There are several ways for you to keep updated about product changes, news releases, and other information about Blue Cross Blue Shield of Massachusetts.
Just select a section below to access our most up-to-date information.
Important Employer Surveys: Medical Loss Ratios and Employer Group Size
In July, employers with a fully insured, premium financial arrangement with Blue Cross Blue Shield of Massachusetts will receive at least one of the following two surveys in the mail. This year, we have emphasized to our accounts that a timely response to both surveys is essential for two reasons. First, it helps us determine if the company is eligible to receive a rebate for 2019 (if any are required to be issued in 2020). Second, it ensures that employees are enrolled correctly and their claims are properly adjudicated along MSP guidelines. We appreciate your support as you encourage your accounts to respond promptly. Learn more.
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?