Direct Pay Changes
As a member of Blue Cross Blue Shield of Massachusetts, you are already enrolled in a health plan that meets all state and federal coverage requirements and gives you access to doctors and hospitals across the state. Use the chart below to see if you need to take any action in the upcoming Open Enrollment period.
|If you purchased coverage directly from Blue Cross Blue Shield of Massachusetts and you want to:
|Continue your current coverage
||Simply continue to pay your bill, and your policy will automatically renew.
Your current coverage ends on December 31. To keep your current coverage, you do not need to do anything during Open Enrollment.
|Change your plan during Open Enrollment
||Starting November 15, you can log in or create a Member Central account and click on Renew Your Plan Now. The "Renew Your Plan Now" link will direct you to the online shopping site where you can select a new plan to begin on January 1.
|If you purchased coverage through the Health Connector and you want to:
|Continue your current plan or change your coverage
||Your current coverage will be cancelled as of December 31. You must purchase a new Blue Cross Blue Shield policy, no later than December 23, through the Health Connector to avoid a gap in your coverage.
We encourage you to enroll and submit your payment as early as possible. You can choose your new plan as early as November 15 at www.mahealthconnector.org or you can call the Health Connector toll-free at 1-877-623-6765 or TTY: 1-877-623-7773.
To find out if you are eligible for a premium subsidy (financial help for your health plan's premium), please contact the Massachusetts Health Connector at 1-877-MA-ENROLL (623-6765) or visit their website. Premium subsidies are only available through the Health Connector and only the Health Connector can assist you in determining your eligibility.
Click here for more information.
New Rules affecting Direct Pay (non-group) Insurance
Summary of Benefits and Coverage
Under the federal Affordable Care Act, health insurers and group health plans are required to provide a Summary of Benefits and Coverage to those who have private insurance. This regulation is intended to give members clear and consistent information about their health plan. This will help you better understand and evaluate your choices.
Since September 23, 2012, we’ve been providing a Summary of Benefits and Coverage to you upon renewal, request, and when material changes occur, at no additional charge. We've also provided an online glossary to help you understand common health care terms.
Summary of Benefits and Coverage to Replace Current Summary of Benefits
We no longer create the benefit summaries that you may have received from us in the past. Instead, we will provide the new Summary of Benefits and Coverage.
We do not provide a Summary of Benefits and Coverage for the following plans:
- Managed Blue for Seniors
- Medicare Advantage
- Dental and vision plans
We will continue to provide current benefit summaries for the plans listed above.
Summary of Benefits and Coverage Services—As of September 23, 2012
- You can find the Summary of Benefits and Coverage on our website. You will receive a new Summary of Benefits and Coverage every time your plan renews.
- You can request a Summary of Benefits and Coverage from Member Service by calling the number on the front of your ID card. Within 7 business days of receiving your request, we will provide one copy of the Summary of Benefits and Coverage to you in electronic (PDF) format.
- If there are changes to your Blue Cross Blue Shield of Massachusetts plan(s) that require updating the Summary of Benefits and Coverage, we'll provide a new one within 30 days.
- Printed copies of the Summary of Benefits and Coverage are available upon request.
Please visit www.bluecrossma.com/national-health-care-reform to access the health care glossary and get updates as they become available. If you have any questions, please call Member Service at the number on the front of your ID card.
Beginning October 1, 2010, Massachusetts residents who are eligible for coverage through an employer-sponsored (group) plan will be ineligible for coverage in the individual (non-group) market.
Massachusetts residents must establish that they are ineligible for coverage through an employer-sponsored plan that meets MCC guidelines to be eligible for coverage in the individual market.
Beginning December 1, 2010, Massachusetts residents will only be able to enroll in a plan in the individual market during the annual Open Enrollment period, unless they meet certain criteria.
Massachusetts residents may only obtain individual coverage outside of an Open Enrollment period if they establish that they requested non-group coverage within 63 days of termination of prior creditable coverage held for 18 or more months under a group health plan, governmental plan, or church plan. Additional restrictions may apply.
Any coverage issued based on your completed application today will be effective the first of the month following the receipt of your completed application.