HMO Blue New England Options. ໂທ ຫາ ຝ່າຍບໍລິການສະ ມາ ຊິກທີ່ໝາຍເລກໂທລະສັບຢູ່ໃນບັດຂອງທ່ານ ໂທ 1-800-200-4255 (TTY: 711). Skilled Nursing Facilities (SNFs) 104. Exclusive Smart90®' requires that associates on certain maintenance medications get a 90-day prescription from their doctor for Express Scripts mail order or CVS Pharmacy refills. ©   Blue Cross and Blue Shield of Massachusetts, Inc., and Our HMO Blue New England and Blue Choice New England plans include coverage for one routine eye exam every 24 months as long as you see a network provider. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. ��1� %8��do��K|�=#�I�r�+o����{�K�s�����(t�0�:"��nKe��ǹ-��R�e��|jk`���Q�#x����k�0j+�������|�m~L��� &�阃[dz7��n�rh���9#m���p���S��0[ţ�y તમા રા  આઈડી કાર  ્ડ પર આપેલા  નંબર પર Member Service  ને કૉલ કરો કૉલ કરો 1-800-200-4255 (TTY: 711). Under this tiered network plan, your cost share amount for network primary care providers and general hospitals will be different based on the benefits tier of the primary care provider or general hospital you choose to furnish your . Participating Hospitals. Llame al número de Servicio al Cliente que figura en su tarjeta de identificación llamada 1-800-200-4255 (TTY: 711 ). 0000062261 00000 n Rele nimewo Sèvis Manm nan ki sou kat Idantitifkasyon w lan (Sèvis pou Malantandan Rele 1-800-200-4255 TTY: 711 ). You can file claims up to 90 days after your termination date for services received while you were working at Blue Cross, You have the option to enroll, and can contribute personal funds up to the annual maximum, If you elect this account, your unused balance is forfeited and doesn’t rollover to the next year. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen 1-800-472-2689 (TTY: 711 ). 446 0 obj <>/Filter/FlateDecode/ID[<5A0E1E6630AE5E438BE7EBFB9A3A29D1>]/Index[424 74]/Info 423 0 R/Length 112/Prev 379349/Root 425 0 R/Size 498/Type/XRef/W[1 3 1]>>stream Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Required fields are marked *. JOHN SAMPLE MTN123456789 Member Service 1-800-000-0000 Copays OV 10 BH 10 ER 50 HMO Blue New England SAMPLE Copays OV: Office visit for primary care provider or specialist BH: Behavioral health office visit ER: Emergency room (waived if admitted) Your ID Number Plan Name Call Us Number to call Withdrawals for non-eligible expenses are subject to a tax penalty. HMO Blue New England, which covers Massachusetts, Connecticut, New Hampshire, Maine, Rhode Island, and Vermont. 0000008673 00000 n 5. 0�"�$`&Mڣ3%��2�vŗ��P�e����,Ea6D���6��C��>3t'�5����a��wC�̸�l�h��h�݄�n��f��B�d h�b```�s�"�� �����VIp NEW: $0 COPAYS These changes will ensure that our plans continue to meet the ongoing requirements of the Affordable Care Act (ACA), while continuing to provide high-quality, affordable health coverage options. ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. For most network general hospitals, you will pay the lowest cost sharing level. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. 0000033075 00000 n 0000023310 00000 n 0000036314 00000 n For general inquiries, call 1-800-262-BLUE (2583) If you are a member, visit MyBlue If you are an employer, visit BlueLinks for Employers If you are a health care provider, visit Provider Central If you are a broker, visit Broker Central For questions about our Corporate Citizenship initiatives, email us For Media or Public Relations inquiries, email us However, if you elected this account in 2020, you may rollover up to $550 of your remaining balance to use in 2021 as long as you elect a Flexible Spending Account for 2021. %PDF-1.4 %���� Click here for a complete list of medications. D77 bee an7tah7g7 ninaaltsoos bine’d44’ n0omba bik1’7g7ij8’ b44sh bee hod77lnih call 1-800-200-4255 (TTY: 711). NEW: EXPANDED TELEHEALTH ... or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. AskB Chatbot. 0000061905 00000 n Our HMO plans offer reliable coverage and access to the best doctors and hospitals in Massachusetts. These categories apply for most cases, but some medication tiers may vary. UWAGA: Osoby posługujące się językiem polskim mogą bezpłatnie skorzystać z pomocy językowej. 注意:如果您讲中文,我们可向您免费提供语言协助服务。请拨打您 ID  卡上的号码联系会员服务部 通话 1-800-200-4255(TTY  号码:711 )。. ધ્યાન આપો:  જો તમે ગુજરા તી બોલતા  હો, તો તમને ભા ષા કીય  સહાય  તા  સેવા ઓ વિ ના  મૂલ્યે  ઉપલબ્ધ છે. endstream endobj 428 0 obj <>stream Your email address will not be published. trailer <]/Prev 127756/XRefStm 2045>> startxref 0 %%EOF 437 0 obj <>stream You pay a copayment per visit for emergency room services. ATENÇÃO: Se fala português, são-lhe disponibilizados gratuitamente serviços de assistência de idiomas. कार  ्ड पर दि ए गए नंबर पर कॉल करें  कॉल 1-800-200-4255 ( टी .टी .वा ई.: 711). Należy zadzwonić do Działu obsługi ubezpieczonych pod numer podany na identyfikatorze zadzwoń 1-800-200-4255 (TTY: 711 ). These health plan options include a tiered network feature called Hospital Choice Cost Sharing. 0000029283 00000 n 3. Learn more about these updates and plan options. Eligible expenses include deductibles, co-insurance, and copayments where applicable. 0000100800 00000 n Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativa chiamata  1-800-472-2689 (TTY: 711 ). You, your spouse, any covered dependents enrolled in the plan6, You, your spouse, your tax dependents (including children up to age 26) whether or not they’re enrolled in the plan6, Your children up to age 12, and disabled adult dependents, whether or not they’re enrolled in the plan6, All eligible7,8 medical and prescription drug expenses in the plan year9, All eligible7,8 medical, prescription drug, dental, and vision expenses in the plan year9, Childcare expenses while you and your spouse work or attend school9, Blue Cross automatically enrolls you into an HRA and contributes a set amount. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. endstream endobj 425 0 obj <>/Metadata 10 0 R/Pages 422 0 R/StructTreeRoot 14 0 R/Type/Catalog>> endobj 426 0 obj <>/MediaBox[0 0 612 792]/Parent 422 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 427 0 obj <>stream 0000057386 00000 n For others, you pay 100% of the cost until you reach your deductible. You make copayments for some services right away. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. HMO Blue New England $2,000 Deductible with Hospital Choice Cost Sharing Plan-Year Deductible: $2,000/$4,000 ... (or the local emergency phone number). 0000002229 00000 n 7. call 1-800-810-BLUE (2583). 0000002045 00000 n 0000008788 00000 n 0000052619 00000 n 0000008559 00000 n 2�p�jݵ$�S�J+¥o�!ñ�!\K��0�v`&�! F[��)���d�b�cp�� �YPi-�8����i�@���-��b�1H����#7ȃ@� � }.� endstream endobj 436 0 obj <>/Filter/FlateDecode/Index[10 357]/Length 34/Size 367/Type/XRef/W[1 1 1]>>stream Please make sure to select and update your PCP ID number in MyBlue or call. 0000100761 00000 n LƯU . 신분증에있는 전화 번호 1-800-200-4255 (TTY : 711)로 회원 서비스에 연락하십시오. ��`�1ٖ��~���z��@�k9�����Mh�h�Fz��^5"a% ��:ȇ��^�R^��|��_���p�й��F�lޯ�~ő�-3K�*�xxW,�K���}�2 a�yuI��n��zx�F���~^�ގ5��PS#�ԅ�����Xx����Ⱦ�7=�,���? Llame al número de Servicio al Cliente que figura en su tarjeta de identificación llamada 1-800-200-4255 (TTY: 711 ). 0000062687 00000 n Your email address will not be published. 0000102117 00000 n 注意:如果您讲中文,我们可向您免费提供语言协助服务。请拨打您 ID  卡上的号码联系会员服务部 通话 1-800-472-2689(TTY  号码:711 )。.