There are several ways for you to keep updated about product changes, news releases, and other information about Blue Cross Blue Shield of Massachusetts.
State of the Industry: The Path Forward, An Executive Briefing for Blue Cross Partners
On Monday, June 28 from 2:00 p.m. - 3:00 p.m. EST, join Blue Cross Blue Shield Executives for a discussion about the rapid changes in health care, the expected financial implications as we emerge from the pandemic, and our innovation and efforts underway to address costs and improve outcomes for all. Learn more.
Quality Care Cancer Program Launching in 2021
We’re launching our new Quality Care Cancer Program on July 1, 2021, to help ensure that our members receive cancer care that is evidence-based, clinically appropriate, safe, and affordable. Through this program, board-certified oncologists and oncology-trained nurses will be available to discuss covered treatment options with our members’ doctors Learn more.
Apply to Have Your Mini-COBRA Premiums Subsidized
Your business may be eligible for a subsidy towards your premium for any former employees and dependents who may be on mini-COBRA from April 1, 2021, through September 30, 2021, under the American Rescue Plan Act of 2021. We’ll cover the cost of these subsidies for eligible accounts. Accounts with 2–19 active employees are eligible for mini-COBRA. Learn more.
Well Connection Is Now Part of MyBlue
We've made it more convenient for members to get the care they need. As of June 10, 2021, members simply need to sign in to their MyBlue account to use Well Connection for their medical or mental health needs. Learn more.
Important Employer Surveys: Medical Loss Ratios and Employer Group Size
In July, we’ll be mailing surveys to fully insured accounts. Accounts will receive either one or two surveys, and should plan to respond as soon as possible. Learn more.
Changes to Telehealth Benefit
Effective July 1, 2021 we'll reinstate member cost share for non-COVID-19 covered services provided via telehealth, including care provided telephonically and via video chat. We're also expanding the types of services eligible for telehealth coverage. Details of these changes can be seen here. Learn more.
You're Invited to Our 2021 Inspirational Speaker Series
We're excited to invite you to join our family-friendly speaker series beginning this May. Each speaker has been carefully selected by our sales leaders and will share their stories of resilience and motivation during challenging times. Learn more.
Changes to the Telehealth Benefit
Starting on July 1, 2021, we will reinstate standard member costs for non-COVID medical- and mental-telehealth visits. How much the member will pay depends on the health plan’s benefits. Medicare members are excluded from this change. Learn more.
Upcoming Coverage Changes for Infused or Injectable Medications Under the Medical Benefit
Effective September 1, 2021, we’re changing the covered sites of service where members can get infused or injectable medications administered. We’re also requiring prior authorization for these sites, as well as the medications listed below. These changes ensure that members are receiving care in clinically-appropriate, cost-effective settings. Learn more.
Dental Blue® and Blue 20/20 Member ID Cards Are on MyBlue
Dental Blue and Blue 20/20 member ID cards have been added to MyBlue. Members now have access to all of their ID cards digitally, whenever they sign in to their MyBlue accounts via the Web and app. Learn more.
See Our Electronic Enrollment Reminders
We’ve created an electronic enrollment fact sheet that will help answer common questions that might come up while submitting your eligibility files. Learn more.
Effective July 1, 2021, Upcoming Changes to the Blue Cross Blue Shield of Massachusetts Formulary
Beginning July 1, 2021, we’re updating our formulary (list of covered medications) for medical plans with pharmacy benefits, as well as Medex®´ plans* with a three-tier pharmacy benefit. Learn more.
Coverage for Certain Infused Oncology Medications Moving to the Medical Benefit
Effective July 1, 2021, certain infused oncology medications will only be covered under our medical benefit through the Quality Care Cancer Program. These medications will no longer be included in our pharmacy benefit. Learn more.
Effective July 1, 2021, New Opioid Safety Review to Be Implemented at Pharmacies
Effective July 1, 2021, pharmacists filling a member’s opioid prescription will be alerted if the member may be receiving a total level of opioids that’s potentially unsafe. This change applies to plans with the Blue Cross Blue Shield of Massachusetts formulary, as well as Medex®’ plans* with a three-tier pharmacy benefit and Managed Blue for Seniors plans. Learn more.
New Prior Authorization Requirements for Select Medications Under the Medical Benefit
Starting July 1, 2021, we’re adding medications to our utilization management program that will require prior authorization before being covered under our medical benefit. Learn more.
Upcoming Coverage Changes for Certain Medications Moving from Our Medical to Pharmacy Benefit
Effective July 1, 2021, coverage for select medications will move out of our medical benefit and only be included under our pharmacy benefit. This change will apply to all medical plans, except Managed Blue for Seniors, group Medicare Advantage, group Medex®´, and Federal Employee Program plans. Learn more.
Streamlined Authorization Management Tool for Providers
We recently launched the next phase of a tool called Authorization Manager, which allows providers to manage their authorizations and referrals for all of our members. Providers can use the tool to submit and view the status of all of their authorization requests, and to view the status of their referral submissions. You don’t need to take any action as a result of this change. Learn more.
Updates to Preventive Dental Benefits
On June 1, 2020, as part of our effort to support members during COVID-19, we relaxed the limits on the following preventive dental benefits: routine cleanings, periodic exams, and fluoride treatment. The changes allow members greater flexibility with access to these benefits twice in a calendar year rather than once every 6 months. In addition, bitewing x-rays and certain benefits included in our Total Health Solution will be updated. Learn more.
New Cost-Share Assistance Program Can Save Self-Insured Accounts and Their Members Money on Eligible Brand-Name Specialty Medications
Self-insured accounts and their members can see savings on eligible brand-name specialty medications,* when accounts add the Cost-Share Assistance Program to their pharmacy benefit. The Cost-Share Assistance Program uses coupons from manufacturers of medication to cover most or all of a member’s out-of-pocket costs for eligible medications. Learn more.
Well Connection Is Coming to MyBlue
Coming soon: Well Connection will be integrated into MyBlue, making it even easier for members to have video visits with licensed providers, therapists, and psychiatrists. Learn more.
Employees Should Make a Plan to Get Their Flu Shot
Flu season can last through the end of May. And with COVID-19, it’s more important than ever for your employees to get their no-cost flu shot. They can follow these steps to plan out the easiest and safest way to get vaccinated. Learn more.
Go Paperless Campaign Launching in February 2021
We’re launching a Go Paperless campaign, targeting members who have a medical, dental, or Medex®´ plan, and haven’t already selected a communication preference. This does not apply to Medicare Advantage members. Starting in February 2021, these members will receive a postcard and email (for those members that have provided an email) saying that they’ll no longer receive claim summary statements (Summary of Health Plan Payments, Explanation of Benefits, and Dental Predetermination of Benefits) in the mail unless they take action. Learn more.
Announcing Upcoming Webinars
We’re excited to announce upcoming webinars in our account webinar series, which allow your organization’s leadership and human resources teams to learn more about your health plan benefits from our subject matter experts. Learn more.
Effective October 1, 2020, Inflectra Is Now Preferred over Remicade for Members with Existing Prescriptions
Effective October 1, 2020, the immune-modulating medication Inflectra is now the preferred brand-name medication over Remicade. This affects members 18 years and older with existing prescriptions, and applies to prescriptions covered under the medical and pharmacy benefit. Learn more.
Coverage Update: Sam’s Club Staying in Our Pharmacy Network
We’re pleased to announce that Sam’s Club will remain in our pharmacy network. Members can continue to fill prescriptions at Sam’s Club pharmacy locations without interruption to their coverage. Learn more.
Upcoming Changes to Opioid Coverage
We’re making several changes to our coverage of opioids. Effective April 1, 2021, we’ll cover Xtampza ER, and with this change, we’ll no longer cover OxyContin and Oxycodone ER, as of July 1, 2021. Also, we’re expanding our Pain Management Policy. Prescribers who don’t have an approved authorization for coverage of a member’s opioid medication must request authorization for that member’s medication before July 1, 2021. Oncologists, palliative care providers, and pain management specialists in the Blue Cross Blue Shield of Massachusetts network are exempt from this prior authorization requirement. Learn more.
Dental Blue® 65 Plans Will Include Enhanced Dental Benefits
Effective January 1, 2021, Dental Blue® 65 plans will be expanded to include Enhanced Dental Benefits for at-risk members with qualifying medical conditions. We’ll provide eligible members with additional, condition-specific support. Learn more.
Addressing Inequities in Health Care: Race and Ethnicity Data Collection on MyBlue
Effective January 1, 2021, as part of our ongoing effort to address inequities in health care, we’re updating the MyProfile section of MyBlue to encourage our members to share information about their race, ethnicity, and language preference with us. Learn more.
Blue 20/20 Online HR Portal Adds Enrollment Management
We’ve expanded the Blue 20/20 HR portal, so new and existing accounts will soon be able to manage member and dependent enrollment online. Learn more.
Additional Behavioral Health Coverage for Children and Adolescents
Beginning January 1, 2021, and effective upon account renewal, Blue Cross Blue Shield of Massachusetts will cover additional behavioral health services for children and adolescents. Learn more.
A Flu Shot Is Crucial for Members This Year
COVID-19 means it’s extra important for members to stay healthy during the flu season. Getting a flu shot is safe, and available at no cost* for members. It can also keep members out of the hospital at a time when others desperately need critical care. Learn more.
Benefits of Choosing Indigo for Your Massachusetts Paid Family Medical Leave (MA PFML) Plan
Beginning January 1, 2021, most employers in Massachusetts are required to provide paid family medical leave to their employees. You can opt out of the state plan and save valuable administrative resources by choosing a private plan through Indigo InsuranceTM Services, the preferred agency of Blue Cross Blue Shield of Massachusetts for ancillary insurance. Learn more.
Updates to the Blue Cross Blue Shield of Massachusetts Formulary Changes, Effective January 1, 2021
We’ve updated the Blue Cross Blue Shield of Massachusetts formulary changes going into effect January 1, 2021. Learn more.
Updates to Blue 20/20 Member Website
We've refreshed the Blue 20/20 website, powered by EyeMed®´ Vision Care, an independent vision benefits company, to help our members more easily find information about their vision plan benefits. Learn more.
Updates to Our Fitness Reimbursement
Effective as of January 1, 2020, we’ve added virtual fitness programs to our fitness reimbursement. We’ve also created an online reimbursement process to make it easier for our members to get rewarded. Learn more.
Introducing Our Plan Comparison Tool
We’re excited to announce the launch of our updated plan comparison tool. With this tool, you can view and compare up to three plans including the corresponding SOB, SBC, and Benefit Change Fact Sheet (if applicable). Learn more.
Introducing Our Account Webinar Series
You asked and we listened! Blue Cross Blue Shield of Massachusetts is excited to host live webinars, featuring subject matter experts and designed to help your organization’s leaders and human resources team learn more about your health plan benefits. Learn more.
Upcoming Changes to the Blue Cross Blue Shield of Massachusetts Formulary, Effective January 1, 2021
Beginning January 1, 2021, we’re updating our formulary (list of covered medications) for medical plans with pharmacy benefits, as well as Medex®´* plans with a three-tier pharmacy benefit. Learn more.
No-Cost Online Behavioral Health Seminars
We’re offering live, online seminars each month, at no additional cost, to help our members cope with feelings of stress, anxiety, and grief, as well as other behavioral health issues, during these unprecedented times. Learn more.
Health Plan Updates for 2021
Effective January 1, 2021, and upon renewal, we’re making changes to our portfolio of health plans to ensure we are continuing to provide high-quality, affordable coverage you and your employees expect from Blue Cross. Learn more.
Quality Care Cancer Program Launching in 2021
We’re launching our new Quality Care Cancer Program on July 1, 2021, to help ensure that our members receive cancer care that is evidence-based, clinically appropriate, safe, and affordable. Through this program, board-certified oncologists and oncology-trained nurses will be available to discuss covered treatment options with our members’ doctors. Learn more.
Personal Protective Equipment Assistance for Dental Blue®´ Providers
For dental services provided from June 1 to August 31, 2020, we’ll be reimbursing our Dental Blue providers in Massachusetts an additional $10 per covered visit. This new reimbursement will help our providers with personal protective equipment (PPE) costs as they returned to practice. PPE is essential to ensuring visits are safe for patients and providers alike. Learn more.
Upcoming Prior Authorization Changes for Medications Covered Under the PPO and EPO Medical Benefit
Beginning January 1, 2021, we’re adding Prior Authorization requirements for our members with PPO and EPO plans for certain medications when covered under the medical benefit. Members currently using these medications, and those newly prescribed on or after January 1, 2021, will need an approved authorization to receive coverage. Learn more.
Acceptable Enrollment Formats for New Business One Time Files
When submitting new business enrollment files, it’s important to submit them in the required format to populate your data. This ensures an accurate enrollment experience and avoids delays. Learn more.
Member Months Coverage Report Available for ASC Accounts at No Cost
We’re offering a Member Months Coverage Report to our ASC accounts for the 2020 tax year at no cost. This information is required by the Internal Revenue Service (IRS) under the Affordable Care Act (ACA). Accounts are responsible for sending the report file to their tax vendor, and filing the data with the IRS. Learn more.
Changes to Our Specialty Pharmacy Network for Fertility Medications
Effective August 31, 2020, AcariaHealth™ Fertility will be leaving our specialty pharmacy network for fertility medications. This change applies to plans with the Blue Cross Blue Shield of Massachusetts formulary, and the National Preferred Formulary (NPF). Learn more.
Upcoming Changes to the Blue Cross Blue Shield of Massachusetts Formulary, Effective October 1, 2020
Effective October 1, 2020, we're updating our formulary (list of covered medications) for medical plans with pharmacy benefits, as well as Medex®´* plans with a three-tier pharmacy benefit. This update includes the changes that were originally scheduled to go into effect on May 1 and July 1. Learn more.
Upcoming 4th Quarter Changes to the Blue Cross Blue Shield of Massachusetts Formulary
In the fourth quarter of 2020, we're updating our formulary (list of covered medications) for medical plans with pharmacy benefits, as well as Medex®´ plans with a three-tier pharmacy benefit. This update includes changes that were originally scheduled to go into effect on May 1 and July 1. Learn more.
Coverage Change for Breast Cancer Risk-Reduction Medications
On October 1, 2020, we’ll begin covering the following generic oral medications in the class of aromatase inhibitors at no additional cost for members when the medications are prescribed to reduce breast cancer risk. Learn more.
Coverage Update for Truvada
On July 1, 2020, we’ll begin covering Truvada, an HIV pre-exposure prophylaxis (PrEP) medication, at no additional cost for members who aren’t currently filling other HIV medications. This change applies to new prescriptions and refills, and to plans with either the Blue Cross Blue Shield of Massachusetts Formulary or National Preferred Formulary. Learn more.
Well Connection Now Offers Psychiatry Care
Well Connection is expanding its behavioral health services to include video-based psychiatry. With this new service, board-certified psychiatrists provide medication management for behavioral health conditions. The psychiatrists can evaluate health, assess the benefits of medications, and prescribe them. Learn more.
Medications That Now Require Prior Authorization, Effective April 1, 2020
Effective April 1, 2020, until further notice, the following medications will have quantity limits for first-time prescriptions for new therapies. Learn more.
July 1st Formulary Changes Temporarily Delayed
In a recent Important Administrative Information (IAI) newsletter we notified you of upcoming formulary (list of covered medications) changes for July 1st that affected medical plans with pharmacy benefits as well as Medex® ́ plans with a three-tier pharmacy benefit. Learn more.
May 1st Formulary Changes Temporarily Delayed
We recently notified you of upcoming formulary (list of covered medications) changes for May 1st that affected medical plans with pharmacy benefits as well as Medex® ́ plans with a three-tier pharmacy benefit. Learn more.
Upcoming Changes to the Blue Cross Blue Shield of Massachusetts Formulary, Effective May 1, 2020 - DELAYED
Beginning May 1, 2020, we're updating our formulary (list of covered medications) for medical plans with pharmacy benefits, as well as Medex®´ plans with a three-tier pharmacy benefit. Learn more.
Changes to Our Specialty Pharmacy Network
Effective March 31, 2020, BriovaRx®' will be leaving our specialty pharmacy network. This change applies to the Blue Cross Blue Shield of Massachusetts formulary, and the National Preferred Formulary (NPF). This does not affect members who have Medicare Advantage with a Part D prescription drug plan; they can continue to use BriovaRx without interruption. Learn more.
How to Help Transition Eligible Employees to a Medicare Plan
You can customize your own Medicare handout by simply adding your company’s logo. This professionally designed flyer will inform both upcoming and late retirees on how to get started, so they can decide which plan is right for them. Learn more.
Changes to Dental Maximum Liability
Effective January 1, 2020, members with a Blue Cross dental plan may only be charged up to the fee schedule amount for additional covered services, according to the in-network dental provider’s contracted fee schedule, even after reaching their benefit maximums. Learn more.
Change to Blue 20/20 Retail Provider Network
Starting February 1, 2020, EyeMed Vision Care®', an independent vision benefits company that administers our Blue 20/20 plans, will no longer contract with Sears Optical, JC Penney Optical, or Stanton Optical. Learn more.
New Online Behavioral Health Resource – Learn to Live
Our new innovative online resource provides support for members who are struggling with depression, insomnia, stress, and anxiety. Learn to Live provides online, self-directed programs and self-assessments based on the principles of Cognitive Behavioral Therapy for employees and their family members (ages 13 or older). Learn more.
No-Cost Flu Vaccine Available for Members
We’re committed to limiting the spread of the flu this season. That’s why there is no cost to the member for the flu vaccine when administered by a participating or preferred health care provider, such as a doctor or nurse practitioner, or at an urgent care center, limited services clinic, or pharmacy-based clinic (like CVS MinuteClinic®’). Learn more.
Weight-Management Program StepIn®´´ Available for Select Self-Funded Accounts
Effective January 1, 2020, StepIn, a new weight-management program, will be included at no additional cost for self-funded accounts with pharmacy benefits who have enrolled in Diabetes Care Value program. Learn more.
Updated List of 2020 Plans Impacted by Member ID Card Distribution Changes
We’ve released a new list of 2020 plans that will be affected by our recent change to the timeline for when we send new member ID cards to Small Group (under 50) accounts that have members in certain plans. Learn more.
Pathway to Savings Now Includes Massachusetts Paid Family and Medical Leave (MA PFML) Products
We’re excited to announce the expansion of our Pathway to Savings program to include MA PFML-compliant products, through our preferred carriers with Indigo InsuranceTM Services. When you choose a MA PFML-compliant plan with one of Indigo’s preferred carriers (USAble, Hartford, AXA, or Symetra) plus one other group line of coverage, you’re eligible to receive .5% off your medical rates for the first year, and .25% off your medical rates for the second year. Learn more.
Members Can Go Paperless
Very soon, members with commercial medical, dental, or Medex®´ plans can choose whether they want to continue receiving claim summary statements (Summary of Health Plan Payments, and Explanation of Benefits) on paper, or go green and view them online using MyBlue. Learn More.
An Easier Way for Members to Manage Their Maintenance Medications
Managing more than one maintenance medication can be complicated and time-consuming. With PillPack, a full-service, in-network pharmacy, members won’t have to worry about going to the pharmacy, organizing their medications, or missing a dose again. That’s because PillPack presorts their medications by day, date, and time, then delivers them to their door in clearly-marked packets, so members know which pills to take and when. PillPack will be available only for fully insured accounts, starting October 22, 2019. Learn more.
Exclusive Savings and Rebates for Blue 20/20 Members
Blue 20/20 members can now take advantage of exclusive savings, discounts, and rebates on eye care products and services. Learn more.
Get Your Employees to Participate in Drug Take Back Day on October 26, 2019
Medications don’t last forever. Over time, their chemical properties change, making them less potent—and even dangerous. Encourage your employees to go through their medicine cabinets and check for any expired or unwanted medications—this includes everything from aspirin to prescription medications. Learn more.
January 2020: Updates to Our Pharmacy Formulary
Beginning January 1, 2020, we're updating our list of covered medications for medical plans with pharmacy benefits, as well as Medex®' plans with a three-tier pharmacy benefit. Learn more.
Enhancements to Our Find a Doctor & Estimate Costs Tool
Find a Doctor and Estimate Costs tool is now available within MyBlue, making it even easier for members to take control of their health care. Learn more.
Enhancements to the MyBlue App
Throughout 2019, we’ve been making several enhancements to the MyBlue App that offers our members a better user experience, improved performance, and full integration with the MyBlue website. Learn more.
Health Plan Updates for 2020
Effective January 1, 2020, and upon renewal, we’re making changes to our health plans to ensure that we continue to meet the ongoing requirements of health care reform, while providing the high-quality, affordable coverage you and your employees expect from Blue Cross. Learn more.
Introducing ScreenRx®´ for Self-Insured Accounts
To help our members manage chronic conditions and stay on track with their medications, we’re offering ScreenRx to self-insured accounts, starting January 1, 2020. Learn more.
Introducing RationalMed®´ for Self-Insured Accounts
Effective January 1, 2020, we’re adding RationalMed, a new medication safety solution, as a core benefit to our pharmacy program for self-insured accounts. Learn more.
Smart90®´ Now Included in Core Benefits for Self-Insured Accounts with Pharmacy Benefits
Starting January 1, 2020, upon renewal, self-insured accounts with pharmacy benefits will include the Smart90 program, which allows members to get a 90-day supply of certain maintenance medications through the mail order pharmacy, or from the more than 9,800 CVS PharmacyTM retail locations nationwide. Learn more.
Blue Cross Blue Shield of Massachusetts Surpassed 2018 Medical Loss Ratio Requirements
In 2018, Blue Cross Blue Shield of Massachusetts exceeded the state and federal medical loss ratio (MLR) requirements for all market segments. As a result, we don’t need to issue account rebates for 2018. Learn more.
Upcoming Changes to Member ID Card Distribution
Beginning November 1, 2019, we’re changing the timeline for when we send new Member ID cards to members in certain plans for Small Group (under 50) accounts. Learn more.
New Federal Medicare Mandate (MACRA)
A federal law will change Medicare Supplement plan options for those who are newly eligible for Medicare on or after January 1, 2020. As of that date, we’ll no longer offer our Medex®´Bronze plan to people who are newly eligible for Medicare. However, benefits for our current Medex Bronze, Choice, or Core plan members won’t change. Learn more.
New Self-Service Reporting Tool for Accounts with 100+ Employees
We’re introducing a new self-service claims analytics tool later this year called BlueInsights. It will be available to all employers with 100+ employees. At that time, we’ll also retire the current ReportBlue system. Learn more.
Member Months Coverage Report Available for ASC Accounts at No Cost
We’re offering a Member Months Coverage Report to our ASC accounts for the 2019 tax year at no cost. This service must be requested prior to November 1, 2019. Learn more.
Updates to Our Dental Blue® Total Health Solution
Effective September 1, 2019 for new and renewing accounts, we’re expanding our list of chronic conditions that qualify members for Enhanced Dental Benefits. Learn more.
Important Employer Surveys
In July, some accounts received at least one of two surveys in the mail from us that require a timely response: the Patient Protection and Affordable Care Act (PPACA) survey, and the federal Medicare Secondary Payer (MSP) survey. These surveys help us determine if an account is eligible to receive a rebate for 2019 (to be issued in 2020), and ensure that employees are enrolled correctly and their claims are properly adjudicated. Learn more about these surveys, medical loss ratios, and national health care reform.
Changes to Specialty Pharmacies and Updated Medication List
Effective July 1, 2019, we’ll implement changes to our retail specialty pharmacy network and to the medications these pharmacies can fill. Learn more. Learn more.
Introducing the Enhanced Diabetes Eye Care Benefit
To help members with type 1 and 2 diabetes better manage their care, we have added an enhanced diabetes eye care benefit to our Blue 20/20 Exam Only and Exam Plus plans, effective July 1, 2019. Learn more.
Introducing Our New Medication Lookup Tool
With our new and improved Medication Lookup tool, members, prospective members, and providers can easily find important information about any medication, including coverage, strength, and additional requirements. Learn more.
We’re Expanding Our Behavioral Health Coverage for Children and Adolescents
Beginning July 1, 2019, Blue Cross Blue Shield of Massachusetts will cover the following services for members under 19 years old:
Read the full article for more information.
Support for Members Affected by Midwest Flooding
In response to the recent Missouri River flooding, we are expediting access to care for members who live in affected areas of Iowa and Nebraska. Learn more.
Safely Dispose of Expired or Unwanted Drugs on April 27, 2019
Medications don’t last forever. Over time, their chemical properties change, making them less potent—and even dangerous. Learn more.
Expanded Coverage for Osteoporosis Screening in Women
As of June 1, 2019, we’re expanding our commercial plan coverage to provide osteoporosis screenings for women under 65 years old who are at increased risk. Learn more.
Enrollment Kits and Benefits@Blue Changes for Small Group Accounts
Starting January 14, 2019, electronic enrollment kits (eKits) and our customized Benefits@Blue websites will be generated automatically for small group accounts in the Inside Sales and Small Groups - 25–50 segments. Learn more.
Flu Shot Program Changes
Our greatest priorities at Blue Cross Blue Shield of Massachusetts (“Blue Cross”) are to assist our members in accessing affordable, quality care, and to provide them with the best consumer experience possible. In support of these priorities, we regularly review our programs and services to ensure that they are still meeting the needs of our account partners and members.
With that in mind, we are announcing a change to our offering. Learn more.
Updates to Our Prior Authorization Requirements
Beginning July 1, 2019, our prior authorization requirements for the medications listed below are changing for members with our HMO, Access Blue, and Blue Choice® plans. Read More.
Upcoming Changes to Our Pharmacy Program
Beginning July 1, 2019, we’re making changes to our list of covered medications for medical plans with pharmacy benefits, as well as Medex®´plans with a three-tier pharmacy benefit. As part of these updates, certain medications may no longer be covered, may be excluded from pharmacy benefit coverage, may switch cost tiers, or might require prior authorization. Read the full article for a complete list of affected medications.
New Orthodontic Payment Schedule
For all comprehensive orthodontic claims, with dates of service on or after January 1, 2019, payment will now be processed on a monthly schedule. This is a change from the previous arrangement, when these benefits were administered in two payments, six months apart. Learn more.
Updates to Our Employer Website
We want to let you know that we’ve added several improvements to our website for Employers. These updates will enhance the user experience and enable additional capabilities in the future. Learn more.
We’re Partnering with Virgin Pulse®´´ to Encourage Employee Health and Well-being
In 2018, Blue Cross and Virgin Pulse created and launched ahealthyme®´ Rewards, a fully-funded turnkey wellness program, as well as Healthy Together, a team-oriented fitness challenge concept. Both initiatives have been successful, and the two companies will build on their partnership with an expanded offering in January 2019. Learn more.
With New Website Design, Promoting ahealthyme Rewards Is Even Easier
Now all the marketing materials you need to spread the word about your new wellness program can be viewed and accessed—right from our newly-designed website. Learn more.
New Health Education and Engagement Services Through Wellness Concepts
We’re excited to announce that beginning January 1, 2019, our health education and engagement services will expand significantly to incorporate a wide range of new topics and events. Learn more.
No-Cost Flu Vaccine Available for Members
For the 2018-2019 flu season, we cover the cost of the flu shot (for all members ages six months and older), and now the nasal spray flu vaccine, commonly known as FluMist (for specific populations), when a member gets the vaccine from a health care professional, a pharmacy-based clinic (like CVS MinuteClinic®’), or another qualified facility. Coverage depends on an individual member’s plan type and the nature of the care received. Members should consult with their health care professional before receiving a flu vaccine. Learn more.
Help for Members Affected by California Wildfires
As deadly wildfires continue to burn in California, Blue Cross Blue Shield is committed to providing support to all of our members who live in affected areas. Learn more.
Safely Dispose of Expired or Unwanted Drugs on October 27, 2018
Medications don't last forever. Over time, their chemical properties change, making them less potent—and even dangerous. Learn more.
Help for Members Affected by Hurricane Michael
Blue Cross Blue Shield of Massachusetts is saddened by the impact of Hurricane Florence. We're committed to providing support to all members who live in affected areas of Florida. Learn more.
ACA Member Months Coverage Report Available for ASC Accounts
Our Administrative Services Contract (ASC) accounts will gain access to a tax reporting service, which follows the Affordable Care Act (ACA) guidelines. As part of our continued efforts to provide service enhancements, we will once again give you the choice to have us run your Member Months Coverage Report at no cost. Learn more.
Prepayment Inpatient Claim Review
As previously communicated in a June IAI, we've partnered with Equian, a nationally known payment integrity vendor, to help continue to manage costs and improve the accuracy of claim payments. Learn more.
Expanded Fitness and Weight-Loss Reimbursement Benefits
Effective upon renewal starting January 1, 2019, we'll expand the definition of qualifying programs for our Fitness and Weight-Loss Reimbursements. This will provide more options for members who use these types of programs and reward them for a broader range of healthy behaviors. Learn more.
Upcoming Changes to Our Pharmacy Program
Beginning January 1, 2019, we're making changes to our list of covered medications for medical plans with pharmacy benefits, as well as Medex®' plans with a three-tier pharmacy benefit. As part of these updates, certain medications will no longer be covered, switch tiers, have a new dosing limit, require prior authorization, or have a change in cost. Learn more.
Help for Members Affected by Hurricane Florence
Blue Cross Blue Shield of Massachusetts is saddened by the impact of Hurricane Florence. We're committed to providing support to all members who live in affected areas of the Carolinas and Virginia. To help expedite access to care, we're adjusting the following policies for members in impacted areas. Learn more.
We Surpassed Medical Loss Ratio Requirements for 2017
For the reporting year of 2017, Blue Cross Blue Shield of Massachusetts won't issue rebates, as our loss ratio exceeded state and federal requirements for all market segments. Learn more.
New Electronic Benefits Enrollment Process for Businesses with 10-150 Enrolled Subscribers
We're pleased to offer a new electronic enrollment support solution for businesses with 10-150 enrolled subscribers (20+ eligible employees) to help simplify benefits administration. As a first-in-market solution, we've partnered with five leading technology platforms and three channel partners to offer a better education, shopping, and administration experience. Learn more.
Introducing Prepayment Inpatient Claim Review
To help manage costs and improve the accuracy of claim payments, we've partnered with Equian, a nationally-known payment integrity vendor, to review certain inpatient claims prior to payment. Effective April 1, 2018 for fully insured accounts and January 1, 2019 on renewal for ASC accounts, inpatient claims that meet identified criteria will be reviewed prior to payment to ensure accurate reimbursement. Learn more.
Introducing Well Connection, Our New Doctor Video Visit Tool for Members
Beginning April 2, 2018, we'll be launching Well Connection, a new digital tool that lets members have live doctor video visits using their smartphone, tablet, or computer. Well Connection is replacing the telehealth platform that our members currently use. This updated service will have a refreshed look and feel, as well as a new app and website. Well Connection will use a new platform that can be seamlessly upgraded to enhance the member experience. Learn more.
Introducing the Future High-Cost Member Report for ASC Accounts
We're pleased to introduce the Future High-Cost Member report for ASC accounts, which uses new predictive modeling logic to better identify members likely to incur high claims. Learn more.
New Massachusetts State Mandate - Contraceptives
On Monday November 20, 2017, Governor Baker signed into law the contraceptive ACCESS bill (An Act advancing contraceptive coverage and economic security in our state). This bill is effective May 20, 2018, and mandates coverage for the following contraceptive methods and services for females, with no cost sharing. Learn more.
Your Employees Are Getting Access to More Dentists
Beginning January 1, 2018, Dental Blue® members will be able to get service from nearly 122,000 dentists, and 300,000 provider locations across the country through our Dental Blue National Network. This new network is one of the largest in the country, and is nearly twice the size of our current national network. Learn more.
Limiting Spread of the Flu Virus
We make it easy for members and their families to get vaccinated. This flu season, we're offering a range of provider, workplace, and pharmacy-based vaccine locations. Coverage depends on the plan type and the nature of the care received. Learn more.
Low-Cost Generic Drug Benefit
Did you know that if your plan includes a mail service pharmacy benefit, covered employees can get a 90-day supply of select generic medications for only $9 when filled through Express Scripts?