Network Blue New England
BCBS Network Blue New England is a health maintenance organization (HMO). The amounts you pay for care (your copays) will depend on the primary care physician (PCP) you choose to coordinate your care.
When you join this plan, you agree to receive all your health care, except emergency care, within the plan network, coordinated or referred by a PCP.
You may name:
- A PCP affiliated with Boston Medical Center (BMC); your copays will be less, even if your PCP refers you to a specialist who is not affiliated with BMC
- A BCBS Network Blue New England PCP who is not affiliated with BMC; your copays will be higher, even if your PCP refers you to a BMC specialist
There are no deductibles in this plan and there is no out-of-network benefit level.
Here is a brief example of how the plan operates depending on your choice of PCP.
|COVERED SERVICE||BMC PCP AND REFERRALS||NON-BMC PCP AND REFERRALS|
|Inpatient hospital including maternity||You pay nothing||You pay a $200 copay per admission|
|Office visits with PCP||You pay a $15 copay||You pay a $30 copay|
|Office visits with Specialist||You pay a $15 copay||You pay a $40 copay|
|Preventive care||You pay nothing||You pay nothing|
|Emergency room||You pay a $100 copay; waived if admitted||You pay a $100 copay; waived if admitted|
|Hi-tech imaging||You pay a $25 copay||You pay a $50 copay|
|Outpatient surgery||You pay nothing||You pay a $100 copay per admission|
|Outpatient rehabilitation therapies||You pay a $15 copay; You pay nothing at Sargent College facilities||You pay a $40 copay; You pay nothing at Sargent College facilities|
Prescription drug coverage is provided through Express Scripts.