Page 2 hneded1000cpaySoB-0122sng Overall Member Cost Share Provisions Deductible The deductible is the cost you have to pay for certain HMO Blue New England $2,000 Deductible WITH COPAYMENT Plan-Year Deductible: $2,000/$4,000 Effective on anniversary dates on or after January 1, 2021 for Individuals and Small Groups UNLOCK THE POWER OF YOUR PLAN MyBlue gives you an instant snapshot of your plan: COVERAGE AND BENEFITS CLAIMS AND BALANCES DIGITAL ID CARD Sign in PDF Network Blue New England $500 Deductible - Smith College console.log('ad description 1 => ' + 'Get your plan in your hand. console.log('ad description 1 => ' + 'Questions about your plan? This chart shows the dollar amount of your deductible and the covered services for which you must first pay the deductible. You can visit in-network and out-of-network providers, but you'll pay lower out-of-pocket costs when you stay in-network for care. Blue New England Deductible HMO PLAN If you have any questions about the Network Blue New England Deductible plan, please call Member Service at 1-888-714-0189. Go to an urgent care center, such as CareWell', for conditions that require immediate treatment. A complete listing of the benefits, exclusions and limitations may be found in the Evidence of Coverage (EOC). PDF HMO Blue New England Options v - Blue Cross Blue Shield of Massachusetts Your Plan Details Understanding your plan is the best way to get the most value from it. endstream endobj startxref If the condition isnt life-threatening, you can: ER Alternatives Depending on how severe your medical concern is, the emergency room isn't always your best option. PDF HMO Blue New England $1,000 Deductible - Simmons University Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Health Maintenance Organization Subscriber Certificate HMO (1-1-2018) Page 1 hneoptdedIISoB-0119sng Schedule of Benefits HMO Blue New England Options Deductible II This is the Schedule of Benefits that is a part of your Subscriber Certificate. and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. 101 Huntington Avenue, Suite 1300, Boston, MA 02199-7611 | Yourdeductible is $1,000for each member (or $2,000per family).The following services are not subject to the deductible: ofcevisits, preventive health services, emergency room visits, homehealth care, hospice services, medical formulas, all mental healthservices, and prescription drugs. ea`3wxaVT/;J&2n] Syv/8m\AqQw,942u-qYI;Wet400 &nd@ZuA20-rY&=l8^2=:JA Z([F.C6cdXLt4~iAg#f[D1`csAAQ. Emergency CareWherever You Are. Your plan has more benefits than you probably realize. and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Were here to help. Its never been easier, faster, or more convenient to stay on top of your coverage. HMO Blue New England Deductible $1,000 HMO Blue New England Deductible $300 with HCCS HMO Blue Select Deductible $300 Blue Care Elect Deductible $300 with HCCS Ancillary Plans Blue 20/20 Print Email Medical Plans . HMO BLUE VALUE HMO PPO 90 Blue Care Elect Preferred 90 Copay (National HMO Blue New England Saver $3,000 Plan-Year Deductible: $3,000/$6,000 Effective on anniversary dates on or after January 1, 2022 for Individuals and Small Groups Your CARE Your Primary Care Provider (PCP) When you enroll in this health plan, you must choose a primary care provider. '); Emergency CareWherever You Are. Licensee of the Blue Cross and Blue Shield Association. A provider's benefits tier may change. After Hours Care If you need care and your doctors office is closed, you have options. HMO Blue New England $2,000 Deductible Gold NO HMO Blue New England $1,000 Deductible with Copayment Gold NO HMO Blue New England $2,000 Deductible with Copayment Silver NO HMO Blue New England $3,000 Deductible Silver NO HMO Blue New England $4,500 Deductible Silver NO . With Blue 20/20, you can save on eyeglasses, contacts, and routine eye exams. UNLOCK THE POWER OF YOUR PLAN MyBlue gives you an instant snapshot of your plan: Download the app, or create an account at bluecrossma.org. 7/1/2022, - The fitness and weight loss reimbursement has increased to $300 each, - The cost share for the first 3 certain outpatient behavioral health visits per member will be waived on some plans. PDF Summary of Benefits and Coverage: What this Plan Covers & What You Pay T ^hd sH``hyPz/lK@b!ZuA3tn ;)PJ20,1rZ Its never been easier, faster, or more convenient to stay on top of your coverage. PDF Schedule of Benefits - Blue Cross Blue Shield of Massachusetts Network Blue New England $500 Deductible with HCCS - Town of Chelmsford Find out how to get in touch with us. endstream endobj 702 0 obj <>/Metadata 130 0 R/Pages 699 0 R/StructTreeRoot 268 0 R/Type/Catalog/ViewerPreferences<>>> endobj 703 0 obj <. Tap into all of them, all in one place. VISIT MYBLUE Your Care Your Primary Care Provider (PCP) . This chart describes . Search for any medication, see what your plan covers, and find covered alternatives to non-covered medications. Plan Options - planinfo.bluecrossma.com hb```l1B Network Blue New England $500 Deductible Calendar-Year Deductible: $500/$1,000 Smith College. Find out how to get in touch with us. HMO Blue New England $1,500 Deductible WITH COPAYMENT Plan-Year Deductible: $1,500/$3,000 Effective on anniversary dates on or after January 1, 2023 for Individuals and Small Groups. PDF Network Blue New England $100 Deductible - Boston.gov fm3efjv=a; V7{V8 k2^L5\L3D0H0)=l`Lm&cbixx0t0104]z$!t\gjmpc!q2#$EXjaa Tap into all of them, all in one place. Registered Marks and TM Trademarks are the property of their '); , Effective: These plans allow members to use our network of doctors, or to receive covered services outside of the network. #ekitProgress {display:none;} MEDICATION LOOK UP Deductible: Max Out of Pocket Anthem (MTHP) Anthem Silver Access Blue New England HMO 3000 20 8500 : Silver Covered : Summary of Benefits Plan Brochure Provider Directory . HMO Blue New England $4500 Deductible with Dental Blue Pediatric Essential Benefits. 1. AETNA HEALTH INC. LARGE GROUP HEALTH MAINTENANCE ORGANIZATION - Mass.gov PDF Network Blue New EnglandSM Deductible - emiia.org View 2022Small Group, Large Group and Connector planbenefitsinformation for HMO & PPO plans regardingSummary of Benefits and Coverage, Explanation of Coverage, Benefit Summary. HMO Blue New England $1,000 Deductible WITH COINSURANCE Plan-Year Deductible: $1,000/$2,000 Benefits effective July 1, 2022 Simmons University. Questions about your plan? Your Out-of-Pocket Maximum Your out-of-pocket maximum is the most that you could pay during a plan year for deductible and copayments (including prescription drug copayments) for covered services. ["EAtTw 3V?"O;{M\`R;#cP "3? Dq This is the . Your providers may also $250. Schedule of Benefits (continued) HMO Blue New England $1,000 Deductible with Copayment This chart shows your cost share for covered services. 800-262-BLUE (2583), About Blue Cross Blue Shield of Massachusetts|Terms of Use, Privacy & Security|Accessibility|. Access Blue New England HMO 5000 0 8500 RxD Silver : Summary of Benefits Plan Brochure Provider Directory List of Covered Drugs I: $5,000 F: $10,000 I: $8500 F: $17000 Its never been easier, faster, or more convenient to stay on top of your coverage. Be PDF HMO Blue New England - Blue Cross Blue Shield of Massachusetts Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Page 1 of 8 . Questions about your plan? 5E$N&wW10? jV 1523 0 obj <>/Filter/FlateDecode/ID[<1C45D311D78F3E4A8BD558A0FAB29320><4177EA08369C534CA0C69314C0922286>]/Index[1496 47]/Info 1495 0 R/Length 123/Prev 362795/Root 1497 0 R/Size 1543/Type/XRef/W[1 3 1]>>stream 727 0 obj <>/Filter/FlateDecode/ID[<4F72F4E412A14546B94B0F8C50CF9B3E><9C3A752942DE364FBF2FDAD395BC52EA>]/Index[701 48]/Info 700 0 R/Length 130/Prev 624764/Root 702 0 R/Size 749/Type/XRef/W[1 3 1]>>stream Get exclusive discounts and deals on sportswear, nutrition, travel, fitness equipment, and more. Read the fact sheet. PDF HMO Blue New England $1000 Deductible - Blue Cross Blue Shield of Access additional tools to help you understand how your insurance works. Employers that have 51 employees and morecan view our 2023plan benefits information for HMO & PPO plans regarding Summary of Benefits and Coverage, Explanation of Coverage, Benefit Summary. ea(0`qSW*Lt(2C#O'=rMb_\._4 b-+=o.)uU;:F2p(A X)H4 trr@vD. '{6 |"%5:WnGST*yZb2*. 0 Blue Options - Blue Cross Blue Shield of Massachusetts From managed care plans to high deductible health plans and everything in between, Health New England offers a range of health care plans to meet your unique needs. UNDERSTANDING YOUR PLAN AND BENEFITS hbbd```b``"H^1"9H>[0"K/?Xv0Ly``,_DJH RH2*Az T5`]. '); SAVE WITH BLUE365 Services are provided through our extensive network of doctors and health care professionals in Western and Central Massachusetts, as well as parts of Connecticut and Vermont. You're covered for eligible services when you visit in-network providers. Find out how to get in touch with us. Doctors and Hospitals With an HMO plan, you must choose a primary care provider (PCP) who can help guide your care, and is the first person you call when you need routine or sick care. Get exclusive discounts and deals on sportswear, nutrition, travel, fitness equipment, and more. Preferred Blue PPO . hb```lB Members in this plan pay different levels of cost share (copayments, co-insurance, and deductibles) depending on the benefits tier of the provider furnishing the services. An Association of Independent Blue Cross and Blue Shield Plans HMO Blue New England $500 Deductible Summary of Bene ts Plan-Year Deductible: $500/$1,000 Effective on anniversary dates on or after January 1, 2009 This health plan meets Minimum Creditable Coverage Standards for Massachusetts residents that will be effective January 1, 2009, as 748 0 obj <>stream You will pay less if you use a provider in the plan's network. PDF Schedule of Benefits - Blue Cross Blue Shield of Massachusetts Printed at Blue Cross and Blue Shield of Massachusetts, Inc. 000433400 (4/20) CAD 910 0 obj <>stream Were here to help. console.log('ad description 1 => ' + 'Search for a doctor, health care professional, or medical facility near you. PDF HMO Blue New England $1000 Deductible - Blue Cross Blue Shield of With a PPO plan, youre covered when you see in-network and out-of-network providers. If you SUMMARY OF BENEFITS BCBSMA Employee Plan This health plan meets Minimum Creditable Coverage Standards for Massachusetts residents that went into effect January 1, 2014, as part of the Massachusetts Health Care Reform Law. PDF HMO Blue New England $500 Deductible - Blue Cross Blue Shield of Tap into all of them, all in one place. Youre one click away from finding the care you need. Lower premium costs The comprehensive coverage and easy to understand benefits of HMO Blue and/or PPO Blue plans Access to office visits, prescriptions, emergency room visits, and mental health care for a copayment, similar to other HMO Blue and/or PPO Blue Compare Medical Plans Have PPO Blue Options? PDF HMO Blue New England Deductible Deductible Your deductible is the amount you pay out-of-pocket before your insurance pays any of the costs for most services. 2962 0 obj <> endobj Visit a limited services clinic, such as CVS Minute Clinic, for simple medical concerns. There are currently three tiered provider networks called HMO Blue New England Options v.5 and Preferred Blue PPO Options v.5. Our Health Maintenance Organization (HMO) plans give you access to doctors and hospitals in our network. Hours of Operation: 8:00 a.m. - 5:00 p.m. B endstream endobj startxref To learn more about this plan and its costs, look at your Summary of Benefits. 701 0 obj <> endobj Your plan has more benefits than you probably realize. Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. hb```B ce`azZqhC->qiumvN6YFsyZMRB$2Np18e@GbKN/uRgWS^8+9Suv h Nlk@J"bX00\aReq2FlRl7eH'{7q5 e`UK vd* '); Employers that have 50 employees and undercan view our 2023plan benefitsinformation for HMO & PPO plans regardingSummary of Benefits and Coverage, Explanation of Coverage, Benefit Summary. 1542 0 obj <>stream Summary of Benefits and Coverage - Blue Cross Blue Shield of Massachusetts Care Management If youre worried about facing a complex or chronic health condition, our Team Blue Care Managers are here to provide extra support to all the moving parts of your care, at no additional cost. You pay lower out-of-pocket costs when you visit in-network doctors and hospitals than when you visit out-of-network, or non-preferred, providers. Member Services Hours: 8:00 a.m. - 6:00 p.m. Walk-In Hours: Due to COVID-19, we are not accepting walk-ins at this time. A provider's benefits tier may change. PDF HMO Blue New England $1,000 Deductible with copayment Be See www.anthem.com or call (800) 933-8415 for a list of network providers. Deductible Applies Not covered Costs may vary by site of service. Your Out-of-PocketMaximum. Your Care Your Primary Care Provider. console.log('ad description 1 => ' + 'Search for any medication, see what your plan covers, and find covered alternatives to non-covered medications. PDF HMO Blue New England $2,000 Deductible - Blue Cross Blue Shield of Blue Cross Blue Shield of Massachusetts is an Independent Schedule of Benefits. hb```+o@(HWYs14reYwPCk\\JZe]u|DNM'V] 2`0qjD[EdU8jL8,$@YT#HdPIqnU;4.{$lJ~N)b>n;ikXjx@"4h."YGT'`Vi :- n,3!ps,gWv{~iO?Z^|6EAID1 PDF HMO Blue New England Deductible %%EOF HMO Blue New England $3000 Deductible with HCCS with Dental Blue Pediatric Essential Benefits. PDF HMO Blue New England $1500 Deductible with Copayment Our plan comparisons are only brief summaries and not intended to describe all of the benefits or limitations of each plan. hbbd```b``^ "H $".H@ Lf}H 'D,m R>,;210120D+!-@ - GET THE MYBLUE APP We also offer Preferred Provider Organization (PPO) plans. Your Primary Care Provider (PCP) When you enroll in this health plan, you must choose a primary care . The PCP will also refer you to specialists for care when needed. If your employer does not offer health insurance and you are not affiliated with the Health Connector, we still might have a plan option for you. We have partnered with EyeMed to bring you more choice, more value, and more flexibility. $0.00 $ 1,000. member / $2,000 . Our Health Maintenance Organization (HMO) plans give you access to doctors and hospitals in our network. When you enroll in HMO Blue New England, you must choose primary care provider (PCP) for you and each member of your family from any New England state. HMO Blue New England Saver $2,000 Effective on anniversary dates on or after January 1, 2021 for Individuals and Small Groups. Referrals are required before you're covered to see a specialist. Plan-Year Deductible: $250/$750 This health plan option includes a tiered network feature called Hospital Choice Cost Sharing. %PDF-1.6 % Health New England offers a variety of plan options for your health care needs. After you meet your deductible, your plan will pay a percentage of the costs, and youll be responsible for the remaining portion. A deductible is the cost you may have to pay for certain covered services you receive during your annual coverage period before benefits are paid by the health plan. console.log('ad description 1 => ' + 'Get exclusive discounts and deals on sportswear, nutrition, travel, fitness equipment, and more. Your Plan Details Understanding your plan is the best way to get the most value from it. Qt.YH20(qE[8{} 0 heK VIEW EKIT PDF Access Blue New England Basic Saver - retailersma.org COVERAGE AND BENEFITS CLAIMS AND BALANCES DIGITAL ID CARD Sign in Download the app, or create an account at bluecrossma.org. Well Connection doctors can review your medical history, and diagnose, treat, and even prescribe medications for medical conditions if necessary. Your deductible is $3,300 per individual membership (or $6,550 per family membership).The entire family deductible must be satisfied before benefits are provided for any one member enrolled under a family membership. HMO Blue New England Options v.5 This health plan includes a tiered provider network called HMO Blue New England Options v.5. You will not need prior authorization or referral to see an HMO Blue New England network provider who specializes in OB/GYN services. (Note: Your monthly premium payments dont count toward your deductible.). %PDF-1.6 % Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of Massachusetts, Inc., 1496 0 obj <> endobj Preferred Blue PPO Preferred Provider Plan Subscriber Certificate HMO-PPO (1-1-2022) Page 1 hppoded1500SoB-0122sng . Youre one click away from finding the care you need. Nearby retail clinics and urgent care centers can treat many conditions in less time and for less money. With a PPO, you aren't required to choose a primary care provider (PCP), but we highly recommend that you have a relationship with a primary doctor who can help guide your care. Your Deductible Your deductible is the amount of money you pay out-of-pocket each plan year before you can receive coverage for most benefits under this plan. $=bwl@$W oo&Ft8# Yi Plan-Year Deductible: $500/$1,000 UNLOCK THE POWER OF YOUR PLAN MyBlue gives you an instant snapshot of your plan: COVERAGE AND BENEFITS CLAIMS AND BALANCES DIGITAL ID CARD Sign in Download the app, or create an account at bluecrossma.org. The following services are not subject to the deductible: office visits, preventive health services, emergency room visits, home health care, hospice services, medical formulas, all mental health services, and prescription drugs. In-network preventive care is covered at no additional cost. Commonwealth of Massachusetts
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