you need to live your healthiest life. As a Highmark BCBSWNY member, you get extra benefits, called value-added benefits, like:
- Free diapers after completing six prenatal visits, or after your baby completes a newborn checkup.
- A car seat or portable crib for pregnant members who complete six prenatal visits.
- Free dental hygiene kits for members ages 13-18 years.
- A stroller for new moms who complete a postpartum checkup within 7-82 days.
- $20 Uber gift card for going to healthcare visits and other places in the community.
Limitations and restrictions apply. Benefits may change.
You can redeem some benefits online through your secure account. View the extra benefits you’re eligible for on theBenefit Reward Hub or call Member Services at 866-231-0847 (TTY 711) Monday through Friday, 8:30 a.m. to 6 p.m. Eastern time.
Log in to your secure account to get started today!
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You should not be charged for personal protective equipment
You do not have to pay doctors in your plan network for personal protective equipment, like masks, gloves, or gowns required during visits. If you paid for this type of gear, you should contact the doctor for a refund. To submit a complaint to us about charges for personal protective equipment from a doctor in your plan network, please contact Member Services at 866 231 0847 (TTY 711).
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Member Handbooks
Your member handbook is your go-to guide for health services. It tells you how you can get the most from Highmark BCBSWNY. You’ll find answers to these items:
- Your benefits
- Your rights and responsibilities.
- How to get help after your doctor's office closes
- How to choose a primary care provider
- Renewing your coverage
- How to reach Member Services if you have a question
Member Handbook
- Medicaid Member Handbook - English
- Pharmacy Benefit Update MHI
- Medicaid Member Handbook - Spanish
- 988lifeline.org
- Dental Benefits Member Handbook Insert – English
- Dental Benefits Member Handbook Insert – Spanish
- Medicaid Pharmacy Transition Member Handbook Insert – English
- Medicaid Pharmacy Transition Member Handbook Insert – Spanish
- Applied Behavior Analysis Medicaid Member Handbook Insert – English
- Applied Behavior Analysis Medicaid Member Handbook Insert –Spanish
- Medically Tailored Meals Member Handbook Insert - English
- Medically Tailored Meals Member Handbook Insert - Spanish
- December 2022 Gambling Disorder Treatment Member Handbook Insert - English
- December 2022 Gambling Disorder Treatment Member Handbook Insert - Spanish
- July 2021 Member Handbook Foster Care Update - English
- July 2021 Member Handbook Foster Care Update - Spanish
- January 2021 Member Handbook Update - English
- January 2021 Member Handbook Update - Spanish
- October 2020 Member Handbook Update
- April 2020 Rx Maximum Co-pay Change - English
- April 2020 Rx Maximum Co-pay Change - Spanish
- February 2020 National Diabetes Prevention Program (NDPP) – English
- February 2020 National Diabetes Prevention Program (NDPP) – Spanish
- December 2019 Member Handbook Update – English
- December 2019 Member Handbook Update – Spanish
- October 2019 ILS Update: Inpatient Psychiatric Admission to an Institution for Mental Disease
- October 2019 Member Handbook Update – English
- October 2019 Member Handbook Update – Spanish
- August 2019 Member Handbook Update – English
- August 2019 Member Handbook Update – Spanish
- June 2019 Member Handbook Update – English
- June 2019 Member Handbook Update – Spanish
- February 2019 Member Handbook Update – English
- February 2019 Member Handbook Update – Spanish
- December 2018 Member Handbook Update – English
- December 2018 Member Handbook Update – Spanish
- November 2018 Member Handbook Update – English
- November 2018 Member Handbook Update- Spanish
- Member Authorization Form — English
- Member Authorization Form — Spanish
Notice of Privacy Practices
- English
- Spanish
Quality Improvement Overview
- English
- Spanish
Pharmacy
Starting April 1, 2023, your prescriptions will not be covered by Highmark Blue Cross Blue Shield. They will be covered by Medicaid NYRx, the Medicaid pharmacy program.
Who's Eligible
We offer New York State-sponsored Medicaid programs. Highmark BCBSWNY will help you get the most out of your Medicaid benefits.
You may be eligible for Medicaid if:
- You live in one of these counties: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans or Wyoming.
- You have high medical bills.
- You receive SSI — see below.*
- You meet certain income, resource, age or disability requirements.g.
*If you receive Supplemental Security Income (SSI), you automatically receive Medicaid without the need to apply.
You may be eligible for SSI if you:
- Are elderly.
- Are blind.
- Have a disability.
- Have a behavioral health condition.
Families who don’t qualify for Medicaid may still get health care for their children.
To find out more about eligibility, visit the New York Medicaid websiteor call NY State of Health, The Official Health Plan Marketplace at 1-855-355-5777.
Already a member and have questions?
Please call Member Services at 1-866-231-0847 (TTY 711) Monday through Friday from 8:30 a.m. to 6 p.m. We are happy to help you with your health care!
Enroll with Highmark BCBSWNY
Highmark BCBSWNY Healthy Rewards
Earn Rewards for Healthy Activities
Healthy Rewards is a no-cost, optional program for eligible members enrolled in our health plan. The program encourages members to seek the care they need to improve their health and create a healthy lifestyle.
Members can redeem these Healthy Rewards through theBenefit Reward Hub
- $25 for pregnant members who go to a prenatal visit in their first trimester, or within 42 days of joining our plan
- $25 for a postpartum visit within 7-84 days of delivering their baby
- $25 for metabolic testing for members using antipsychotic medication
- Up to $40 for asthma medication management
- $25 for diabetic A1c screening for members taking antipsychotic medication
- $35 for childhood immunizations
- $35 for HPV vaccination
- $5 for vaccination importance quiz
- $25 for colorectal cancer screening
- $25 for following up with their doctor after a behavioral health hospitalization discharge
- $25 for a diabetic retinal eye exam
- $10 for a diabetic A1c screening
- $5 for diabetic management quiz
Log in to the Benefit Reward Hub, to redeem your Healthy Rewards. You can also call the Healthy Rewards Customer Service Line at 888-990-8681 (TTY 711) Monday through Friday, 9 a.m. to 8 p.m. Eastern time.
View the extra benefits you are eligible for on theBenefit Reward Hub or call Member Services at 866-231-0847 (TTY 711) Monday through Friday, 8:30 a.m. to 6 p.m. Eastern time. To begin earning rewards, log in to your secure account.
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Benefit Reward Hub
LiveHealth Online
LiveHealth Online allows you to visit a doctor through live video chat on your computer, tablet or smartphone. It’s an easy way to get care for you or your family at any time, day or night, without leaving your home.
As a Highmark BCBSWNY, you can use LiveHealth Online at no cost to you.
Sign up today so you can:
- See a doctor in minutes: Use LiveHealth Online to get help when you have a common health problem like a cold, the flu, fever, pink eye, sore throat, sinus infection and more!
- Get prescriptions sent to your pharmacy if needed.*
- Make an appointment with a Spanish speaking doctor: Speak to a doctor in your own language seven days a week through Cuidado Médico on LiveHealth Online.
It’s easy to get started. Sign up for free on the LiveHealth Online website or download the app:
*Prescription availability is defined by physician judgment.
LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Highmark Blue Cross Blue Shield of Western New York.
