Blue Cross Blue Shield of Massachusetts Connector Plans
Choose Your Health Plan
Thank you for your interest in Blue Cross Blue Shield of Massachusetts. Below you'll find the Summary of Benefits and Coverage and the corresponding coverage policy for each of our plans that are available through the Massachusetts Health Connector. All of our plans are available for both groups and individuals, unless otherwise noted. Our Medication Lookup tool, which provides prescription coverage information, and our Find a Doctor & Estimate Costs tool, which helps you to find a health care provider and compare costs, can assist in your decision-making process when choosing a health plan.
This plan has the highest monthly premiums but the lowest out-of-pocket costs for medical expenses.
Gold plans generally have higher monthly premiums than Silver plans. These plans offer a good balance between lower out-of-pocket costs and a higher monthly premium.
Standard High Gold: HMO Blue Copayment SBC
Non-Standard Low Gold: HMO Blue Deductible with Copayment SBC
These plans generally have a higher monthly premium than Bronze plans. You'll have moderate out-of-pocket costs when you receive medical care.
Standard High Silver: HMO Blue Basic SBC
Standard Low Silver: HMO Blue Saver SBC*
Non-Standard Silver: Preferred Blue® PPO Deductible with Coinsurance SBC*
* available for small groups only
This plan offers the lowest monthly premium. However, you pay higher out-of-pocket costs when you receive medical care.
This plan is for individuals under 30. You're covered for medical care at a low monthly premium.
More Financial Help Than Ever
The American Rescue Plan has increased the amount of Advanced Premium Tax Credit subsidies and expanded eligibility, offering more financial help for health insurance premiums to more people than ever before. These tax credits are available to qualified members who enroll in our plans through the Massachusetts Health Connector.
Open Enrollment at the Health Connector runs from November 1, 2021 to January 23, 2022. However, if you want coverage by January 1, 2022, you must apply, pick a plan, and make your first payment by December 23, 2021.
Use the Health Connector’s Get an Estimate calculator to see if you qualify for financial help, then apply at MAhealthconnector.org
Prescription Coverage
Our list of covered medications is based on a tiered cost structure. When you fill a prescription, the amount you pay the pharmacy is determined by the tier your medication is in and your benefits. The amount you pay may also include your copayment, co-insurance, and deductibles. The pharmacist will tell you how much you owe. For more information about how our plans will cover your prescriptions, look them up using our Medication Lookup tool.
With the Medication Lookup tool, you can:
-
Look up any medication to see if it's covered by a plan
-
Find safe and effective covered alternatives for medications not covered by a plan
-
Search for low-cost generic alternatives, specialty medications, and medications that have $0 copays
Blue Cross Blue Shield of Massachusetts Formulary
Pediatric Dental Benefits
All the above health plans include pediatric dental coverage for members up to the end of the month the member turns age 19. View the documents below to learn more about this coverage:
Find a Doctor & Estimate Costs
Pick the doctor who's right for you using our Find a Doctor & Estimate Costs tool. In minutes, you can:
-
Find doctors, dentists, hospitals, and other health care providers
-
Get cost estimates for about 1,600 common medical procedures
-
Read and write reviews on doctors
Visit Find a Doctor & Estimate Costs
To learn more about Blue Cross Blue Shield of Massachusetts, read our fact sheet.
Choose Your Health Plan
Thank you for your interest in Blue Cross Blue Shield of Massachusetts. Below you'll find the Summary of Benefits and Coverage and the corresponding coverage policy for each of our plans that are available through the Massachusetts Health Connector. All of our plans are available for both groups and individuals, unless otherwise noted. Our Medication Lookup tool, which provides prescription coverage information, and our Find a Doctor & Estimate Costs tool, which helps you to find a health care provider and compare costs, can assist in your decision-making process when choosing a health plan.
This plan has the highest monthly premiums but the lowest out-of-pocket costs for medical expenses.
Gold plans generally have higher monthly premiums than Silver plans. These plans offer a good balance between lower out-of-pocket costs and a higher monthly premium.
Standard High Gold: HMO Blue Copayment SBC
Non-Standard Low Gold: HMO Blue Deductible with Copayment SBC
These plans generally have a higher monthly premium than Bronze plans. You'll have moderate out-of-pocket costs when you receive medical care.
Standard High Silver: HMO Blue Basic SBC
Standard Low Silver: HMO Blue Saver SBC*
Non-Standard Silver: Preferred Blue® PPO Deductible with Coinsurance SBC*
* available for small groups only
This plan offers the lowest monthly premium. However, you pay higher out-of-pocket costs when you receive medical care.
This plan is for individuals under 30. You're covered for medical care at a low monthly premium.
More Financial Help Than Ever
The American Rescue Plan has increased the amount of Advanced Premium Tax Credit subsidies and expanded eligibility, offering more financial help for health insurance premiums to more people than ever before. These tax credits are available to qualified members who enroll in our plans through the Massachusetts Health Connector.
Open Enrollment at the Health Connector runs from November 1, 2021 to January 23, 2022. However, if you want coverage by January 1, 2022, you must apply, pick a plan, and make your first payment by December 23, 2021.
Use the Health Connector’s Get an Estimate calculator to see if you qualify for financial help, then apply at MAhealthconnector.org
Prescription Coverage
Our list of covered medications is based on a tiered cost structure. When you fill a prescription, the amount you pay the pharmacy is determined by the tier your medication is in and your benefits. The amount you pay may also include your copayment, co-insurance, and deductibles. The pharmacist will tell you how much you owe. For more information about how our plans will cover your prescriptions, look them up using our Medication Lookup tool.
With the Medication Lookup tool, you can:
-
Look up any medication to see if it's covered by a plan
-
Find safe and effective covered alternatives for medications not covered by a plan
-
Search for low-cost generic alternatives, specialty medications, and medications that have $0 copays
Blue Cross Blue Shield of Massachusetts Formulary
Pediatric Dental Benefits
All the above health plans include pediatric dental coverage for members up to the end of the month the member turns age 19. View the documents below to learn more about this coverage:
Find a Doctor & Estimate Costs
Pick the doctor who's right for you using our Find a Doctor & Estimate Costs tool. In minutes, you can:
-
Find doctors, dentists, hospitals, and other health care providers
-
Get cost estimates for about 1,600 common medical procedures
-
Read and write reviews on doctors
Visit Find a Doctor & Estimate Costs
To learn more about Blue Cross Blue Shield of Massachusetts, read our fact sheet.