Privacy Policy

Policy Protecting Competitively Sensitive Information (PDF)

This Online Privacy Statement discloses the practices of Highmark Health Options regarding information gathering and disclosure from the Highmark Health Options website.

1. Collection of Information from Website Visitors – Highmark Health Options may collect information regarding its website visitors and the computers they use, such as email addresses, files downloaded, home server domain names, type of computer, search engine, operating system and web browser. HHO may also collect information the visitor submits online when the visitor completes forms or surveys, sends emails, or enters other data into website fields. In the event an email is addressed to specific HHO staff or is sent using the “Contact Us” portion of this website, Highmark Health Options may retain the message for up to one year. HHO uses information and discloses it to third parties as permitted by law and to the least extent necessary.

Highmark Health Options’s website and certain link sites use cookies to facilitate navigation. A cookie is a small piece of information about an Internet session that may be created when a person accesses a website. Cookies may contain a variety of information including the name of the website that issued them, what parts of the website the user accessed, passwords and user’s name. Most web browsers can be modified by users to prevent cookies from being attached.

2. Use of Personal Data Collected – Personal data collected by Highmark Health Options may be used by HHO for many reasons, including analysis of how and when the website gets visited, for development of Highmark Health Options services or for changes in the content and appearance of this website. Aggregate data on visitors' home servers may be used for internal purposes or provided to third parties. Individually identifying information, such as names, postal and email addresses, phone numbers and other personal information that visitors voluntarily provide to Highmark Health Options may be added to Highmark Health Options's databases and/or used for future calls and mailings regarding website updates, new products and services, upcoming events, and for other purposes that comply with federal and state law.

Highmark Health Options may contact website visitors regarding membership issues, including specific issues affecting a member and general issues affecting groups of members, for example, changes to the Member Handbook, privacy statement, business practices or Highmark Health Options policies.

3. Disclosure of Personal Data to Third Parties – Highmark Health Options does not sell its member lists. Unless otherwise authorized by a visitor or validly requested by governmental authorities or legal process, Highmark Health Options does not distribute its members’ specific information to outside persons or firms unless a disclosure is needed for the member’s care, payment of members’ claims, or the necessary operations of the health plan.

Highmark Health Options may disclose to its affiliates and service providers that assist in meeting the needs of Highmark Health Options member’s personal information of users that has been collected through its website, as permitted by law. Information collected by Highmark Health Options affiliates and service providers may also be shared with Highmark Health Options as permitted by law. Information disclosed by users online may be re-disclosed if needed to respond to the user’s requests and inquiries. Highmark Health Options affiliates and service providers are required to follow no less than the privacy and confidentiality standards of law.

4. Links to Other Websites – While Highmark Health Options may provide links to other websites, a link on the Highmark Health Options website is not and should not be construed as an endorsement of the content, viewpoint, policies, products or services provided or advertised on the linked site. Website visitors linking to other sites receive messages about leaving the Highmark Health Options website. Once a visitor leaves the Highmark Health Options website by linking to a site not maintained by Highmark Health Options, the visitor should become familiar with the online privacy statement of the linked website before accessing or supplying information.

5. Security Measures – Although Highmark Health Options makes reasonable efforts to protect user information from unauthorized use or alteration, users should be aware that there is always some risk in sending information over the Internet. Highmark Health Options uses commercially reasonable security features; however, the confidentiality of any communication or material transmitted to/from the Highmark Health Options website or email cannot be guaranteed. Highmark Health Options only grants access to personal information to those employees, affiliates, service providers, and other third parties as required by law, as required to provide health care products and services or as the user permits.

For private health matters, members of Highmark Health Options or their authorized representatives are encouraged to contact Highmark Health Options by telephone at the number listed on the member identification cards.

6. Correction of Personal Data Collected Online – Highmark Health Options will provide website visitors with a summary of their personally identifiable information retained by Highmark Health Options from online sessions, upon request by mail, email or phone. Website visitors may modify, correct, change or update personally identifiable information that Highmark Health Options has collected online by contacting Highmark Health Options via regular mail, email or telephone.

7. Collection of Personal Data from Minors – To the extent that Highmark Health Options is able to determine the age of website visitors by their submissions to or communications with Highmark Health Options, Highmark Health Options will not knowingly collect or post information from individuals under age 18 without consent of a parent or guardian.

If registration is required on the Highmark Health Options website for offered services and a visitor submits information through the website that indicates the visitor is a minor, the minor's parent or guardian will be contacted regarding the registration. If the parent or guardian agrees, the registration processing will continue. If the parent or guardian indicates a desire to withdraw the registration, Highmark Health Options will provide instructions to the parent or guardian for deletion of the registration. No information collected through the Highmark Health Options website from users self-identified as minors will be used knowingly for any direct marketing or promotional purposes.

8. Compliance Program – The Highmark Health Options Compliance Program regarding privacy and security of user information includes oversight of privacy practices, training of employees and maintenance and updates to security systems. Highmark Health Options will investigate privacy and security complaints through its Compliance Officer or Security Officer.

9. Changes to this Privacy Statement – This online Privacy Statement is subject to change at any time and should be reviewed by interested website visitors periodically. Questions or concerns regarding use of online information may be directed to Highmark Health Options by clicking Contact or from the footer of any Highmark Health Options web page.

Highmark Health Options Health Personal and Health Privacy

THIS NOTICE DESCRIBES HOW HEALTH AND FINANCIAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Highmark Health Options is required by law to protect the privacy of your health information and non-public personal (financial) information. This protection extends to all forms of communication (oral, written, and electronic) of this information. Also, Highmark Health Options is required to give you this notice about how it uses or shares (“discloses”) your health and personal (“nonpublic”) information. We are required to notify you if you are affected by a breach of unsecured health information.

To provide services to you, Highmark Health Options will share your health information with:

• You or someone who acts for you.
• Doctors and health care providers who care for you.
• Our contracted vendors who help us provide services to you (such as member services support and pharmacy benefit management).
• Other government programs such as Medicare and Medicaid to manage your benefits and payments.
• State and federal agencies that have the legal right to receive such data.
• The U.S. Secretary of the Department of Health and Human Services, if necessary, to make sure your privacy is protected.

Highmark Health Options will use your health information to:

• Coordinate and manage your care.
• Determine your eligibility for your plan benefits.
• Pay for your health care.
• Contact you about new or changed benefits.
• Contact you for appointment reminders, medication management, or disease management programs and alternative treatments that may interest you.
• Check the quality of our services and make improvements where required.
• Conduct or arrange for medical reviews, audits, or legal services, including fraud and abuse detection and compliance programs.
• Plan and carry out our business activities, management and general administration.
• Give you information about health-related benefits and services that may be of interest to you.

Highmark Health Options may also use or share your health information:

• For public health activities (such as reporting disease outbreaks; child abuse and neglect; reporting domestic violence; preventing or controlling disease, injury or disability).
• For government health care oversight activities (such as fraud investigations, audits, and activities related to oversight of the health care system).
• For judicial and administrative proceedings (such as in response to a court order).
• For law enforcement purposes or when required by law, for example, locating a suspect, fugitive, material witness or missing person; complying with a court order or subpoena; and other law enforcement purposes.
• For purposes of national security.
• To comply with worker’s compensation or similar laws.
• For research studies that meet all privacy law requirements such as research related to the prevention of disease or disability.
• To avoid a serious and likely threat to health or safety.
• To create a collection of information that can no longer be traced back to you.
• To group health plans, to coordinate plans and to permit the plan to administer benefits.
• To coroners, medical examiners, funeral directors, and organ donations.
• To your school when proof of immunization is required by law.
• To others involved in your health care (if you are not present or able to agree to these disclosures of your health information, we may use our professional judgment to determine whether the disclosure is in your best interest).
• For underwriting purposes if needed, however, we are not allowed to use or share your genetic information to decide whether coverage can be given or at what price.

Marketing 

If we receive compensation from another company for providing you with information about other products or services (other than drug refill reminders or generic drug availability), we will obtain your authorization to share information with this other company. 

Sharing information for other purposes

Highmark Health Options must have your written permission (an “authorization”) to use or give out your health and claims information for any purpose that is not listed in this notice.  Giving us permission to use or give out your health and claims information will not be a condition for getting health care and will not be used to determine your eligibility for enrollment or benefits, or for paying claims. You may take back (“revoke”) your written permission at any time, except if Highmark Health Options already took action based on your permission. 

Some examples of when we need your permission to use or give out your information are:

• For fundraising
• For selling your protected health information (PHI)

You have the right to:

Get a copy of your health and claims information.
You can ask to see or get a copy of your health or claims records and other health information we have about you. We will provide a copy or a summary of your health or claims records within 10 calendar days of your request.

Ask us to correct health and claims records.
You can ask us to change your health and claims records if you feel they are incorrect or incomplete. We may say “no” to your request but we’ll tell you why in writing within 60 days. If Highmark Health Options cannot change your records, you may have a statement of your disagreement added to your personal medical information.

Get a list of those with whom we’ve shared information.
You can ask for a list (called “an accounting”) of the times we’ve shared your health information within the last six years. You must tell Highmark Health Options the dates for which you are requesting the list. The list will not cover information that was given to you or your personal representative, or information given for health care payments, for Highmark Health Options business operations, or for law enforcement needs.

Request confidential communications.
You can ask us to contact you in a specific way, for example, on a home or office phone or to a different address. We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.

Ask us to limit what we use or share.
You can ask us not to share certain health information for treatment, payment or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.

Choose someone to act for you.
If you have given someone medical power of attorney, or if someone is your legal guardian, that person can act for you and make choices about your health information. We will make sure the person has this authority before we take any action.

Get a copy of this privacy notice.
Contact us for a separate paper copy or email copy of this Notice.

What is the nonpublic information that Highmark Health Options collects and shares about you?

• It is personal information but is non-medical, for example, the information you completed on your enrollment application that identifies who you are and how you can be contacted.
• Also, it is information collected for a request for services by you or your doctor.
• Also, it is information collected to answer a question or concern from you.
• With whom does Highmark Health Options share your non-public information?
• With health care providers, for example, physicians, hospitals, long term care agencies, durable medical equipment providers, and pharmacies.
• With those who plan your benefits and your care, for example, for utilization reviews; external reviews; and case management.

How does Highmark Health Options protect your nonpublic information?

• Highmark Health Options does not make your nonpublic information available to anyone other than those necessary to provide medical or health plan services to you.
• Highmark Health Options does not give out your nonpublic information, except if required or permitted by law.
• Highmark Health Options does not give out your nonpublic information to anyone unrelated to providing your care under the health plan unless you or your representative gives permission.
• You have the right to give or withhold permission for other uses or disclosures of this information, except as required by law.

Questions and Complaints

If you have a question about this notice or believe Highmark Health Options has violated your privacy rights as stated in this notice, you can file a complaint by contacting:

Privacy Office
Highmark Health Options West Virginia
614 Market Street
Parkersburg, WV 26101

For more information on filing a complaint or your rights stated in this notice, call Member Services at 1-833-957-0020 (TTY/TDD users: 711).

Filing a complaint will not affect your benefits. Translations services are available at no cost to you.

You may also file a complaint with the U.S. Secretary of the Department of Health and Human Services:

For more information, visit the "Notice of Privacy Practices" page on the HHS website.

Change to the terms of this notice
Highmark Health Options is required to follow the terms in this privacy notice. Highmark Health Options has the right to change the way your medical information is used and given out and to apply those changes to all the information we maintain about you. If Highmark Health Options makes any material changes they will be posted on our website, and you will be notified within 60 days of the change.

These privacy practices were revised Jan. 1, 2024.