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

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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.

Highmark Open Enrollment Video

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.

City of Wilmington EPO Actives July 2025
City of Wilmington PPO 2 Union Actives July 2025
City of Wilmington PPO 1 Actives July 2025
2025 Preventive Schedule, Non-Grandfathered
Transparency in Coverage
Dietician Provider Directory

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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.
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