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For adults 21 or older who have Medicaid, and have been diagnosed with a serious mental illness or substance use disorder
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For children under 19 years old who don’t qualify for Medicaid and don’t have health benefits
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See if you’re eligible, and find out how to choose Highmark BCBSWNY.
Learn moreStarting September 1, 2022, you will need to use a prescriber and pharmacy that is enrolled with Medicaid Fee for Service. If your prescriber or pharmacy is not enrolled with Medicaid Fee for Service, the prescriptions and supplies that they prescribe or fill will not be covered. You should have received a letter from us in June 2022 if you filled a prescription by a prescriber or pharmacy who was not enrolled. Please follow the instructions in the letter to find a new provider or pharmacy before September 1, 2022. You can use the Find a Doctor tool to find a provider or pharmacy enrolled in Medicaid Fee for Service.
Covered services provided adhere to the Paul Wellstone and Pete Dominici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), 42 U.S.C. 18031(j), along with any subsequent amendments, federal guidance, and regulations related to those Acts. Comparative analyses are conducted following the guidelines outlined in MHPAEA. The latest comparative analysis can be found at Compliance with the Mental Health Parity and Addiction Equity Act Comprehensive Report: New York Medicaid Managed Care, Alternative Benefit Plan, and Children´s Health Insurance Program (ny.gov)
Highmark Blue Cross Blue Shield of Western New York Health and Recovery Plan (HARP) is available for eligible Medicaid members ages 21 or older. Learn more.
Starting October 1, 2019, Highmark BCBSWNY will cover Children’s HCBS for eligible Medicaid members. Learn more in your Member Handbook update: August 2019 Member Handbook Update – English
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