Network Blue New England

View video presentation about this plan.

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 your PCP You pay a $15 copay You pay a $30 copay
Office visits with a 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
Out-of-pocket maximum $2,500 for employee coverage;$5,000 for family coverage $2,500 for employee coverage;
$5,000 for family coverage

Prescription drug coverage is provided through Express Scripts.

BCBS Member Central

As a member of a BCBS health plan, you have access to Member Central, a safe and secure web site designed to help you better manage your health care needs. Be sure to log on www.bluecrossma.com/member and set up your personal account.