Highmark: SPAP SEP Reminders and more

PA Regional MA Provider Directories Now Available!

Highmark is pleased to announce that Medicare Advantage (MA) provider directories are now available in regional versions! This enhancement provides easier navigation and a better experience for both you and our members.

The following directories are now available in regional formats as listed below.

• Freedom Blue PPO: CPA/NEPA*; SEPA*
• Complete Blue PPO: WPA; CPA*; NEPA/SEPA*
• Community Blue HMO: WPA; CPA/NEPA/SEPA*
• Complete Blue Plus PPO: NEPA; SEPA
• Community Blue Plus PPO: NEPA; SEPA

*Also available in Spanish

Please note that the single, statewide versions of these directories are no longer available for order. When ordering regional directories, please confirm the member's specific region to ensure accurate provider information.

You can find the new regional directories on medicare.highmark.com under Plan Documents. To order physical copies, please visit Marcom.

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SPAP SEP Reminder

For clients 65+ who are new to or losing eligibility for a State Pharmaceutical Assistance Program (SPAP) like PACE/PACENET/EPIC, remember they have a one-time opportunity to enroll in a new Prescription Drug Plan each year. The enrollment period begins the month of loss of eligibility (or notification) and lasts for two months.

When submitting SPAP Special Enrollment Period (SEP) enrollment requests, verifying the accuracy of the qualifying event date is crucial. This allows Highmark to confirm the client's eligibility period and avoid potential processing delays.

To ensure efficient Medicare SEP enrollments, please remember to use the SEP Quick Reference Guide. This is a helpful tool for navigating SEP requirements.

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Changes to MA, D-SNP, and Medigap Application Submission Process Beginning August 1, 2025

Please be advised of an important update regarding the submission process for Medicare Advantage (MA), Dual Eligible Special Needs Plan (D-SNP), and Medigap applications. Highmark is transitioning to a fully digital submission process to improve efficiency, accuracy, and tracking for all parties involved.

For applications submitted on August 1, 2025 or later, commissions will no longer be paid for MA, D-SNP, and Medigap applications received via fax.

To ensure you continue to receive timely and accurate commission payments, Highmark requires all applications to be submitted through their secure online portals or other approved portals:

• Medicare Advantage and Medigap - Producer Portal: Access the Producer Portal here: producer.highmark.com
• Highmark Wholecare (PA D-SNP) - Cavulus: Using your Chrome browser, access Cavulus for Highmark Wholecare by Clicking Here
• Highmark Blue Cross Blue Shield Delaware D-SNP - Cavulus: Using your Chrome browser, log into the Producer Portal (producer.highmark.com), select D-SNP Line of Business, and click the Enroll button. This will redirect you to Cavulus.

If you do not have access to these online portals, please contact your Channel Sales Representative or Sales Support for immediate assistance.

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