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Frequently Asked Questions

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Stop in, call, or schedule an appointment.

PA Store Hours

Monday - Saturday
9:00AM to 6:00PM

NY Store Hours

Monday - Friday
9:00AM to 4:00PM

TTY users call 711

General

What can I do at a Highmark Direct store?

We offer many ways to serve you!

Current and potential Highmark plan members can meet one-on-one with a store representative to:

  • Compare, shop and enroll in a Highmark plan that best first your needs
  • Make monthly premium payments
  • Better understand current coverage and benefits
  • Locate participating providers and schedule appointments
  • Resolve medical billing or claim questions
  • Get connected by setting up your online member account through the myHighmark app
  • For individuals aging into Medicare, attend a Medicare Options Seminar for personalized support along the way
  • Participate in free monthly activities such as yoga, Book club, Doc talks and more! Check your local store event calendar for more information.

How do I find a Highmark Direct store in my area?

Highmark Direct health insurance stores are conveniently located throughout Pennsylvania. Check our store locations page to find a Highmark Direct health insurance store near you.

Do you accept premium payments at your stores?

Yes, you can visit your local Highmark Direct store anytime to pay your monthly insurance premium. Our store representative cannot take payments over the phone. All of our stores accept checks and money orders. Depending on your plan, you also may be able to pay with a debit or credit card. See store locations page .

What insurance plans does Highmark offer?

Highmark offers a range of health insurance plans to fit your needs and budget. Our licensed sales agents can help you shop for and compare plans, as well as assist with enrollment.

Our plan options include:

  • Medicare Advantage plans (Part C), standalone prescription drug coverage (Part D) and Medigap supplemental insurance
  • Individual and Family plans through the Accordable Care Act (ACA)
  • CHIP - Highmark Healthy Kids comprehensive health coverage offered to Pennsylvania children who under the age of 19, regardless of household income
  • Medicaid plans offered through Highmark Wholecare
  • Other insurance, such as travel, dental and vision

Appointments

Do I need to make an appointment?

No, an appointment is not necessary. You can drop in anytime during store hours. We're open 9:00 AM to 6:00 PM (Mon-Sat). You can also schedule an appointment if you prefer.

How do I schedule an appointment?

For a personalized one-on-one meeting with a licensed Highmark Direct Store Associate, schedule an appointment at one of our convenient store locations.

What should I bring to my appointment?

To ensure you get the most help from your appointment, below are some items we recommend bringing with you. If you are eligible for Medicare, please bring:

  • Your red, white and blue Medicare card
  • Identification (such as a driver?s licenseI)
  • Medicaid card (or number, if applicable)
  • Name and policy number of your current health insurance plan
  • Retirement month and year (if applicable)
  • Primary care physician?s name and contact information
  • List of current medications

If you are shopping for an individual or family health insurance, please bring:

  • Names and birthdates of all family members who need health insurance
  • Social Security numbers for all family members who need health insurance
  • Identification (such as a driver?s license)
  • Employer and income information, such as most recent pay stub and W-2 form
  • Name and policy number of your family?s current health insurance plan
  • Policy cancellation letter (if you recently lost health coverage)
  • List of current medications

How much time should I expect to spend at my appointment?

Most appointments take 1 hour. However, you may need more or less time depending on your specific needs.

Medicare

How do I know if I qualify for Medicare?

To quality for Medicare, you must be:

  • A U.S. resident or a legal resident living in the U.S. for at least 5 consecutive years
  • Age 65 or older
  • People under 65 who have qualifying disabilities like: permanent kidney failure (end-stage renal disease) requiring dialysis or a kidney transplant

When can I enroll in Medicare?

The best time to sign up for Medicare is as soon as you're eligible. There are 4 basic enrollment periods that allow you to sign up for Original Medicare or a Medicare Advantage plan.

Initial Enrollment Period (IEP) is for people who are new to Medicare and want to enroll when they turn 65. If you are new to Medicare, you have a 7-month window to enroll which is:

  • 3 months before your birthday month
  • Your birthday month
  • 3 months after your birthday month

Special Enrollment Period (SEP) is for people who want to enroll in Medicare after 65 or for people who experience a major life event.

Annual Enrollment Period (AEP) runs from Oct 15 - Dec 7th and is the time for people who are already enrolled in a Medicare plan to switch plans or add coverage.

Open Enrollment Period (OEP) runs from Jan. 1 to March 31st and allows you to switch Medicare Advantage plans once during this time. You may choose to do this if for any reason you are dissatisfied with your current plan.

What is a Medicare Options Seminar at the Highmark Direct Stores?

At Highmark, our goal is to make your transition to Medicare easier. That's why we host events each month at every Highmark Direct Store location. At this exclusive event, you'll have a chance to meet and speak with a Licensed Medicare Advisor to:

  • Learn the steps you need to take as you approach age 65 or get ready to retire
  • Understand the range of plans Highmark offers to meet your individual needs
  • Receive answers to any questions you may have

Join us each month to learn the basics and speak with a licensed Medicare advisor.

Check your local store event calendar to sign up.


Join us for Social Events

Attend a Medicare Seminar

Enroll in a Fitness Class

Join us for Social Events

Join us for Social Events

Take some time out for an engaging Book Club meetup where we discuss some of the latest bestsellers

Find a book club in a store near you

Attend a Medicare Seminar

Attend a Medicare Seminar

New to Medicare? Join us each month to learn the basics and speak with a licensed Medicare advisor

Find a Medicare Seminar in a store near you

Enroll in a Fitness Class

Enroll in a Fitness Class

We offer a variety of exercise classes like gentle yoga that incorporate balance and general fitness

Find a fitness class in a store near you