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:
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.
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. 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.
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. 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. Learn more.
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.
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.
Reminder: Account Toolkit for Split-Level Cost Sharing for Diagnostic Tests and Imaging Services
As communicated in our 2019 Product and Benefit Updates brochure for small employers, effective January 1, 2019, upon renewal, we'll apply two cost-share levels for outpatient Diagnostic Tests and Imaging Services on certain Merged Market medical plans. Learn more.