Highmark Medicare Advantage 2025 Review: Pros, Cons, Costs

Highmark Medicare Advantage pros and cons

Our full review

Highmark Medicare Advantage star ratings

Average star rating, weighted by enrollment: 4.52

Highmark Medicare Advantage plans are rated well above the industry average, receiving an average rating of 4.52 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.95.

Of Highmark Medicare Advantage plans with star ratings in 2025, all are rated 4 stars or higher. Hence, all of Highmark’s members are in highly rated plans^[0]

CMS maintains its own database of star ratings on every Medicare Advantage and Medicare prescription drug plan, ranging from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

You can find a plan’s rating with the Medicare plan finding tool.

What does Highmark Medicare Advantage cost?

In 2025, about a third of Highmark’s Medicare Advantage plans offer $0 premiums. You'll also be responsible for paying your Medicare Part B premium, which is $185 per month in 2025^[0]

(Most people pay this standard Part B amount, but if your income is above a certain threshold, you’ll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium.)

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

• Whether the plan covers any part of your monthly Medicare Part B premium.

• The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

• Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

• The plan’s in-network and out-of-network out-of-pocket maximums.

• Whether your medical providers are in-network or out-of-network or how often you may go out of network for care.

• Whether you require extra benefits and whether the plan charges for them.

Here are examples of Highmark Medicare Advantage costs for the most popular plans in a mid-range city:

To get a sense of costs, use Medicare’s website to compare information among available plans in your area. You can select by insurance carrier to see only Highmark plans or compare across carriers.

Available Highmark Medicare Advantage plans

Highmark offers HMO and PPO plans as well as stand-alone Medicare Part D prescription drug plans. Highmark also has a plan designed for veterans.

Plan offerings include the following types:

Third-party ratings

AM Best Financial Strength Rating: A (Excellent)

AM Best is a credit rating agency that specializes in the insurance industry. In September 2023, AM Best affirmed its Financial Strength Rating of A (Excellent) for Highmark and its life/health subsidiaries^[0]

An A rating in this category indicates that AM Best believes Highmark has an excellent ability to meet its ongoing insurance obligations.

J.D. Power Ranking

In its 2024 U.S. Medicare Advantage Study — the 10th it's done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the 10 biggest state Medicare markets. On these measures, Highmark placed second of all major providers in Pennsylvania (the only state in which Highmark had enough market share to be considered)^[0]

Highmark Medicare Advantage service area

Highmark Medicare Advantage plans are available in four states — Delaware, New York, Pennsylvania and West Virginia — and more than 420,000 people are enrolled in Highmark plans. The company added 27,000 members for the 2024 plan year, according to a report from health care analytics firm The Chartis Group^[0]

Highmark Medicare Advantage customer service

Highmark Medicare Advantage members can contact their plan’s customer service in the following ways:

• Call the number on their member ID card from 8 a.m. to 8 p.m. local time seven days a week.

• Request a call from a Highmark Medicare Advisor.