Compare Highmark Medicare Advantage Plans 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

The first step in comparing Highmark Medicare Advantage plans for 2027 is picking between Freedom Blue PPO and Community Blue Medicare HMO, followed by weighing premiums, out-of-pocket limits, drug costs and networks, and looking at UPMC if you are in western Pennsylvania.

Highmark is the Blue Cross Blue Shield company serving Pennsylvania, Delaware, West Virginia and parts of New York. The main difference between its two primary Medicare Advantage lines is how flexible the network is.

See Highmark Medicare Advantage plans.

✔ Licensed across all 50 states
✔ Built on CMS 2027 data
✔ No-cost plan comparison

Key Highlights

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Out-of-network care is covered by Freedom Blue PPO at a higher cost.

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Community Blue Medicare HMO generally costs less, but you must use in-network care.

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In western Pennsylvania, weigh Highmark against UPMC.

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Nationally, the average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

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The Annual Enrollment Period is October 15 to December 7, 2026.

Compare plans and enroll online

Freedom Blue PPO vs Community Blue HMO

Freedom Blue PPO

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Out-of-network coverage

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Usually no referrals

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Higher costs

Community Blue Medicare HMO

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In-network care

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Usually lower costs

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PCP coordinates care

Benefits Highmark Plans May Offer

Highmark Plans May Include

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Hospital and medical coverage matching Original Medicare Part A and B

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Part D prescription drug coverage on most plans

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Routine dental, vision and hearing benefits

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Fitness programs and over-the-counter allowances

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Telehealth visits and care coordination programs

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A yearly out-of-pocket maximum on every plan

Benefits are not offered by every plan. They differ by plan and county and may change for 2027. Review the Evidence of Coverage for each plan before enrolling.

Benefits Offered by Highmark Medicare Advantage Plans

What Changed for 2027

Key Takeaway

Each year, Highmark makes changes to its plans. Review your Annual Notice of Change.

Keep an eye out: a non-renewal letter will arrive if your plan is ending. You stay covered through December 31, 2026. Taking no action sends you back to Original Medicare with no drug coverage.

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

Comparison Worksheet

Factor	Freedom Blue PPO	Community Blue HMO	UPMC or Other
Premium
Out-of-pocket maximum
Specialist copay
Your doctors in network?
Drug costs

Fill in each plan’s numbers for your county.

Highmark vs UPMC

Highmark is linked to Allegheny Health Network in western Pennsylvania, while UPMC Health Plan is linked to UPMC. Which one fits usually depends on your doctors’ health system.

Part D Plans and Prescription Coverage Within Advantage Plans

How Medicare Advantage Works

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

In return, Highmark plans generally rely on networks of doctors and hospitals, and some services may need referrals or prior authorization. Unlike Original Medicare, every Medicare Advantage plan sets a yearly out-of-pocket maximum for covered medical care. You continue to pay your Part B premium, along with your plan’s premium if there is one.

Feature	HMO	PPO
Out-of-network care	Not covered except emergencies and urgent care	Covered at a higher cost
Referrals for specialists	Usually required	Usually not required
Premiums	Usually lower	Usually higher
Out-of-pocket maximum	In-network limit	In-network limit plus a higher combined limit
Best for	Lower costs, local care	Flexibility, travel, keeping specific doctors

Pros and Cons of Medicare Advantage

Advantages

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Often a low or $0 premium

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A yearly out-of-pocket maximum

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Drug coverage usually included

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Dental, vision and hearing benefits may be included in many plans

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One card and one plan

Tradeoffs

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Networks; except for emergencies, HMOs require in-network care

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Prior authorization and referrals are common

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Copays add up if you use a lot of care

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Plans and networks can change every year

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Moving to Medigap later may involve health questions

Highmark Drug Coverage for 2027

Part D drug coverage is included in most Highmark Medicare Advantage plans. Every plan has its own formulary, drug tiers and pharmacy network, and costs are often lower at preferred pharmacies and through mail order. In 2027, a plan’s Part D deductible can be as high as $700, and out-of-pocket costs for covered drugs are capped at $2,400.

Tier	Typical Drugs	Typical Cost
Tier 1	Preferred generics	Lowest copay
Tier 2	Generics	Low copay
Tier 3	Preferred brand-name drugs	Moderate copay
Tier 4	Non-preferred drugs	Higher copay or coinsurance
Tier 5	Specialty drugs	Highest coinsurance

Each plan sets its own tiers. Review every plan’s formulary.

A drug you take may not be on a plan’s 2027 formulary, or it may come with a rule such as prior authorization. Even then, you have options:

If Your Drug Is Not Covered

Request a transition fill. During the first 90 days of a new plan or plan year, plans generally have to provide a temporary supply of a drug you already take, giving you time to change drugs or ask for an exception.

Talk to your doctor about other options. A covered drug from the same class could work just as well for less money.

Ask for a tiering or formulary exception. Your doctor sends a statement explaining why you need the drug or a lower copay. Plans have to decide within set time limits.

Challenge a denial. When the plan turns you down, you have the right to appeal through several levels of review.

See steps to appeal a Medicare Part D denial.

If Your Plan Is Ending

A non-renewal notice should have reached you in early October if your Highmark plan is not being offered in your county for 2027. You do not lose coverage immediately; it lasts through December 31, 2026, which gives you time to decide.

If Your Plan Is Ending

Review your non-renewal letter. It verifies that your plan is ending and lays out your choices.

Write down your doctors and drugs. Comparing replacement plans requires them.

Compare your 2027 plan choices. Look at networks, drug coverage and the out-of-pocket maximum, not only the premium.

Pick a plan by December 31 to avoid a gap. If you enroll during Annual Enrollment by December 7, your coverage starts January 1, 2027.

Rely on your Special Enrollment Period if necessary. If your plan is ending, you generally have until the end of February 2027 to make a choice.

If you take no action: on January 1, 2027, you go back to Original Medicare, and you will have no drug coverage unless you pick a Part D plan. Being without drug coverage may result in a late enrollment penalty.

Medigap rights: if your Medicare Advantage plan exits your area, you generally get a guaranteed issue right, lasting up to 63 days after your coverage ends, to purchase certain Medicare Supplement plans with no health questions.

How to Compare Highmark Plans for 2027

How to Compare

Review your Annual Notice of Change. It spells out every 2027 change to the plan you have now.

Verify your doctors and hospitals. Make sure every provider is in the 2027 network, not only the 2026 network.

Review your prescriptions. Verify every drug, the tier it falls on and any step therapy or prior authorization rules.

Look at the full annual cost. Total up the premium, usual copays and drug costs, and review the out-of-pocket maximum.

Look at star ratings. Medicare scores plans on quality and service using a 1 to 5 star scale.

Sign up by December 7. Coverage under your new plan begins January 1, 2027.

2027 Enrollment Dates

Enrollment Period	Dates	What You Can Do
Annual Enrollment Period	October 15 to December 7, 2026	Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment	January 1 to March 31, 2027	In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period	7 months around your 65th birthday month	Sign up for Medicare and choose your first plan
Special Enrollment Periods	Varies	Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Special Needs Plans

Special Needs Plans (SNPs) are Medicare Advantage plans designed for particular groups. Their benefits, networks and drug lists are shaped around the members they serve, and many come with care coordinators. In 2027, SNPs are one of the few places large insurers are adding plans, even while cutting PPOs.

Type	Who Qualifies	What Is Different
Dual Special Needs Plan (D-SNP)	People with both Medicare and Medicaid	Coordinates both programs; costs are often very low, with extra benefits
Chronic Condition SNP (C-SNP)	People who have qualifying conditions like diabetes, heart failure or chronic lung disease	Doctors, drugs and programs designed around the condition
Institutional SNP (I-SNP)	People who live in a nursing home or need that level of care at home	Care delivered where the member lives

Turning 65 in 2027

When you turn 65 in 2027, you get a seven-month Initial Enrollment Period: the three months before your birthday month, the birthday month itself and the three months that follow. If you sign up in the first three months, coverage begins on the first day of your birthday month.

Turning 65 Checklist

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Enroll in Part A and Part B, unless you have qualifying employer coverage and decide to postpone Part B

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Choose between Medicare Advantage and Original Medicare plus Medigap

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Enroll in a drug plan, or a Medicare Advantage plan that includes drugs, to avoid a late Part D penalty

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If you go with Medigap, purchase during your six-month Medigap Open Enrollment Period

Star Ratings

Each fall, Medicare gives every Medicare Advantage and Part D plan a rating of 1 to 5 stars, based on factors such as preventive care, how well chronic conditions are managed, member complaints, customer service and accuracy of drug pricing. You can see the ratings in Medicare Plan Finder.

Using Star Ratings

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Ratings of 4 stars or more are generally a good indicator of quality and service

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A special enrollment period lets you move into a five-star plan once during the year

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A new plan may not have a rating yet, and that alone isn’t a bad sign

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Ratings reflect the plan as a whole, not how well it covers your particular doctors and drugs

Medicare Advantage or Medigap?

	Medicare Advantage	Original Medicare + Medigap
Monthly premium	Often low or $0 (2027 average $12, CMS)	Higher; varies by plan letter, age and ZIP
Doctors	Usually a network	Any provider in the U.S. that accepts Medicare
Costs when you get care	Copays and coinsurance up to a yearly maximum	Low and predictable; on Plan G, little or nothing once the Part B deductible is met
Drug coverage	Usually included	Add a separate Part D plan
Dental, vision, hearing	Many plans may include some coverage	Not included
Changing later	Every year during Annual Enrollment	Health questions in most states once your Medigap Open Enrollment Period ends

Guaranteed issue: when your Medicare Advantage plan exits your area, you can generally purchase certain Medicare Supplement plans with no health questions asked, up until 63 days after that coverage ends.

Help Paying Medicare Costs

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Medicare Savings Programs

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Run by your state Medicaid office

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May cover your Part B premium, and in some cases deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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Those enrolled in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Reading Your Annual Notice of Change

Check Every Line

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Your 2027 premium and deductible

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Doctor, specialist and hospital stay copays

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The out-of-pocket maximum

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Changes to your drug list, tiers and coverage rules

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Whether your doctors, hospitals and pharmacy stay in network

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Updates to dental, vision, hearing and other extras

The Annual Notice of Change must reach members by September 30. It is the most useful single document you receive each fall, since it spells out exactly how your plan will change on January 1.

Special Enrollment Periods

Outside of the fall and early-year windows, changing plans generally requires a Special Enrollment Period. Typical reasons include:

You May Qualify If

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Your plan is leaving your area or ending

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You move outside your plan’s service area

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You lose employer or union coverage

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Your Medicaid status changes, or you qualify for a Medicare Savings Program or Extra Help

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You want to join a 5-star plan, once a year

Every Special Enrollment Period has a separate time limit, so move as soon as the event occurs.

Getting Help

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Free Help Comparing Plans

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Available any time: Medicare Plan Finder on Medicare.gov

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1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

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Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

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A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Bottom Line

The Bottom Line

Line up Highmark’s PPO and HMO against each other, then against UPMC and national insurers, and sign up during Annual Enrollment, October 15 to December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ How do I compare Highmark plans?

First decide whether you want a PPO or an HMO, then compare premium, out-of-pocket maximum, copays, drug coverage and network. Confirm your doctors and hospitals participate, since Highmark’s networks vary by region. Finally, look at extras the plan may include, such as dental or vision.

➤ What is Freedom Blue?

Freedom Blue is Highmark’s Medicare Advantage PPO line. PPOs let you see out-of-network providers at a higher cost and usually do not require referrals, which can help if your doctors are spread across health systems.

➤ What is Community Blue?

Community Blue is Highmark’s Medicare Advantage HMO line. HMOs generally require you to use network providers for non-emergency care, often in exchange for lower costs. Before enrolling, check that your primary care doctor, specialists and preferred hospital all participate in the plan’s network.

➤ Highmark or UPMC?

It depends on which health system your doctors belong to. Highmark and UPMC networks differ in parts of Pennsylvania, so choose the plan that includes your doctors and hospitals, then compare costs and drug coverage.

➤ Is Highmark leaving Medicare Advantage?

We found no report of Highmark exiting Medicare Advantage for 2027. Plan details can still change each year, so read your Annual Notice of Change for any premium, copay or network changes. If something no longer fits, you can switch during Annual Enrollment.

➤ When can I enroll in a Highmark Medicare Advantage plan for 2027?

You can enroll in a Highmark plan during Annual Enrollment, October 15 to December 7, 2026, with coverage starting January 1, 2027. If you are already in Medicare Advantage, you can make one change from January 1 to March 31, 2027.

➤ What happens if my Medicare Advantage plan is ending?

Your insurer will send a non-renewal notice, and your coverage continues through December 31, 2026. You can choose another plan during Annual Enrollment or a Special Enrollment Period, and you generally have a guaranteed issue right to buy certain Medigap plans.

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

ZRN Health & Financial Services, LLC, a Texas limited liability company

Russell Noga( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.

that cover doctors & Rx drugs

1-833-641-4938 TTY 711

Compare Highmark Medicare Advantage Plans 2027

Key Highlights

Compare plans and enroll online

Freedom Blue PPO vs Community Blue HMO

Benefits Highmark Plans May Offer

What Changed for 2027

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

Comparison Worksheet

Highmark vs UPMC

How Medicare Advantage Works

Pros and Cons of Medicare Advantage

Highmark Drug Coverage for 2027

If Your Plan Is Ending

How to Compare Highmark Plans for 2027

2027 Enrollment Dates

Special Needs Plans

Turning 65 in 2027

Star Ratings

Medicare Advantage or Medigap?

Help Paying Medicare Costs

Reading Your Annual Notice of Change

Special Enrollment Periods

Getting Help

Bottom Line

Compare plans and enroll online

Frequently Asked Questions

➤ How do I compare Highmark plans?

➤ What is Freedom Blue?

➤ What is Community Blue?

➤ Highmark or UPMC?

➤ Is Highmark leaving Medicare Advantage?

➤ When can I enroll in a Highmark Medicare Advantage plan for 2027?

➤ What happens if my Medicare Advantage plan is ending?

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET