Blue Cross and Blue Shield of Massachusetts
Massachusetts • EPO, High-Deductible Health Plan (HDHP), Traditional Indemnity
This is an Exclusive Provider Organization (EPO) prefix. EPO plans do not cover out-of-network care except in genuine emergencies. Members can see any in-network specialist without a referral from their primary care physician. Claims for out-of-network non-emergency services will be denied.
HDHP coverage under this prefix means the member carries a higher annual deductible in exchange for lower monthly premiums. Claims are processed normally but the member's cost-sharing will be higher than standard plans until the deductible is met. Preventive services are typically the exception and are covered at no cost to the member.
This prefix includes traditional indemnity coverage. Indemnity plans are the oldest form of health insurance and offer maximum provider choice with no network restrictions. Members pay a percentage of charges after meeting their deductible. Reimbursement is based on reasonable and customary rates for the service area.
Independent licensee serving Massachusetts members with commercial, Medicare and Medicaid plans.