Highmark Critical Updates: New Provider Search Process and 2026 MA Network Provider List

Important Provider Search Process Update

Highmark has identified certain limitations with the Provider Search results that are being pulled through the Producer Portal. To ensure you have access to the most comprehensive and accurate Provider information, they strongly recommend utilizing the myhighmark.com Member Portal for all your Provider Search needs.

The following steps will deliver efficient and reliable Provider Search results:

1. Go to myhighmark.com.

2. Select Plans in the top left toolbar which will then display a dropdown menu.

3. In the Medicare section, select Doctors and Drugs.

4. Select Find a Doctor or Hospital. Note: You will receive a prompt stating you are leaving the Highmark website. Select Yes to continue.

5. Select Choose a location and plan. IMPORTANT: Bookmark this page for quick access to future Provider Searches.

6. Enter an address, city, or zip code and select Yes, this is correct.

7. Do NOT enter the Alpha Prefix. Select Don't know your Alpha Prefix? Browse a list of plans.

8. Enter Freedom Blue PPO (broadest network) as the initial plan in the search bar (or select from list), then choose Confirm Selection.

9. On the home page, select Search all. Note: You have the option to search by Name, Specialty, Place, and Type

10. Locate the provider and select the link under Plans accepted.

11. A sidebar will open listing the available states. Select the state dropdown to see which plans are accepted as well as which plans will be out of network as of 1/1/2026.

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Updated 2026 Medicare Advantage Network Adjustment Provider List

To follow-up their 2026 Medicare Advantage Network Adjustments communication released on September 12th, Highmark would like to provide an updated provider list that reflects adjustments to some benefits and provider networks for 2026 within the Medicare Advantage program.

These adjustments are a result of rising healthcare costs and utilization exceeding federal reimbursement. While some Primary Care Physicians and Specialists in select Medicare Advantage plans will no longer be in-network, please note that these changes do not affect hospitals, facilities, Federally Qualified Health Centers, or practices needed for network adequacy. Commercial and Affordable Care Act (ACA) plans are also not impacted.

You can find the updated provider list here.

Highmark encourages all members to verify which products include their providers in-network during AEP. For the most up-to-date information, please utilize the Provider Search tool on myhighmark.com.

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Complete Blue HMO and Community Blue Medicare HMO Network Reminder (WPA)

As AEP progresses, Highmark wanted to take this opportunity to highlight the significant network advantages of their Complete Blue HMO and Community Blue Medicare HMO plans in Western Pennsylvania.

As a reminder, in addition to offering rich medical and supplemental benefits, the Complete Blue HMO plans also include a broad network of UPMC Providers. Furthermore, both Complete Blue HMO and Community Blue Medicare HMO plans offer access to Cleveland Clinic.

For the most up-to-date list of providers, please utilize the Provider Search tool located on myhighmark.com.

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Jefferson Health In Network Effective January 2026 (D-SNP)

The Highmark Wholecare network just got bigger in the Philadelphia region. Starting January 2026, Jefferson Health will be in network for Southeast Pennsylvania (SEPA) D-SNP members.

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Plan Termination Special Enrollment Period (SEP)

The Plan Termination SEP, running from December 8th through the last day in February, provides an opportunity for members whose plans are terminating on December 31st to enroll in a new plan for the following year.

As a reminder, if an impacted member enrolls into a plan during AEP, they still retain their SEP and can switch their enrollment between December 8 - December 31, 2025 for an effective date of January 1, 2026.

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Agent of Record Reminder

Please note that all internal plan changes will continue to maintain the existing Agent of Record (AOR). There will be no automatic change to the AOR when a client makes an internal plan adjustment.

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