Insurance
We participate in most insurance programs offered in our area. You can find a complete list of insurance plans accepted on this page.
Insurance Link List
Insurance Accepted at Baystate Health
We participate in most insurance programs offered in our area. You can find a complete list of insurance plans accepted at the top of this page.
Information about your insurance coverage was taken when you were admitted. In order to submit an insurance claim for you, we need proof of your insurance identification card or claim form from your insurance company. If you did not present this information when you were admitted, please have a friend or family member bring it to the Access Services Department when they visit you. Please remember that insurance plans do not necessarily cover the entire hospital bill. We understand that insurance coverage can be complicated, so if you need any assistance, please call our Financial Counselors.
Physician's Fees
If you receive services in the hospital from your primary care physician or from other specialists such as anesthesiologists, surgeons, or consultants, you will be billed separately by them. If you have any question about these bills, please contact the physician's office directly. For BMP Physician services, contact the Customer Service Department of the Physician Billing Office at 413-794-5700 or toll free at 800-436-6865.
Deductibles, Coinsurance, and Co-Payments
Most insurance policies today require you to pay certain out-of-pocket costs in addition to your monthly premium. These costs include deductibles, coinsurance and co-payments. A deductible is how much you have to pay for covered health services before your insurance company pays anything. Co-payments and coinsurance are payments you make each time you get a medical service after you have reached your deductible. You will be notified about any amounts not covered by your insurance that you are responsible to pay. Payments may be made by cash, personal check, VISA, MasterCard, or Discover Card when you are discharged.
High Deductible Health Plans and Health Savings Accounts
Over the past several years, many employers, as well as the state and federal marketplaces, have been offering high deductible health plans (HDHPs) in order to lower monthly premiums. These HDHPs have deductibles (in 2015) that exceed $1,300 for single coverage or $2,600 for family coverage. Employers can offer a Health Savings Account (HSA) with these HDHPs. HSAs allow you to pay for certain medical expenses (including your deductible, coinsurance and co-payments) with untaxed dollars.
If you are a patient in one of these plans, here are some things to consider:
- Prepare & Save: Lower premium plans will often have higher out-of-pocket expenses over the course of the year. Consider using savings from lower premiums to accumulate funds for when care is needed. Saving in an HSA or other healthcare reimbursement account can help 'ease the financial burden' of the expense while also having tax advantages.
- Know Your Plan: The details of your insurance coverage are not always easy to memorize or access. Each insurance plan can be different. Often deductibles are waived for preventive care, but deductibles will apply to treatment for acute and chronic conditions, you should know the basic structure of your plan and know how to contact the member services department of your insurance company for more information on coverage.
- Prioritize Your Care: Don't avoid necessary care, routine wellness care or chronic care management. These mistakes can be costly to your health and finances over the longer term.
- Plan: Planning and anticipating your and your family's healthcare needs can go a long way to smoothing the ups and down of paying deductibles that reset each year. Many deductibles reset on January 1 or July 1. If a major illness requires frequent visits at the end of a plan year, please remember that the claims early in the new plan year will again reflect a "new deductible" that must be met.
- Ask for Information: If you need an estimate of how much your care will cost, need details of a visit for claim submission or would like to know your options for paying a deductible amount owed over time, we're here to help. Call Patient Billing Services at 413-794-9999 or 877-461-1931.
Accepted Insurance Lists & FAQ
Baystate Health hospitals and physician practice sites accept health plans offered by the following insurance companies. Click on the appropriate link below to learn more about a specific company or plan.
Please note that Baystate Health does not necessarily accept all products at all locations. If you have a question about whether your specific health plan is accepted,
please call Patient Billing at 413-794-9999.
Aetna
Beacon Health Options
Blue Cross / Blue Shield of Massachusetts
BMC HealthNet (limited specialty services)
Celticare Ambetter
Children's Medical Security Plan
CIGNA of Massachusetts
Commonwealth Care Alliance
Connecticare of Massachusetts
Consolidated Health Plan
Coventry / First Health
Fallon Health Plan
Harvard Pilgrim Health Care
Health New England
HealthNet Federal Services (Tricare and VA plans) HMC / Northeast Health Care Alliance
MassHealth
Medicare
Multiplan / PHCS
NHP (specialty services only)
Tufts Network Health (specialty care only)
Northeast Direct
Oxford
Senior Whole Health (specialty services only)
Serenity Care
Tufts Health Plan
Unicare State Indemnity Plan
United HealthCare
US Family Health Plan
Aetna (commercial plans only)
AllWays Health Partners (formerly Neighborhood Health Plan) HMO, PPO, QHP
BCBS of Massachusetts (commercial products)
BCBS of Massachusetts Medicare
BMC HealthNet (MassHealth - All ACO's) — Home Health only
BMC HealthNet (MassHealth - MCO) — Home Health only
Cigna Y — For Hospice, check with plan
Commonwealth Care Alliance (OneCare)
Commonwealth Care Alliance (SCO)
Commonwealth Care Alliance (Medicare Preferred)
Commonwealth Care Alliance (Medicare Value)
Connecticare (commercial HMO, PPO only)
Coventry/HCVM/First Health
Fallon Health Plan (Select Care) (no Fallon Medicare or Fallon Community Plan)
Fallon Navicare (SCO)
Fallon Summit Eldercare (PACE) — Home Health only
Harvard Pilgrim Health Care (commercial plans only)
Health New England Commercial Plans
HNE Be Healthy Partnership MassHealth ACO
HNE Medicare Advantage
MassHealth (Medicaid - ACO) Community Care Cooperative
MassHealth (Medicaid - ACO) Partners Health Care
MassHealth (Medicaid - ACO) Steward Health Choice
MassHealth (Medicaid Standard - no Health Safety Net or Limited)
MassHealth (Medicaid - Family Assistance Plan)
MassHealth (Medicaid - PCC Plan)
Multiplan/NEHCA/PHCS
Northeast Health Direct
Senior Whole Health (SCO)
Serenity Care PACE
Tufts Health Plan - Commercial HMO, PPO, POS plans (no Silver Plans)
Tufts Medicare Preferred HMO (No SCO plans)
Tufts Public Plans Direct (QHP and ConnectorCare plans) — For Hospice, check with plan
Tufts Public Plans Together (MassHealth - All ACO's) — Home Health only
Tufts Public Plans Together (MassHealth - MCO) — Home Health only
Tufts US Family Health Plan
Unicare State Indemnity Plan (GIC Basic, Plus, Community Choice)
United HealthCare (commercial plans, including Oxford & UHC/HP plan)
VA
Wellfleet - Cigna Network
Wellfleet - MultiPlan/Coventry/First Health Networks
What is a deductible?
Deductibles are the annual expenses you are responsible to pay before your health insurance will pay your health claims. Deductible amounts are set by your insurance company. When the hospital/office submits a claim for your visit, your insurance will review your plan benefits and determine if they will be paying the claim or if the services will apply to your annual deductible. Once the amount is determined, you will receive a bill from the facility/office that you visited. Some services under your plan of benefits, for example, routine services, may be paid by your insurance without being applied to your deductible responsibility. Check with your plan for more information on your annual deductible and when it resets each year.
What is a coinsurance?
Coinsurance is a percentage of your health care bill that you pay which is determined by your insurance carrier – usually as a percentage of the amount they calculate as full payment.
What is a co-payment?
Copayments are set amounts you must pay when you go to your health care provider for service. Copayments are collected when you present at the place of service. Copayment amounts are normally listed on your insurance card and set by your insurance company. They will often vary by the type of provider or service.
Why am I getting a bill for the same services that I had done?
I had this service done last month and it was paid, but I had to come back and have it done again and now I have a bill. Your first service was considered a screening/routine/preventative. Your insurance processes these visits without a deductible. When you were called back, the visit was considered non-routine or therapeutic and your deductible was applied by the insurance company.
Why am I paying my deductible amounts again?
I had extensive services several months ago and received notification from my insurance company that my deductible was met. Now I am having services done again, and a deductible is being applied. Why is this happening? Your most recent services may have taken place in a new benefit year. Your insurance calculates your deductible based on benefit year. Therefore, you must now meet the new deductible before your insurance begins to pay your medical claims.
*It is very important that you understand your plan of benefits you have with your insurance carrier. By contacting them directly, they will summarize your plan and have the ability to send you information on all aspects of your benefits, as well as answering your specific questions and concerns.
Need Health Insurance?
A part of Baystate Health's integrated healthcare system, Health New England is a regional, provider-owned health plan serving members throughout western Massachusetts.
How to buy insurance and get care:
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