Highmark Reviews

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About Highmark

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Highmark offers health insurance and related services, including individual, family, Medicare and employer-sponsored plans. Founded in 1977, the company operates primarily in Pennsylvania, West Virginia and Delaware. Highmark combines health care coverage with wellness programs and member support resources to enhance health care access and quality.

Pros
  • Friendly customer service
  • Comprehensive coverage options
  • Affordable premiums
Cons
  • High out-of-pocket costs
  • Poor communication from reps
  • Frequent claim denials

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Highmark Reviews

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    How do I know I can trust these reviews about Highmark?
    • 4,697,285 reviews on ConsumerAffairs are verified.
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    • We use intelligent software that helps us maintain the integrity of reviews.
    • Our moderators read all reviews to verify quality and helpfulness.
    Page 1 Reviews 0 - 10
    CoveragePrice

    Reviewed July 7, 2025

    So Highmark in its infinite wisdom has dropped weight loss meds from coverage. Why? Cost. Plain and simple. They chose a blanket answer to a problem that is dealt with individually every month when you have to contact your physician to get it refilled. They document your weight, BP and side effects. I am sure there are people who aren't using it as prescribed but that falls back on the individual case to deny not block everyone. I hope someone sues the daylights out of them and it's a class action one that costs them millions.

    To give you an example (mine) along with the weight loss, it has eliminated sleep apnea (supplies were roughly $350 a month (paid by insurance) plus the discomfort of just dealing with the machine in general and a specialist that I had to see a couple times a year), lowered my cholesterol (eliminated a med) and bp (eliminated another med), mitigated my arthritis to the point that if it does bother me I can take 2 ** (vs a shot every week that was very expensive @ $5k a month billed to insurance and a rheumatologist that I saw a few times a year along with the blood work, and x-rays they would order at almost every appt). BUT Highmark you know what is best for consumers right??

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    Customer ServiceCoverageStaff

    Reviewed June 19, 2025

    I am dealing with retiree benefits. The segment of the company I deal with has no email or website. I have to call or mail everything. They are waiting for this small group of customers to die-they simply do not care AT ALL if you get any help or ever get paid. I hate this company with every ounce of my being. DO NOT use this insurance if you EVER want even a mediocre experience. ABSOLUTELY AWFUL. 0/10. When the class action lawsuit gets filed, I hope I get a call from an attorney.

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      Customer ServiceCoverage

      Reviewed June 12, 2025

      Husband's work switched from UPMC which never had a problem with, never ever had to call customer service all around no worries. Well they switched to this insurance and all I got to say is I and others are demanding we go back to UPMC for we are the ones paying!

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      CoveragePrice

      Reviewed June 4, 2025

      If I could give Highmark negative stars, I would. Their handling of weight loss medication coverage is not only disheartening but downright unethical. I was approved for weight loss medication when I was considered “morbidly obese,” and with the help of that medication, dedication, and support from my doctor, I was able to drop into the “obese” category. You’d think this would be a success story. But instead of supporting continued progress, Highmark decided I wasn’t “fat enough” to keep the medication covered. Yes, you read that right—still obese, still at-risk, still under medical care—but not fat enough anymore.

      Let’s be real: Highmark doesn’t care about long-term health. They care about cutting costs, even if it means putting people’s lives and well-being at risk. Their decision completely ignored my doctor’s professional recommendation to continue the medication. We’re not talking about cosmetic weight loss—we’re talking about managing a chronic health condition that impacts joints, heart health, mental well-being, and more. And Highmark thinks they know better than a board-certified physician?

      To add insult to injury, the logic is completely backwards. If someone with high blood pressure lowers it with medication, do we take them off the meds and wait until their blood pressure gets dangerously high again? Of course not. But Highmark seems to think weight loss is different. Apparently, they’d rather you balloon back up, suffer more, and maybe rack up more expensive treatments down the road, just so you can maybe qualify again.

      This isn’t just a policy failure—it’s cruelty disguised as “criteria.” It’s a blatant disregard for people trying to better their health. Cutting off support mid-journey, when it’s clearly still needed, isn’t just unfair—it’s dangerous. Highmark should not have the authority to override a doctor’s orders, and they certainly shouldn’t play games with people’s health because they don’t meet a specific number on a chart anymore. Shame on you, Highmark. You’ve made it clear you care more about saving money than saving lives.

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      Customer ServiceStaff

      Reviewed April 30, 2025

      Had two calls this morning from two different Matrix reps trying to schedule in home appointment and saying that Sunday May 11th which is Mother’s Day was their only available time. They were quite pushy! Of course we said no. As an aside, I just lost my mother. Not impressed with this group!

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      Customer ServicePriceStaff

      Reviewed April 3, 2025

      I am in a financial bind because of information that multiple representatives at Highmark Medicare and or Express Scripts regarding my medications. Before I committed to an additional recommended drug in January, I contacted Express Scripts (mail order co. for Highmark) who handles the pharmacy claims etc. to discuss the new $2000. out of pocket for Medicare members in 2025. I repeatedly called and spoke to reps or supervisors confirming each time what I had been told. Based upon what one supervisor told me in January that the total included what I paid for a covered drug and what my part D plan paid. He directed me to

      Summary of Benefits online and this is what was listed for my area plan: Community Blue Medicare PPO (2 different plans). You pay the following until your total yearly drug costs reach $2,000. Total yearly drug costs are the total drug costs paid by both you and your Part D plan. I then confirmed at least 2 more times this was true with Highmark/Express scripts reps. Now, in March when my out of pocket should be satisfied, I am getting a whole new answer. I have 3 explanation of benefits which show the total cost was applied to the out of pocket and the Benefit Summary as I posted above. This was for the first 3 claims of the 2025 year.

      I wrote a letter to the President of the company and was passed to his "team". Although his one team member listened to the calls I had made in Jan and Feb and agreed I was totally misquoted by several representatives I have not been offered assistance. No resolution is forthcoming helping me now to pay for this new expensive drug.

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      Customer ServiceOnline & AppReliability

      Reviewed March 24, 2025

      In my 23 years of adult life, I have never had such horrifically bad service from ANY company. Their website works randomly or not at all, and when I can actually get to their login screen my login creds never work. I try to reset the password using the info they request, member ID #, first name and birthdate and the site tells me it's wrong. I spend 45 minutes on the phone with someone who gives me a temp password, which works, then I create a new one, which then doesn't work. Rinse and repeat this scenario over and over again. I can access my claims, benefit info or search for covered doctors or services. I can't wait until next year when I can switch from this god-awful insurance company.

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      Customer ServiceCoverage

      Reviewed March 13, 2025

      They "accidentally" dropped our renewal in Jan 2024 despite being active on Jan 1 and COBRA being paid. They had to reinstate. Then in Feb of 2025 while COBRA was still active, they somehow expired both myself and husband. Then after being denied an MRI on Mar 2 due to "coverage expired", I spent over 6 hours March 3 on on the phone getting it reinstated only to find out they forgot to reinstate Rx as well. Had to call back.

      Then on March 13th my husband went for an appt and was told he wasn't covered. Highmark only reinstated me despite COBRA sending a letter confirming we were both on the plan. Have spent another 5 hours on the phone with them and COBRA which they asked for the letters to be sent yet again. So Highmark gets paid from COBRA for the policy I'm paying full price for and they continually drop our coverage for no reason and ask everyone else to call and COBRA to resend letters again. WORST CUSTOMER SERVICE! Stay away!

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      Coverage

      Reviewed March 11, 2025

      Absolutely terrible! I was on Wegovy for 5 months, lost 20 lbs and my high blood pressure was under control and then they changed the criteria. Denied for Wegovy and Zepbound by a pediatric doctor that reviewed my case and I'm a disabled adult limited on how I can exercise. Why do they go against my doctor's advice on drugs that ARE covered? The premiums that I pay are absurd, but if I had Medicaid it wouldn't be an issue. They don't even deserve one star. I was on Wegovy for almost 6 months and they covered it but because I lost 20 lbs but I wasn't anorexic looking they won't cover it and my blood pressure is all messed up and they don't care.

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      Customer ServiceReliability

      Reviewed March 6, 2025

      Took 6 months and 5 or more phone calls and sitting on hold for 40 mins at a time to finally get refunded for health insurance payments I paid and then was told my insurance was cancelled. They refunded me $177 after I paid $290 that they need to fully refund. Now I try to login and I can’t access my login. Of course.

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      Highmark Company Information

      Company Name:
      Highmark
      Website:
      www.highmark.com