Medical Insurance: Highmark Blue Cross Blue Shield of Delaware
The City of Wilmington offers medical insurance through Highmark Blue Cross Blue Shield of Delaware. The below chart is a brief outline of the plan options.
Highmark Customer Service: 1-844-946-6259
Highmark website: www.highmarkbcbsde.com

Highmark mobile app: download the Highmark app to access your and your covered dependents’ medical cards and claims.
Transparency in Coverage website: https://mrfdata.hmhs.com/
There is an opportunity to receive a 2% discount on your medical premium each year. To learn more about our Wellness Discount Program CLICK HERE
Which Medical Plan is Right?
Evaluate Your Needs. Consider your prior health care usage and select plans and options that fit your lifestyle and needs.
A little bit of planning will help you select the best plans, coverage levels, and financial programs for your unique situation.
Medical Plan Comparison
| Highmark Blue Cross Blue Shield PPO Plan 1 |
Highmark Blue Cross Blue Shield PPO Plan 2 |
Highmark Blue Cross Blue Shield EPO Plan |
|||||||
---|---|---|---|---|---|---|---|---|---|---|
PPO In-Network | PPO Out-of-Network | PPO In-Network | PPO Out-of-Network | Schedule of Benefits | ||||||
Annual Deductible | ||||||||||
Individual | $0 | $300 | $0 | $300 | $500 | |||||
Family | $0 | $900 | $0 | $900 | $1,500 | |||||
Coinsurance | 100% | 80% | 90% | 70% | 100% | |||||
Total Maximum Out-of-Pocket | ||||||||||
Individual | $3,300 | N/A | $3,300 | N/A | $3,300 | |||||
Family | $6,600 | N/A | $6,600 | N/A | $6,600 | |||||
Physician Office Visit | ||||||||||
Primary Care | 100% after $5 copay | 80% after deductible | 100% after $10 copay | 70% after deductible | 100% after $30 copay | |||||
Specialty Care | 100% after $10 copay | 80% after deductible | 100% after $20 copay | 70% after deductible | 100% after $30 copay | |||||
Preventive Care | ||||||||||
Adult/Well-Child Preventive | 100% | 80% after deductible | 100% | 70% after deductible | 100% | |||||
Diagnostic Services | ||||||||||
X-ray and Lab Tests | 100% after deductible | 80% after deductible | 90% after deductible | 70% after deductible | 100% after deductible | |||||
Complex Radiology | 100% after deductible | 80% after deductible | 90% after deductible | 70% after deductible | 100% after deductible | |||||
Urgent Care Facility | 100% after $10 copay | 80% after deductible | 100% after $20 copay | 70% after deductible | 100% after $30 copay | |||||
Emergency Room Facility Charges | 100% after $150 copay waived if admitted | 100% after $150 copay waived if admitted | 100% after $50 copay; waived if admitted | 100% after $50 copay; waived if admitted | 100% after $150 copay; waived if admitted | |||||
Inpatient/Outpatient Facility & Surgical Charges | 100% after deductible | 80% after deductible | 90% after deductible | 70% after deductible | 100% after deductible | |||||
Mental Health/Substance Health | ||||||||||
Inpatient | 100% after deductible | 80% after deductible | 90% after deductible | 70% after deductible | 100% after deductible | |||||
Outpatient | 100% after deductible | 80% after deductible | 100% after $10 copay | 70% after deductible | 100% after $30 copay | |||||
Retail Pharmacy (30 Day Supply) | ||||||||||
Generic | $10 copay | Not covered | $10 copay | Not covered | $10 copay | |||||
Preferred | $20 copay | Not covered | $20 copay | Not covered | $20 copay | |||||
Non-Preferred | $35 copay | Not covered | $35 copay | Not covered | $35 copay | |||||
Mail Order Pharmacy (90 Day Supply) | ||||||||||
Generic | $20 copay | Not covered | $20 copay | Not covered | $20 copay | |||||
Preferred | $40 copay | Not covered | $40 copay | Not covered | $40 copay | |||||
Non-Preferred | $70 copay | Not covered | $70 copay | Not covered | $70 copay |
Note: Please consult plan documents for full benefits, exclusions, and limitations.
Clarity 360
Clarity 360: Highmark
Personalized support to help you:
- Make important care decisions and ensure
you receive the highest quality of care. - Manage a health condition.
- Improve lifestyle habits.
- Reduce risk for chronic diseases like diabetes
or heart disease. - Get preventive care.
- Get answers to your health and coverage
questions and more.
- Make important care decisions and ensure