Health Plan - Highmark Delaware
Centers of Excellence (COE) – Spine
Highmark Blue Distinction Specialty Care Benefits
COE Facilities in Delaware and Surrounding Area
Providers with COE Admitting Privileges
Note: Highmark refers to COE facilities as Blue Distinction Centers.
The following services are covered under the State of Delaware Group Health Insurance Program (GHIP). Costs noted are for an inpatient stay.
Highmark Delaware Comprehensive PPO Plan
Note: Requires a prior authorization
| Type of Procedure | Site of Care | Your Cost Per Visit |
|---|---|---|
| Spine (i.e., Cervical and lumbar fusion, cervical laminectomy, and lumbar laminectomy / discectomy procedures) |
COE Facility (Preferred) |
$100 copay per day; $200 copay max per admission |
| Spine (i.e., Cervical and lumbar fusion, cervical laminectomy, and lumbar laminectomy / discectomy procedures) |
Non-COE Facility | $500 copay per admission |
Highmark Delaware First State Basic Plan
Note: Requires a prior authorization
| Type of Procedure | Site of Care | Your Cost Per Visit |
|---|---|---|
| Spine (i.e., Cervical and lumbar fusion, cervical laminectomy, and lumbar laminectomy / discectomy procedures) |
COE Facility (Preferred) |
10% coinsurance (after plan year deductible is met) |
| Spine (i.e., Cervical and lumbar fusion, cervical laminectomy, and lumbar laminectomy / discectomy procedures) |
Non-COE Facility | 10% coinsurance (after plan year deductible is met) |
Note: Aetna refers to COE facilities as Institutes of Quality and Institutes of Excellence.
Frequently Asked Questions (FAQs)