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The Plan

And for around $2151 per month,
the cost is much less than what you'd pay without insurance.

Learn more about your costs.

See your premium.

1. Monthly cost may vary

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

Massage and
acupuncture discounts

And more to help you
live your life healthier

The Details

Benefits

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.

Plan Specifics

Deductible

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.

Emergency Care

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.

After-Hours Care

When you need care and your doctor’s office is closed, you have options:

  • Call the Blue Care LineSM toll-free at
    1-888-247-BLUE (2583) to speak with a nurse 24/7.
  • Go to an urgent care center if you have an illness or injury that needs immediate attention, but isn't life threatening.
  • Find After-Hours Care
  • ER Alternatives Fact Sheet

What You Pay

In addition to your monthly premium, your plan includes the following types of costs.

Co-insurance
and copayments

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.

Out-of-Pocket
Maximum

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.


Deductible

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.

Just in Case

Wellness

Resources

About Us

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:

  • Making quality health care affordable
  • Improving the health of the communities where we live and work through our environmental sustainability program
  • Our promise to always put our members first