Network Blue New England Deductible (HMO)
The Network Blue® New England Deductible HMO plan is a managed care plan with a deductible of $100 per member and $200 per family. With this plan, you’re required to choose a primary care provider (PCP). Your PCP is the first person you should call when you need routine or sick care. They can refer you to specialists when needed, and coordinate your care.
Learn more about this plan
Dependent Benefits
Coverage for Dependents
This plan covers dependents to the end of the month in which the dependents turn 26, even if they aren’t considered dependents on a tax return, don’t attend school, and regardless of whether or not they have a job.
Coverage for Out-of-Area Students
With the HMO plan, covered students living outside of the New England service area can receive in-network coverage for non-emergency medical and mental health care, in addition to emergency and urgent care. They must call Member Service at 1-888-714-0189, and register before accessing care.
Deductible cost
A deductible is the amount you pay before your insurance provider begins paying any of the costs for certain services during each calendar year.
Your deductible under this plan is $100 member / $200 family.
Copayments
- Preventive care visit: Nothing
- Primary care visit: $20 per visit
- Specialist visit: $35 per visit
- Diagnostic test (x-ray, blood work): Nothing*
- Emergency Room visit: $100*
* Subject to deductible
Pharmacy Coverage
This plan gives you access to the National Preferred Formulary (NPF) for your prescription medications. The NPF is available through Express Scripts®´´, an independent company that administers your pharmacy benefits on behalf of Blue Cross Blue Shield of Massachusetts.
| Prescription Drug Benefit | Member Pays |
|---|---|
| Retail pharmacies (up to a 30-day supply) | $10 generic drugs $30 preferred brand drugs $55 non-preferred brand drugs |
| Mail order supply (up to a 90-day supply) | $20 generic drugs $60 preferred brand drugs $135 non-preferred brand drugs |
