Health New England is making things easier for you with our all-new member portal, Your at-home COVID-19 test kit should automatically ring up at no cost to you. Definition: A process of evaluating an institution/facility to determine whether it meets the standards set up by the accrediting body, and granting recognition of the fact. 9 0 obj Step 3: Click on the Find Next button. Our plans differ by residency requirements; which providers you can use; what premiums you pay; and whether you are eligible for Medicare. HNE also conducts outreach to the provider for data validation on a regular basis. Health New England One Monarch Place, Suite 1500 Springfield, MA 01144-1500 Member Services (local): (413) 787-4004 Member Services (toll-free): (800) 310-2835 TTY: 711 Member Services Hours: 8:00 a.m. - 6:00 p.m. Source: This information is self-reported and verified during the initial credentialing process and every two years on the providers re-credentialing application, which is a signed document in which the provider confirms the information is accurate and complete. Prizes include: *Donations will be chosen from a pre-selected list of organizations. These quality of care indicators are important factors to take into consideration when selecting a health care organization. On Your ID Card: Look for the GIC logo on your ID Card. You will be able to choose from more than 5,500 primary carephysicians and specialists who serve Western Massachusetts, Worcester County and parts of Connecticut. Please remove any contact information or personal data from your feedback. In doing so, let me again point out that news generated by the GIC is not only important to retirees and employees covered by the state insurance plans. Total Choice lets you see any doctor and use any hospital the benefits, and the cost to you stay the same. Looking to create your personal Health New England account? Theres bound to be a plan hospital near you. Source: This information is self-reported and verified during the initial credentialing process and every three years on the hospitals re-credentialing application, which is a signed document in which the provider confirms the information is accurate and complete, as well as regular outreach to the hospital for data validation. "The mark of a great insurance company is how it works when things go unexpectedly wrong. xVmkI0wC)K ^qBJmv'iyN8c,Eg$=onA\^_PqTH!)b=FtjY\'k6RJ 'tJj{`#1o If youre thinking about enrolling in a UniCare plan, give us a call to find out more at 877-633-6396. Call UniCare Member Services toll free at 877-633-6396. Member Services Hours: 8:00 a.m. - 6:00 p.m. Walk-In Hours: Due to COVID-19, we are not accepting walk-ins at this time. Top-requested sites to log in to services provided by the state. But many of us dont.With this new EAP financial benefit, you now have access to tools, tips and a Money Coach to help you create, manage and achieve your financial goals. Your PCP is responsible to coordinate all of your non-emergency healthcare needs. Health New England processes claims and performs other activities needed to manage the plan. Validation is conducted through one of the following primary sources: Definition: Self-explanatory. Our members have been telling us for years: UniCares Basic plan was anything but basic. Carrier Name: Health New England Table 1: Proposed Weighted Average Base Rate Change 1Q 2024 Annual Weighted Average Base Rate Change Min Rate Change Max Rate Change Renewing Enrollees 1Q 2024 7.1% -6.0% 14.9% 29,825 Note: The Min and Max rate change is among existing and modified plans only. <> Top-requested sites to log in to services provided by the state. healthnewengland.org/medicare/provider-lookup, https://www.medicare.gov/hospitalcompare/search.html, ABMS: American Board of Medical Specialties (, ABPM: American Board of Podiatric Medicine (, ABOMS: American Board of Oral and Maxillofacial Surgery (, BACB: Behavioral Analyst Certification Board (, AAAHC: Accreditation Association for Ambulatory Health Care, Inc. (, AABB: Advancing Transfusion and Cellular Therapies Worldwide (, AASM: American Academy of Sleep Medicine (, ABC: American Board for Certification in Orthotics, Prosthetics & Pedorthics (, ACHC: Accreditation Commission for Health Care (, BOC: Board of Certification / Accreditation (, CHAP: Community Health Accreditation Partner (, CLIA: Clinical Laboratory Improvement Amendments (, DNVGL: Det Norske Veritas Germanischer Lloyd DNV GL Healthcare (, HFAP: Healthcare Facilities Accreditation Program (, IAC: Intersocietal Accreditation Commission (, The Joint Commission (formerly JCAHO: Joint Commission on Accreditation of Healthcare Organizations) (. EFFECTIVE JULY 1, 2021 EMPLOYEES AND RETIREES WITHOUT MEDICARE This health plan meets Minimum Creditable Coverage standards and will satisfy the individual mandate that you have health insurance. Most OTC COVID-19 test kits are covered through the CVS SilverScript pharmacy benefit. You can search on any text, such as a provider first name, last name, or specialty. Effective May 12, 2023 - Changes to Over-the-Counter COVID-19 Test Kit Coverage: Health New England covered the costs of FDA-authorized, rapid, at-home COVID-19 tests and will continue to cover until the end of the public health emergency (PHE), which will end on May 11, 2023. A receipt of purchase is required for reimbursement. Please update your browser if the service fails to run our website. Description: Health New England's Medicare Advantage (MA) Plans cover those who are eligible for Medicare Parts A and B. Member Services Hours: 8:00 a.m. - 6:00 p.m. Walk-In Hours: Due to COVID-19, we are not accepting walk-ins at this time. UniCare offers three health plans for non-Medicare GIC members and their families and one plan for Medicare members. For non-Medicare eligible retirees living outside of New England, one key change is important to note. Request plan materials by sending a message through our online form. Leapfrog's public reporting initiatives offer valuable benchmarking capabilities to hospitals, as well as provide consumers and purchasers of healthcare with the quality and safety they need to make informed choices about their, or their employees' care. Having a PCP can give you a trusting, ongoing relationship with someone that will be involved in your care for a long time. It serves as the basis of our corporate identity. Free. You have coverage for prescription drugs, eliminating a coverage gap that could leave you with high bills. Frequency Validated: On initial credentialing and at least every two years at re-credentialing, as well as regular outreach. Whats new starting July 1, 2023 for Total Choice? All GIC Medicare health plans include prescription drug benefits. The employer group pays for medical care and pharmacy services. The information in the Find a Provider tool is updated daily. Log into your Express Scripts account at express-scripts.com; Click the Order At-home COVID-19 Tests link; Complete the order form by selecting the name of the subscriber or dependent(s); associated with the order (Be sure to check that the mailing address and subscriber email address are correct;). Take Me To: To register or login as a Health New England Provider, please visit HNEDirect.com Members Benefit details Claims overview & Explanation of Benefits (EOBs) Cost of care calculator Pharmacy benefits HNE also conducts outreach to the provider for data validation on a regular basis. All records are kept confidential in accordance withfederal and state laws.Information provided by this service is for informational purposes only. The feedback will only be used for improving the website. Please remove any contact information or personal data from your feedback. 1 0 obj This means we understand the concerns, needs and values . Materials for the July 1, 2023 June 30, 2024 plan year will be added to our plan materials page by July 1, 2023. HNE's Commercial service area covers members who live or work in the four counties of Western Massachusetts (Berkshire, Franklin, Hampden and Hampshire) and Worcester County in Central Massachusetts. Call UniCare Member Services toll free at 877-633-6396 . Semi-Annual Notice of Chances (Effective 7/1/2023), Semi-Annual Notice of Changes (Effective 1/1/2023), Summary of Benefits and Coverage (Effective 7/1/23), Summary of Benefits and Coverage (Effective 7/1/22), 2023 Chart of Benefits (Effective 7/1/23), 2022 Chart of Benefits (Effective 7/1/22). Share sensitive information only on official, secure websites. In August I had a terrible fall I never had to worry about a doctor refusing my insurance or which doctor I visited for treatment. If youre a renewing UniCare member, its always a good idea to check out the plans and see whats changed since last year. You want the freedom to see any doctor or go to any hospital without any differences in coverage. Health New England MA Plans are available to residents of Hampden, Hampshire, Franklin, and Berkshire Counties. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. The providers tier effective 7/01/2023 is shown in Column H. (Column G shows the providers current tier until June 30, 2023.). But, if you still prefer to have your EOBs mailed to your home, you can make that selection by. How to Claim Medicare Reimbursement for OTC Covid-19 Tests, If your purchase does not ring up at $0 and/or you purchased an FDA-approved test kit for the full cost online or in-store after January 15, and the CVS Caremark mobile app (available for. ) We have added the tools that you have been asking for, while continuing to provide the service youve come to expect from Health New England. 113 GIC Benefit Breakdown - How To Enroll in a Health New England Plan 135 GIC Benefit Breakdown - How To Use Your Wellness Reimbursement 106 GIC Benefit Breakdown - Get In Touch With Health New England Members are eligible for up to eight at-home COVID-19 tests (up to four 2-pack testing kits) per individual at the pharmacy counter every 30 days for a $0 copay. News and Announcements. stream Members are encouraged to call their local store to determine their participation. Need help getting through times of uncertainty and crisis? Log in to find discounts available to you. Attention:GIC is working to ensure the health and safety of the public and accommodate the important needs of our members and staff. For every healthy choice you make in your life, we will give you points to trade in for raffle prize entries. Download ourCompare Our Plansbrochure or ourMedicare Extensionbrochureto review a summary of each plans benefits. Raffle points redeemable toward a donation to a local organization*, Issues with alcohol, tobacco, gambling or drugs. Looking to create your personal Health New England account? If you need assistance, please Contact the GIC. Please limit your input to 500 characters. If you need assistance, please Contact the GIC. Another new feature of the member portalis that Explanations of Benefits (EOBs) are now available online at Thank you for your website feedback! Questions? Source: This information is self-reported and verified during the initial credentialing process and every two years the provider's re-credentialing application, which is a signed document in which the provider confirms the information is accurate and complete. 219 GIC Benefit Breakdown - Top Ways To Save With Health New England 231 GIC Benefit Breakdown - What Providers Are In My Network? 800-442-9300. Download plan changes for Total Choice. Ku=i`sl3VS2PH0M I^.g Retired State, County And Municipal Employees Association Of Massachusetts. This page is located more than 3 levels deep within a topic. Other resources are available to GIC members and other residents of Massachusetts to obtain testing, some of which are listed below: The feedback will only be used for improving the website. Frequency Validated: On initial credentialing and at least every three years at re-credentialing, as well as regular outreach. Virtual care doctors can diagnose many conditions, follow up on other care youve had, and arrange for lab work. Definition: Health New England Network associated with the plan selected by the member or employer group. The GIC provider search can be found here: (f4)z$(Zx'/z0/G7%"YO L*EK{,dTU.ZrZ6*$X>^"R 7sI%ITGDr4W=QC"FEY=\0\{,(W/;e:Z:GaXo3i7 Claims for at-home OTC COVID-19 test kits will automatically process at $0 when checking out at a participating pharmacy. Member Services Email: memberservices@hne.com Write us a note: Compose Message Use one of the search tools below and look through the most updated listing of participating primary care providers, specialists, hospitals, pharmacies, eyewear providers and more. When I called to ask a question, I always spoke with a real human being. Bring an at-home COVID-19 test kit to the pharmacy counter, not the regular checkout lane; Check out at the pharmacy counter and show your Express Scripts ID card. PLUS offers great benefits and flexibility at a lower premium. The next major step in the GICs procurement process will be the announcement in December of the Medicare and non-Medicare pharmacy benefits. Medicare Directions for Purchasing OTC COVID-19 Tests In-Store, Members can purchase OTC COVID-19 test kits from participating pharmacies at no-cost at the time of purchase. Definition: Detailed information about a hospitals performance and how it compares to similar organizations. HNE also conducts outreach to the provider for data validation on a regular basis. We are uniquely positioned to tailor what we do to those who receive their health coverage through the GIC. You can enroll in Total Choice if you live in any of the six New England states. Starting July 1, 2023 Harvard Pilgrim Health Care will become the GICs National plan replacing the UniCare Basic Plan. Hospital Compare allows consumers to select multiple hospitals and directly compare performance measure information related to heart attack, heart failure, pneumonia, surgery and other conditions. The GICs health plan announcement will be one of several important items discussed. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Frequency Validated: On initial credentialing and at least every two years at re-credentialing, as well as regular outreach. Source: This information is self-reported and verified during the initial credentialing process and every three years or more often on the provider's re-credentialing application, which is a signed document in which the provider confirms the information is accurate and complete. If you are a current UniCare member looking for current plan year materials, visit our plan materials page for more information about the July 1, 2022 June 30, 2023plan year. On Monday, January 10, 2022, the Federal Government issued guidance that health insurance carriers and health plan sponsors (such as the Group Insurance Commission) are required to cover the cost of up to eight Food and Drug Administration (FDA)-approved at-home tests (four 2-pack testing kits) per individual for COVID-19 every 30 days. The shape of our logo represents the things that we strive to be every day: a health plan partner that is always caring, thoughtful and committed to quality. That means that providers are assigned different copay levels (or tiers) based on access, quality and performance. Acknowledgment of the terms is required before clicking the Submit Order button. %PDF-1.7 Printable copies of these forms and additional information on obtaining eight free COVID-19 tests (four 2-pack testing kits) per individual through your CVS SilverScript benefit are available at CVS Caremark and also through the GIC website. Please keep this Amendment with your SPD as it changes the terms of that SPD. When you see a non-preferred provider, UniCare pays 80% of the allowed amount (after copay and deductible, if any), and you are responsible for the other 20%. Whats new starting July 1, 2023 for the Community Choice Plan. Join with our 52,000 members as we continue the fight. Source: This information is self-reported and verified during the initial credentialing process and every three years on the hospitals re-credentialing application, which is a signed document in which the provider confirms the information is accurate and complete. Some page levels are currently hidden. Log in to find discounts available to you. With your receipt, you may use an online claims submission process through CVS Caremark and the CVS Caremark mobile app (available for Android and Apple) is available. endobj You can even be a Total Choice snowbird, as long as your registered home address is in New England. stream Please view the FY24 Benefits Guide and City of Springfield Rate Sheet prior to choosing your plan. Members can purchase OTC COVID-19 test kits from participating pharmacies at no-cost at the time of purchase Take your GIC SilverScript card to any in-network pharmacy that elects to offer Covid-19 test kits through this program. Receive discounts on health and wellness coaching programs, vitamins, and allergy products. Harvard Pilgrim Health Care and Tufts Health Plan are specific insurance plans offered by Point 32. Source: This information is self-reported and verified during the initial credentialing process and every two years on the provider's re-credentialing application, which is a signed document in which the provider confirms the information is accurate and complete. Use one of the search tools below and look through the most updated listing of participating primary care providers, specialists, hospitals, pharmacies, eyewear providers and more. The new portal offers simple language, straightforward menu options, and easy access from any device smartphone, tablet or computer. All GIC non-Medicare health plans include prescription drug benefits. healthnewengland.org/gic-provider-search Governor Salem Mayor Kim Driscoll. Enroll in one of our plans online on the GIC website. changing your mailing preferences once you are logged into the member portal. The feedback will only be used for improving the website. Enjoy discounts on gym memberships, weight loss, wearable health devices, physical therapy, podiatry, and more. View thisflyerto learn more. The trusted choice for GIC Medicare Retirees. my.HealthNewEngland.org. However, the door remains open for the inclusion of such a national plan in the future. Frequency Validated: On initial credentialing and at least every two years at re-credentialing, as well as regular outreach. On Monday, January 10, 2022, the Federal Government issued guidance that health insurance carriers and health plan sponsors (such as the Group Insurance Commission) are required to cover the cost of up to eight Food and Drug Administration (FDA)-approved at-home tests (four 2-pack testing kits) per individual for COVID-19 every 30 days. Claims for at-home OTC COVID-19 testing kits will automatically process at $0 copay when checking out at in-network pharmacy counters or ordering at-home testing kits from Express Scripts Pharmacy online. If you havent already done so, register for the new my.HealthNewEngland.org and start managing your health care benefits. * Should any difficulties occur during in-store purchases, claims for at-home COVID-19 test kits using UPC codes from any retail or online provider can always be manually submitted. Those decisions have not yet been made by the GIC. Frequency Validated: On initial credentialing and at least every two years at re-credentialing, as well as regular outreach. Harvard Pilgrim Health Care, Tufts Health Plan and Fallon Health, which are the second-, third- and fourth-largest insurers in the state, have been dropped by the state Group Insurance. In fact, the majority of GIC Medicare retirees choose this plan. Policy decisions made by the GIC are closely watched by local officials, who can very quickly replicate those policies at the local level with limited input from local retirees and active employee unions. You skipped the table of contents section. Just remember, currently we do not have any information regarding plan design or costs. 3 0 obj <> <> Visit the The City offers a wide selection of health plans for you and your family to choose from through the State of Massachusetts Group Insurance Commission (GIC). Log in to find discounts available to you. While a lot of work remains to be done and many details are still unknown, this weeks announcement is very good news for retirees. If you need assistance, please Contact the GIC. If you're a current UniCare member living in a New England state and you want to stay in your plan, your coverage will continue automatically in the same plan on July 1, 2023.
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