First three non-routine doctor visits
for $35 or less per visit
Access to great doctors and
facilities throughout Massachusetts
Deductible of $6,350 for
individuals and $12,700 for families
for all other services
Help to quit smoking
And more to help you
live your life healthier
Preventive care, routine physicals, GYN, well child, routine hearing and vision exams, family planning
You Pay: $0 (no copay or deductible)
Office visits (sick care, non-preventive)
For first three visits each year, you pay 50% or $35 per visit (whichever is less).
For additional visits, you pay up to your deductible amount and then there's no charge.
Emergency room, inpatient hospital care, outpatient surgery
After you pay your deductible, there is no charge.
Prescription drug coverage
With this plan, you pay nothing for Tier 1 (mainly generics) birth control. For all other covered prescriptions, you pay up to the amount of your deductible and then there is no charge.
You Pay - $6,350 (individual)
or $12,700 (family)
Doctors & Hospitals
Your Primary Care Provider
When you enroll in this health plan, you must choose a
primary care provider in Massachusetts.
Referrals Are Required
If you need care from a specialist, your primary care provider will refer you to one. You must have a referral in order for your specialist care to be covered.
In an emergency , go to the nearest medical facility or call 911. Once you’ve met your deductible for the year, emergency care is at no charge.
When you need care and your doctor’s office is closed, you have options:
What You Pay
In addition to your monthly premium, your plan includes the following types of costs.
With this plan, you are covered for routine preventive care and services at no cost. You also get three doctor visits each year for either 50 percent co-insurance (you pay half the cost of the visit) or a $35 copayment. You do not pay toward your deductible until after these three visits.
Your out-of-pocket maximum
is the most you pay per plan year for covered health expenses
before the plan pays 100 percent of covered expenses for the rest of that year.
This plan's out-of-pocket maximum is $6,350 per individual or $12,700 per family.
Your deductible is the amount you pay before your insurance begins picking up any
of the costs for most services. After you pay your deductible, you’ll pay nothing
for covered services for the rest of the year. (Note: Your monthly premium payments
don't count toward your deductible.)
This plan's deductible is $6,350 per individual or $12,700 per family.
We are a community-focused, tax-paying, not-for-profit health plan rated among the nation's best health plans for member satisfaction and quality that is committed to: