Important Administrative Information (IAI) is a quarterly mailing that delivers the latest news about Blue Cross Blue Shield of Massachusetts products and services to employers and consultants.
Current Editions:
Annual Report Now Available
As we face a once-in-a-century pandemic, we’re proud to stand with you. Today, we share the story of how we’ve mobilized our business to meet unprecedented challenges. We’ve made sure our members don’t have to pay for COVID-19 testing, treatment or vaccination. We’ve expanded our multifaceted approach to mental health and substance use disorder to meet our new needs during a perfect storm of social isolation, economic uncertainty, and stress. At the same time, we’ve continued to develop innovative partnerships, products and services that improve health outcomes, reduce waste, and improve the overall value of our members’ health care. Read 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. Starting in February 2021, we’ll be contacting these members to let them know they’ll no longer receive claim summary statements in the mail, unless they sign in to MyBlue and choose that option. 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.
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.
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.
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.
1099-HC Tax Form Is Now Available on MyBlue
Subscribers can now view, download, and print their 1099-HC tax form for their 2020 taxes through MyBlue. 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.
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.
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 Managed Blue for Seniors plans, plans with the Blue Cross Blue Shield of Massachusetts formulary, as well as Medex®’ plans with a three-tier pharmacy benefit. 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.
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 group Medicare Advantage, group Medex®´, and Managed Blue for Seniors plans. Learn more.
Coverage for Certain Infused Oncology Medications Moving to 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.
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.