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Blue Options v.3 and Hospital Choice Cost Sharing Tiering Update

As a result of favorable improvements in Boston Children's Hospital's cost performance at three satellite locations, we will update the hospital tiering in our Blue Options benefit designs for version 3 and for the Hospital Choice Cost Sharing benefit design for services at these satellite facilities. The updates will be effective in a one-day change for all plans and accounts on January 1, 2013.

Three satellite locations of Boston Children's Hospital will move to the Standard (middle) tier, and, as a result, members will have lower out-of-pocket costs when receiving services at these sites. The downtown Boston location of Boston Children's Hospital, will remain in the Basic Benefits Tier/Higher Cost Share.

Hospital Name Previous Blue Options Tier / HCCS Cost Share New Blue Options Tier / HCCS Cost Share Reason for Change Types of Services
Boston Children's at Lexington1 Basic Benefits Tier / Higher Cost Share Standard Benefits Tier / Lower Cost Share Cost Score (meets benchmark for moderate cost) Surgical day care services; outpatient services, including diagnostic high-tech radiology, diagnostic X-rays and other imaging tests, diagnostic lab tests, and short-term rehabilitation therapy
Boston Children's at Waltham1 Basic Benefits Tier / Higher Cost Share Standard Benefits Tier / Lower Cost Share Cost Score (meets benchmark for moderate cost) Surgical day care services; outpatient services, including diagnostic high-tech radiology, diagnostic X-rays and other imaging tests, diagnostic lab tests, and short-term rehabilitation therapy; limited specialized inpatient services
Boston Children's North at Peabody1 Basic Benefits Tier / Higher Cost Share Standard Benefits Tier / Lower Cost Share Cost Score (meets benchmark for moderate cost) Surgical day care services; outpatient services, including diagnostic high-tech radiology, diagnostic X-rays and other imaging tests, diagnostic lab tests, and short-term rehabilitation therapy

1. Note: Boston Children's Hospital's downtown Boston location will remain in the Basic Benefits Tier/Higher Cost Share.

 

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