Important information on the Cierant data incident

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A WHOLE NEW WAY TO DO
PRIMARY CARE

An innovative way to do primary care that’s convenient and comprehensive. Led by a Virtual PCP, the Virtual Care Team is here to help — on your terms, on your schedule, wherever you are.

Sign in to MyBlue or create an account to find your team.

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DISCOVER HOW A VIRTUAL CARE TEAM CAN HELP YOU

One team to manage your care and connect you to everything you need. It’s primary care that’s a prime experience.

 

Convenient

With virtual visits, there’s no waiting room and no sitting in traffic. Plus, you can make appointments within days, not weeks.

 

Comprehensive

Get whole-health care from your team, which may include specialists to help manage your mental health or a chronic condition.

 

Coordinated

Your care coordinator will help you set up visits, arrange prescriptions, find in-person specialists when needed, and more.

 

Connected

Reach out to your team whenever you want, however you want. Talk, email, text, video, and more – it’s your choice.

WATCH THE VIDEO TO LEARN MORE

If you’ve been looking for primary care that’s convenient, thorough, engaging, and modern,…you now have a whole new choice: your very own Virtual Care Team.

This is your team of experts, including a primary care physician, all committed to providing the personalized care you need.

And who show up when you choose, wherever you are, on any of your devices.

Short on time? Or hate to wait?

Your Virtual Care Team is available when you are.

Ready to give you live, real-time exams that are as thorough as you’d expect, from routine check-ups to mental health and chronic condition support.

You’ll get one team to manage your care, connecting you to everything you need, from doctors and nurses to lab results, to arranging prescriptions and even helping to set up in-person follow-ups with in-network specialists.

You’ll also get your very own in-home devices to measure and monitor your health.

Appointments are simple: just hop online and grab a slot.

And you can talk, text or chat with your team whenever you want, however you like.

Imagine, trips to the doctor’s office, without the trip.

Imagine, primary care that’s a prime experience, one that many patients call ‘easy and quick’ and ‘on the tech frontier’, ‘with the proactive approach, that’s huge’.

Imagine, trading the waiting room for your living room.

Your dedicated Virtual Care Team is just one click away.

So get started by choosing your virtual care provider today.

FIND YOUR TEAM

Virtual PCPs are accepting new patients.
Sign in to MyBlue or create an account to find a provider that meets your needs.

Get Started

FREQUENTLY ASKED QUESTIONS

It’s a whole new way to do primary care. Your PCP and the rest of your Virtual Care Team are available for visits on your devices to support your physical and mental health, and your care coordinator will work with you to make sure you’re getting all the care you need.

Plus, you can reach out to your team whenever questions or concerns come up. Talk, text, email, video call – whatever works for you.

You’ll select your own virtual PCP. When you’re ready for your Virtual Care Team, you can choose a PCP from an independent provider group listed on this page.

If you’re a member of an HMO plan, you’ll need to update your designated PCP when you sign up for the Virtual Care Team. To do so, click here or call Team Blue at the number on your ID card.

The providers on your Virtual Care Team are qualified and prepared to deliver care through video visits. The wide range of services you can get virtually include:

  • Wellness and preventive care
  • Sick visits
  • Behavioral and mental health care
  • Chronic condition support, such as diabetes and blood pressure management
  • Health coaching

Plus, you’ll receive a welcome kit with one or more connected health devices. You can use your devices to monitor your health and share the results with your team. If you need care that can only be delivered in-person, your care coordinator will help find a specialist that works for you.

If you need care that can only be done in person, such as blood work and lab testing, your care coordinator will help guide you to in-network specialists that work for you. Your Virtual Care Team will check in with you after your in-person visit to discuss your results.

No. When you select a new virtual PCP, that provider will replace your current PCP, if you have one.

Yes. When scheduling visits, the PCP on your Virtual Care Team will be your first stop for care. You can visit them regularly for routine health checkups, just like a traditional PCP. Your Virtual Care Team may also include specialists that you can visit as needed.

In cases where you need to be seen quickly, such as urgent care visits, you may work with a provider outside of your Virtual Care Team to ensure timely access to care. However, your team will be notified and will have access to the provider’s records and notes from the visit.

Once you’ve signed up and selected your PCP, scheduling care is as easy as hopping online. Simply sign in to your provider portal or app, then select a date and time that works for you. You can also use the app to reach out to your team with questions or concerns any time.

Family of three Family of three

WELCOME TO BLUE CROSS BLUE SHIELD
OF MASSACHUSETTS

Thank you for your interest in Blue Cross Blue Shield of Massachusetts. We offer a wide variety of health care plans for individuals and families – all designed to provide high quality, affordable care.

To be eligible for a plan, you must:

  • Be a Massachusetts resident (you might be asked to supply documentation).
  • Meet other eligibility requirements and provide proof of prior coverage or an enrollment waiver from the Massachusetts Office of Patient Protection.
  • Agree to an electronic invoice and electronic payment of monthly premium.

 

Get A Quote

Browse and compare health plans, get a quote, or create an account to start your enrollment application.

Click here

 

Returning Users or Existing Members

Finish an enrollment application, upload supporting documents, renew your membership, or see your application status.

Click here

The Massachusetts Division of Insurance and the Federal Government set the Open Enrollment dates for individual (non-group) coverage. Different eligibility rules apply during Open Enrollment. Outside of this Open Enrollment period, you can enroll in a private health insurance plan through the Marketplace only if you qualify for a Special Enrollment Period. You can use the Marketplace application to apply for Medicaid and the Children’s Health Insurance Program (CHIP) at any time. Learn more about Special Enrollment Periods.

NASCO MOVEit Privacy Incident

NASCO, a third-party provider of benefits administration services to health plans, used a third-party software application, MOVEit Transfer by Progress Software (“MOVEit”), to exchange files. On May 30, 2023, NASCO experienced a data security incident, due to a previously unknown vulnerability in MOVEit, in which a threat actor acquired data from NASCO’s MOVEit server. When NASCO learned of this incident on July 12, 2023, it promptly took steps to secure its systems, notified law enforcement authorities and launched an investigation that found that some of the acquired files contained the personal information of certain health plan members. NASCO is providing notification to impacted individuals and offering them 24 months of complimentary enrollment in Experian’s identity monitoring services.

The information involved in the incident included the following data elements of some health plan members: [name, demographic information (including social security number, address, phone number, gender, date of birth), phone number, health insurance number, medical ID number, date of service, medical device or product purchased and provider/care giver name.] Importantly, not every affected individual had all of these data elements impacted, or the same combination of data elements impacted.

NASCO takes the protection of personal information seriously as data privacy and security are among our highest priorities. Upon discovering the incident, we promptly took steps to mitigate the risk to our customers and personal information. We encourage affected individuals to enroll in the complimentary identity monitoring services, to remain vigilant against incidents of identity theft and fraud, to review their account statements, and to monitor their free credit reports for suspicious activity and to detect errors. Affected individuals should also review benefits documents that they receive from their heath plan to confirm that you received the health care services described. The Reference Guide below describes some steps individuals can take to protect their information.

If you are an impacted health plan member with questions about the incident or how to enroll in Experian identity monitoring services, call 1-855-873-7643, Monday through Friday between 9:00 a.m. and 11:00 p.m., and Saturday and Sunday between 11:00 am and 8:00 pm Eastern Time, excluding major U.S. holidays.

We apologize for any inconvenience or concern this may cause. NASCO takes security very seriously and protecting your information is among our highest priorities. We have applied additional safeguards within our environment to further enhance threat prevention.

REFERENCE GUIDE

Affected individuals should remain vigilant for incidents of fraud and identity theft by reviewing credit card account statements and monitoring credit reports for unauthorized activity.

Credit Reports. Under federal law, U.S. individuals are entitled to one free copy of their credit report every 12 months from each of the three nationwide credit reporting agencies. You may obtain a free copy of your credit report by going to www.AnnualCreditReport.com or by calling (877) 322-8228. You also may complete the Annual Credit Report Request Form available from the FTC at www.consumer.ftc.gov/articles/pdf-0093-annual-report-request-form.pdf, and mail it to Annual Credit Report Request Service, P.O. Box 105281, Atlanta, GA 30348-5281.

You may contact the nationwide credit reporting agencies at:

Table of credit reporting agencies
Equifax Experian TransUnion
P.O. Box 105788
Atlanta, GA  30348
www.equifax.com
(800) 525-6285		 P.O. Box 9554
Allen, TX  75013
www.experian.com
(888) 397-3742		 P.O. Box 2000
Chester, PA. 19016
www.transunion.com
(800) 680-7289


Fraud Alerts. You may place a fraud alert on your file by calling one of the three nationwide credit reporting agencies above. A fraud alert tells creditors to follow certain procedures, including contacting you before they open any new accounts or change your existing accounts. For that reason, placing a fraud alert can protect you, but also may delay you when you seek to obtain credit.

Credit Freezes (for Non-Massachusetts Residents): You may have the right to put a credit freeze, also known as a security freeze, on your credit file, so that no new credit can be opened in your name without the use of a PIN number that is issued to you when you initiate a freeze. A credit freeze is designed to prevent potential credit grantors from accessing your credit report without your consent. If you place a credit freeze, potential creditors and other third parties will not be able to get access to your credit report unless you temporarily lift the freeze. Therefore, using a credit freeze may delay your ability to obtain credit. In addition, you may incur fees to place, lift and/or remove a credit freeze. Credit freeze laws vary from state to state. The cost of placing, temporarily lifting, and removing a credit freeze also varies by state, generally $5 to $20 per action at each credit reporting company. Unlike a fraud alert, you must separately place a credit freeze on your credit file at each credit reporting company. Since the instructions for how to establish a credit freeze differ from state to state, please contact the three major credit reporting companies as indicated above.

You can obtain more information about fraud alerts and credit freezes by contacting the FTC (as described below) or one of the national credit reporting agencies listed above.

Credit Freezes (for Massachusetts Residents): Massachusetts law gives you the right to place a security freeze on your consumer reports. A security freeze is designed to prevent credit, loans and services from being approved in your name without your consent. Using a security freeze, however, may delay your ability to obtain credit. You may request that a freeze be placed on your credit report by sending a request to a credit reporting agency by certified mail, overnight mail or regular stamped mail to the respective address indicated above.

Unlike a fraud alert, you must separately place a credit freeze on your credit file at each credit reporting company. The following information should be included when requesting a security freeze (documentation for you and your spouse must be submitted when freezing a spouse’s credit report): full name, with middle initial and any suffixes; Social Security number; date of birth (month, day and year); current address and previous addresses for the past five (5) years; and applicable fee (if any) or incident report or complaint with a law enforcement agency or the Department of Motor Vehicles. The request should also include a copy of a government-issued identification card, such as a driver’s license, state or military ID card, and proof of current residential address (e.g., a copy of a utility bill, bank or insurance statement). Each copy should be legible, display your name and current mailing address, and the date of issue (statement dates must be recent). If you have been a victim of identity theft, and you provide the credit reporting agency with a valid police report, the agency cannot charge you to place, lift or remove a security freeze. In all other cases, the credit reporting company may charge a reasonable fee of up to $5 to place a freeze or lift or remove a freeze.

Report Incidents of Identity Theft. If you believe you are the victim of identity theft or have reason to believe your personal information has been misused, you should promptly report the issue to law enforcement, the FTC or your state Attorney General. For information on how to prevent or avoid identity theft, you can contact the FTC at:

Federal Trade Commission, Consumer Response Center, 600 Pennsylvania Avenue, NW, Washington, DC 20508, www.ftc.gov, 1-877-IDTHEFT (438-4338).

For North Carolina residents. For information on how to prevent identity theft, you can contact the North Carolina Office of the Attorney General, Consumer Protection Division at: 9001 Mail Service Center, Raleigh, NC 27699-9001, www.ncdoj.gov, 1-877-566-7226.

2023 IN BRIEF

YEAR IN REVIEW

In 2023, we focused on what matters most to our members, customers and communities: more affordable care, access to high-quality primary and specialty care, health equity for all, and a health care experience that is much simpler and more personal. Here are some of the steps we took:

Images of a family in the kitchen. Images of a family in the kitchen.

OUR HIGHLIGHTS

Focusing on health care costs

Affordability is our No. 1 priority, and in 2023, our leaders worked toward a healthier, fairer, more accessible system.

We saved millions of dollars for our members and customer around the country with our new pharmacy benefits partnerships. We also put our advanced technology to work to save our customers money -- for example, using artificial intelligence to identify fraudulent claims. And we prepared to bring a suite of innovative, more affordable medical, pharmacy, dental and vision options to our members in 2024. We also advocated for a more affordable health system statewide.

And we introduced a new Flex Card for our Medicare Advantage members, loaded with up to $2,160 in savings for fitness, weight-loss, vision and dental care, and more.

Read More

Guiding members to high-quality care

Our members around the country deserve the right care, in the right place, at the right time and at the right price. That’s why we act as a guide, helping them access new options for primary care and specialty care and specialty care, in-person and online, as well as special programs for managing chronic conditions such as kidney disease.

In 2023, we introduced innovative approaches to encourage shared decision-making between patients and clinicians and made it easier for members to get second opinions about medical issues. 

We also eliminated red tape to help our hospitalized members move to home health care more easily when appropriate.

Read More

Expanding access to mental health care

We know the need for high-quality, affordable mental health care has never been greater. So we’ve more than doubled our spending on mental health services since the beginning of the COVID-19 pandemic.

We expanded our network of mental health providers and added new online tools to help members find the care that’s right for them and their families. We waived member cost share for life-saving, over-the-counter medication to reverse opioid overdoses. We expanded dental care to members with mental health conditions.

We are proud to have received national attention for our Mental Health Advocate Program. And our Foundation launched a community mental health grant program to support nonprofits that are addressing underlying social, economic and cultural causes of anxiety, stress and depression.

READ MORE

We aim to give our members access to high-quality mental health care, whenever and wherever they need it.

Recognizing the urgent demand:
Support is more essential than ever. It can be hard to find the right resources, and the time to get help.

Facing the challenge:
We’re responding with an expanded network of clinicians. +46% from five years ago. We offer mental health advocates who work as navigators, helping members find the right support, whether in-person, online, or in a treatment facility.

Our tools:
We offer enhanced online support. Our online mental health center is personalized and interactive. We offer digital programs that provide 24/7 support for challenges including anxiety, depression & substance use disorders.

Innovative options:
Employers can choose plans with $0 copays for mental health treatment. Our plans also include rewards for stress reduction, wellness & relaxation programs like yoga, acupuncture, meditation.

We believe everyone should have access to the right mental health care, in the right place, at the right time and the right price.

 

 

 

 

Addressing inequities in care

By the end of 2023, nearly every health care organization in Massachusetts was engaged in our health equity work. More than half our Massachusetts members were getting care from clinicians who signed on to our groundbreaking effort to eliminate racial and ethnic inequities in health care.

And an independent study found our Equity Action Community -- which provides opportunities for learning, collaboration and financial support for health care organizations in our value-based network -- is producing results: Clinicians are developing new ways to address inequities in care for diabetes, heart disease and other conditions.

Read More

Improving Support for Women and Families

We expanded women’s health offerings, including comprehensive menopause support and treatment. And we offered greater support for parents and families with high-risk pregnancies and premature babies. We also created a new dedicated reproductive health clinical team that offers customized support to members trying to navigate the complicated fertility landscape.

Investing in our communities

For decades, we have contributed financial support and the expertise and passion of our employees to help local organizations make their communities healthier. In 2023, we helped build free, state-of-the-art fitness courts in a dozen cities and towns, and we sponsored summer fitness programs in communities including Boston and Worcester.

Hey, look at that.

One thing we've learned after what we've been through relative to the pandemic is that we really need to emphasize the importance of health and wellness. We know that if people can be active, their health is affected in a very positive way.

But we know that everyone doesn't have access to gyms and they don't always have the ability to afford to go to some kind of gym. A lot of times we hear that people can't access healthy programs either because of cost or time or location. This edition of the fitness court here in Malden addresses all three of those factors.

There are no barriers to this fitness court. Every member of our community will have the opportunity and the ability to use this for themselves and their families.

These fitness courts are in community areas. They're at school, they're in parks, they're in community centers. And severyone has access to them. This particular fitness court here in the city of Malden is located near our Malden train station. It's really centrally located in Malden in general.

We see a lot of people come to the track here and walk I know myself if I'm running around and I see anything like this. I love to come by, knock out some push ups, pull ups, you know, just use it.

This is for everyone at every level. I feel like anybody can do this. You could be in a wheelchair and you can still do some things here. You could be a younger person and do things here. You can be an older person and do things here. You don't have to be an adult to use this. Kids can get out with their parents and do something here with their parents doing.

What we're finding and what we know is that if people can be active, it helps obviously their physical health, but also their mental health, you can be outdoors, you're going to feel better, it's proven that you'll feel better.

And if you can do that be active and you can improve your health and your mental and physical health, it's a real win win.

Well, you have a state of the art facility and you give individuals the tools and the knowledge on how to take care of yourself in a better way, physically, socially and emotionally, through exercise and eating. Well, you in turn, you're doing something really well for yourself and it will help your pocket in the end.

 

In 2023, we were named one of America’s best employers by Forbes, a reflection of our extraordinary, community-focused culture. During our annual Service Day, nearly 3,000 employees volunteered across the state to work on community projects with 57 not-for-profit organizations. We continued to deliver on our commitment to reduce our environmental impact as a company and to support organizations that are addressing environmental health inequities in their communities. For the fourth straight year, we’ve been honored as one of the 50 most community-minded companies in the U.S.

Read More

Welcome, welcome, welcome to 2023 Blue Cross Blue Shield. Here we are 13 years later, 3000 associates strong to be able to put our effort into a local cause.

It brings us together and within the community to be able to volunteer my time to make someone else's life just even a little bit better.

It just, it makes you feel, it makes your heart swell.

I feel committed to volunteering because I want to give back to my community and I want to make the commonwealth a healthier more just place that's equitable for everyone.

This is one of the moments that I think exemplifies who we are as a group of leaders, as a group of associates and as a company. Thank you for making this possible.

 

2023 FINANCIAL RESULTS

Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.

Audited Statutory-Basis Financial Statements and Supplementary Information for the years ended December 31, 2023 and 2022 with Report of Independent Auditors.

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Blue Cross and Blue Shield of Massachusetts, Inc.

Audited Statutory-Basis Financial Statements and Supplementary Information for the years ended December 31, 2023 and 2022 with Report of Independent Auditors.

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Image of CEO Sarah Iselin. Image of CEO Sarah Iselin.

CEO PERSPECTIVE

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Our company at a glance

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2023 IN BRIEF

Ceo perspective

Image of CEO Sarah Iselin. Image of CEO Sarah Iselin.

Dear friends:

As we begin 2024, I’d like to share a brief overview of our company’s strategic priorities, the values that drive our work, and the ambitious goals we’ve set for ourselves. I also want to thank you for your continued support and collaboration, which mean so much to us. 

As I’m sure you know, it’s a critical time for all of us in health care, with huge opportunities to do better. Two challenges stand out: 

  • The health care system is letting people down, especially when they are most vulnerable and in need of help. Patient and consumer experiences with health care and insurance can be confusing, disappointing, aggravating, and ultimately unhealthy because of a lack of clarity, coordination and continuity.
  • Rising health care costs are hurting everyone. Health care is taking a growing portion of budgets for businesses, families and individuals, as well as for every level of government, pushing aside other worthy priorities.

Over the past several months, I’ve been working with our Blue Cross leadership team to take a fresh look at how we can meet these challenges, what our members and customers expect of us, and what will continue to set us apart from our local and national competitors.

The result: A refreshed mission and strategy built on the promise that we will always show up for our members when they need us most, and that we will guide them to the exceptional health care they deserve. Health care that’s affordable, equitable and seamless.

This means that, along with being the best at carrying out our traditional financial, administrative and member service functions, we aim to be the best at making sure our members across the country – with all their unique needs, expectations and life experiences – never fall through the cracks. We want to be there as a trusted ally whenever they face tough questions and decisions about their care: What do I do next? How do I know I’m getting what’s best for me? What are my options? What will I have to pay? 

So, what about cost? There’s pressure from all directions: advances in medical technology, breakthrough drugs, demand for care delayed during the pandemic, rising labor costs and shortages, and more. Making health care more affordable is an absolute top priority for Blue Cross, but our company can’t do it alone. Insurers, providers, pharmacies, employers, community leaders, lawmakers and regulators all need to work on these challenges together.

We’ll do our part to bring down the total cost of care. We’re cutting through unnecessary red tape to help decrease costs for clinicians in our network, and finding new ways to trim our own administrative spending. We’re collaborating with the health care organizations in our network to ensure our payments are based on clear accountability for quality, equity and efficiency. We’re targeting drug costs through new pharmacy partnerships and benefit options for our members. We’re investing in advanced technology that can identify fraud and waste, and save our members, customers and provider partners both time and money. And, we’re advocating for policy changes that can help make the health care system work better for everyone.

Of course, we all face other related challenges. A few that I’m especially invested in addressing: Our current system doesn’t adequately support urgently needed improvements in mental health and women’s health, both of which have suffered from stigma and neglect. And, there are far too many racial and ethnic disparities in who gets needed care, such as preventive services, tests and access to the best information and treatments.

As our 2023 highlights show, we’re supporting our communities, customers and members in Massachusetts and across the country by taking the lead on these difficult issues. With determination, innovation and collaboration, I’m confident that we’ll succeed.

All the best,

Sarah signature

Sarah Iselin
President and CEO

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Year in Review

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Our company at a glance

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Impact Report

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WE'VE GOT YOUR QUESTIONS COVERED

Health plans have a lot of moving parts, so we're here to help you make sense of it all. Check out our FAQs for additional support.

Read OUR FAQs

 

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Stay up to date

When you opt in to receive email or texts, we'll send you information throughout the year to help you better understand and use your plan benefits, provide helpful wellness tips and care reminders, and more.

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Frequently Asked Questions

MyBlue is your personalized online member account that makes understanding and using your health plan simple. Create a MyBlue account here to access your health plan details, claims, providers, member ID information, and more. You can also download the MyBlue app and instantly tap into the resources and features you need most, like adding your member ID card to your digital wallet. Keep in mind, if you create your account before your plan’s effective date, you won’t be able to access your plan details until your plan has started. Learn more about MyBlue here.

You must have your member ID number to create a MyBlue account. It helps us to verify your identity and link your account to your plan. Your member ID card will arrive in the mail after you’ve enrolled in a plan.

Our Find a Doctor & Estimate Costs tool helps you search for in-network doctors, dentists, hospitals, and other health care providers by entering the provider’s name, specialty, or procedures. When using the Find a Doctor tool, sign in to MyBlue to see providers that match your current plan and network.

If your plan requires a PCP, like an HMO plan, just sign in to your MyBlue account, and use the Find a Doctor & Estimate Costs Tool to search for one. Once you’ve found your provider in the results, click Add PCP to begin the online process. You can also add a PCP from your My Doctors page by clicking the Add PCP button.

It depends on your plan type. Generally, PPO and EPO plans don't require referrals. HMO plans require a referral from your PCP before seeing a specialist. To get a referral for your upcoming appointment, call your PCP's office before the appointment. Without that referral, you could be responsible for the whole cost of the appointment (not just the copay or co-insurance).

Once you've created your MyBlue account, you can use our Medication Lookup Tool to see if your existing prescriptions will be covered under your new health plan. Look for your current or new medications by entering the medication name in the search bar.

To ensure that your claim will process correctly when you pick up prescriptions, call your pharmacy ahead of time and provide your new insurance information. You can also bring your card to the pharmacy the first time you fill a prescription in 2025, so that they can update your information. To get a digital copy of your member ID card, download the MyBlue app. Learn more.
 

Sign in to your MyBlue account, then use our Find a Doctor & Estimate Costs Tool to help you plan and budget for any upcoming appointments or procedures.

Visit our Contact Us page for address information. Here you’ll also find general frequently asked questions and helpful links and resources.

STILL HAVE QUESTIONS?

Team Blue Member Service is here to help.

Call 1-800-262-BLUE

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SPECIALTY MEDICATIONS HANDLED WITH EXPERT CARE

If you have a complex health condition that requires specialty medications, our trusted network of specialty pharmacies has resources to help you manage your medications.

Find a specialty pharmacy in our network.

WHAT IS A SPECIALTY MEDICATION?

Specialty medications are often used to treat certain serious, complex, and chronic health conditions. They're limited to a 30-day supply and may:

  • Need specialty handling and temperature-controlled storage
  • Require assistance with administering, such as infusions or injections
  • Need instructions from your primary care provider (PCP) or other health care providers
  • Need specialized clinical counseling that standard retail pharmacies are unable to provide
A bottle of medication A bottle of medication
A person wearing glasses and looking down at a smartphone A person wearing glasses and looking down at a smartphone

FIND OUT IF YOUR SPECIALTY MEDICATION IS COVERED

This list of specialty medications lets you know which medications are included in your coverage and where to get them filled.

Certain medications are covered only under your pharmacy benefit. To see if your medication is covered, use our Medication Lookup tool.

 

ABOUT IN-NETWORK SPECIALTY PHARMACIES

Unlike traditional retail pharmacies, specialty pharmacies are experts in supplying specialty medications. They offer valuable services, resources, and convenient access to the care you need, including:

  • Providing all necessary supplies, at no additional cost, for using specialty medications
  • Delivering medications to your home or location of your choice
  • Providing access to nurses and pharmacists who specialize in treating your condition and are available 24/7
  • Educating you on usage, side effects, administering injections, and more
A cardboard mail package A cardboard mail package

FIND A SPECIALTY PHARMACY

To get started, have your prescribing provider’s contact information and your member card available. Find which pharmacy can fill your medication on the specialty medication list, then call that in-network specialty pharmacy to fill your order. Your prescribing provider can also send your prescription directly to the specialty pharmacy you choose.

 

Specialty pharmacy network

 

 

Accredo
1-877-988-0058
Fax: 1-800-391-9707
VISIT SITE

 

Walgreens Specialty Pharmacy
1-888-347-3416
Fax: 1-877-231-8302
VISIT SITE

 

CVS Specialty 
1-866-846-3096
Fax: 1-800-323-2445
VISIT SITE

 

Fertility medication network

These pharmacies specialize in filling prescriptions for fertility medications.

 

 

CVS Specialty 
1-866-846-3096
Fax: 1-800-323-2445
VISIT SITE

 

Freedom Fertility Pharmacy
1-866-297-9452
Fax: 1-888-660-4283
VISIT SITE

 

Village Fertility Pharmacy
Boston (Waltham), MA location only
1-877-334-1610
Fax: 1-877-334-1602
VISIT SITE

family of four family of four

GET YOUR NO-COST FLU SHOT

Getting the flu shot is quick and easy. It protects you and everyone around you by reducing the risk of getting the flu and can ease your symptoms if you do become sick.*

WHERE TO GET YOUR SHOT

Your flu shot is covered at no additional cost when you get it at an in-network provider or care location, including your primary care provider's office, walk-in clinics like MinuteClinic, urgent care centers, community health centers, and more.

Protect yourself and your loved ones and make your flu shot part of your preventive care routine this season.

 

Individual smiling pointing to an adhesive bandage Individual smiling pointing to an adhesive bandage
box of tissues box of tissues

FIND HELP WHEN YOU FEEL SICK

Talk to someone who can help you when you need it most:

  • Call your PCP: Your PCP can guide you to the treatment that’s right for you. If you need to find a PCP, go to Find a Doctor & Estimate Costs.
  • 24/7 Nurse Line: Speak to a registered nurse, day or night, at no additional cost. Call 1-888-247-BLUE.
  • Well Connection: Get care from a provider through your tablet, laptop, or smartphone. Sign in to MyBlue or create an account and click Well Connection Video Visits under My Care to see a provider.

 

Frequently Asked Questions

Top flu-rated questions answered:

 

If you have medical coverage, your flu shot will be available at no cost* when you get it at one of these approved providers:

  • Your in-network primary care provider 
  • Limited service clinics (such as MinuteClinic®´´ at CVS®´´) 
  • Urgent care centers 
  • Community health centers 
  • Public access clinics (available in some cities and towns, and may be available at no charge) 
  • Hospital outpatient departments 
  • Skilled nursing facilities, if you’re in outpatient care, like physical or occupational therapy 
  • Home health care providers (in your home or at a flu clinic hosted by a home health care provider) 
  • Certified nurse-midwife’s office 
  • Physician assistant’s office or specialist physician’s office 
  • Nurse practitioner’s office 

If you have Medicare coverage, your flu vaccine is covered under Medicare Part B for Medicare Advantage members. Medicare Advantage members can receive the vaccine from an in- or out-of-network provider at no cost. 

*Please keep in mind, if you receive a flu vaccine along with other covered services at a provider’s office, you’ll be required to pay the cost of the other services. Check your plan’s Summary of Benefits to confirm out-of-pocket costs and for more information.

Yes, you can. It’s safe to receive both vaccines in the same visit, according to the Centers for Disease Control and Prevention (CDC): cdc.gov, Getting a Flu Vaccine and Other Recommended Vaccines at the Same Time, December 8, 2023.

Flu vaccines are covered under Medicare Part B for Medicare Advantage members. Medicare Advantage members can receive the vaccine from an in- or out-of-network provider at no cost.

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* CDC, “Seasonal Flu Vaccine Basics” https://www.cdc.gov/flu/vaccines/?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/flushot.htm

** Flu vaccines recommended by the CDC are covered in full when administered by an in-network provider. Exceptions may apply. Check plan materials for details. Flu vaccines are covered under Medicare Part B.

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SUPPORT FOR FINDING YOUR PLAN

The perks start now — with resources that can guide you through the decision-making process.

 

2025 Benefits Decision Guide

See your plan options and benefits for 2025, all in one place.

Read the guide

 

Guía de decisiones sobre beneficios para 2025 (Versión en Español)

Revisa tus opciones de beneficios para 2025, todo en un solo lugar.

Coming soon!

 

Year-to-Date Summary

Get an up-to-date statement telling you what you’ve spent toward your plan and how much Blue Cross contributed. Keep track of every penny you’ve spent and saved.

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Direct Pay Eligibility

Direct pay changes

Health Plan Updates for 2026

Effective January 1, 2026, and upon renewal, we’re making changes to our health plans to ensure that we continue to meet the ongoing requirements of health care reform, while providing the high-quality, affordable coverage you expect from Blue Cross.

Please read the 2026 Benefits and Coverage Updates brochure and sign in MyBlue to review your current plan benefits.

As a Blue Cross member, you’re likely already enrolled in a health plan that meets all state and federal coverage requirements. The changes we’re making in 2026 will keep your plan in compliance with federal and state law. You don’t need to take any action. We simply want you to be aware of all changes to your coverage.

If you purchased coverage directly from Blue Cross Blue Shield of Massachusetts and you want to:

  • Continue your current coverage—Continue to pay your bill, and your policy will automatically renew provided that the plan remains active. Any change to your premium will go into effect on January 1, 2021.
    NOTE: If you pay your bill quarterly, you may receive a revised invoice depending on your billing cycle.
  • Change your plan during open enrollment—Starting November 1, 2020, you can sign in to or create a MyBlue account, then click View, Change, or Renew Your Plan. This link will direct you to the shopping site, where you can select a new plan to go into effect on January 1, 2021.

If you purchased coverage through the Health Connector and you want to:

  • Continue your current coverage—Continue to pay your bill, and your policy will automatically renew provided that the plan remains active. Any change to your premium will go into effect on January 1, 2021.
  • Change your plan during open enrollment—Starting November 1, 2020, you can go to mahealthconnector.org, or you can call the Health Connector toll-free at 1-877-623-6765 or TTY: 1-877-623-7773. We encourage you to enroll and submit your payment as early as possible.

To find out if you’re eligible for a premium subsidy (financial help for your health plan’s premium), please contact the Massachusetts Health Connector at 1-877-MA-ENROLL (623-6765) or visit their website. Premium subsidies are only available through the Health Connector, and only the Health Connector can assist you in determining your eligibility.

There is no individual mandate for health insurance at the federal level. However, Massachusetts has had its own requirement since 2007. Most Massachusetts residents over the age of 18 are still required to have health insurance coverage, or else they'll be charged a penalty.

The individual mandate is a requirement that most residents obtain health insurance coverage. Failing to have coverage that meets the minimum standards will result in a tax penalty.

We'll continue to send out the 1099-HC form to all members with a Massachusetts address on file. All tax forms will be mailed by January 31, 2021.

Summary of Benefits and Coverage

Under the federal Affordable Care Act, health insurers and group health plans are required to provide a Summary of Benefits and Coverage to those who have private insurance. This regulation is intended to give members clear and consistent information about their health plan. This will help you better understand and evaluate your choices.

Since September 23, 2012, we've been providing a Summary of Benefits and Coverage to you upon renewal, request, and when material changes occur, at no additional charge. We've also provided an online glossary to help you understand common health care terms.

Summary of Benefits and Coverage to replace current Summary of Benefits

We no longer create the benefit summaries that you may have received from us in the past. Instead, we'll provide the new Summary of Benefits and Coverage.

We don't provide a Summary of Benefits and Coverage for the following plans:

  • Managed Blue for Seniors
  • Medicare Advantage
  • Medex®'
  • Dental and vision plans

Summary of Benefits and Coverage services—as of September 23, 2012

  • You can find the Summary of Benefits and Coverage on our website. You will receive a new Summary of Benefits and Coverage every time your plan renews.
  • You can request a Summary of Benefits and Coverage from Member Service by calling the number on the front of your ID card. Within seven business days of receiving your request, we will provide one copy of the Summary of Benefits and Coverage to you in electronic (PDF) format.
  • If there are changes to your Blue Cross Blue Shield of Massachusetts plan(s) that require updating the Summary of Benefits and Coverage, we'll provide a new one within 30 days.
  • Printed copies of the Summary of Benefits and Coverage are available upon request.

Learn more

Please visit Health care reform to access the health care glossary and get updates as they become available. If you have any questions, please call Member Service at the number on the front of your ID card.

Eligibility requirements

Effective October 1, 2010, Massachusetts residents who are eligible for coverage through an employer-sponsored (group) plan will be ineligible for coverage in the individual (non-group) market.

Massachusetts residents must establish that they're ineligible for coverage through an employer-sponsored plan that meets MCC guidelines to be eligible for coverage in the individual market.

Enrollment requirements

Effective December 1, 2010, Massachusetts residents will only be able to enroll in a plan in the individual market during the annual Open Enrollment period, unless they meet certain criteria.

Massachusetts residents may only obtain individual coverage outside of an Open Enrollment period if they establish that they requested non-group coverage within 63 days of termination of prior creditable coverage held for 18 or more months under a group health plan, governmental plan, or church plan. Additional restrictions may apply.

Any coverage issued based on your completed application today will be effective the first of the month following the receipt of your completed application.

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