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Search Help

Find a Doctor is our online tool that lets you search for doctors, hospitals, and other health care professionals within our provider networks. Find a Doctor lets you search by name, location, specialty, and plan network. You can also print maps and driving directions to a provider’s location. Check out our frequently asked questions to learn more.

Frequently Asked Questions

A provider is a licensed health care facility, program, agency, doctor, or other health professional that delivers health care services. Providers may also be certified and recognized under state law.

Find a Doctor lists many types of doctors and facilities, including primary care providers, specialists, therapists, hospitals, clinics, and other health care professionals. Providers in your search results are filtered based on the network you are searching (which can be seen at the top of the screen).

Depending upon the network and type of provider you're looking for, you can find a provider’s name, ID number, phone number, address, specialty, gender, languages spoken, awards and recognitions, location amenities, professional affiliations, and ratings and reviews. You can also get maps and driving directions to the provider’s location.

You can enter a provider’s name, such as a doctor, dentist, hospital, or other healthcare provider, in the search bar at the top of each page. As you type, a list of provider’s names from which you can choose will appear below.

You can enter a provider’s specialty in the search bar at the top of each page. As you type, you will see a list of options below that match your search. If you’re not sure of the exact specialty you are looking for, you can start on the home page by choosing the type of care you are searching for. The tool will guide you through the options available, and give you a list of providers that match your needs.

The tool will estimate your location using information from your Internet browser. If your estimated location is not correct, you can change it at the top of the page by clicking on the default location and entering a new city or zip code. As you type, you’ll see a list of possible locations to choose from. On the results page, you will see the providers closest to your starting location. If a provider has more than one location, you can click See More Locations to view the other locations for that provider. Click each location to see specific details, such as contact information, amenities, specialties practiced, and if the provider accepts new patients at that location.

Members with qualifying plans, who log on to Member Central, can find the cost of common tests and procedures by using the search bar at the top of every page to enter a specific test or procedure, or by clicking the Find a Cost tile on the homepage. Use the following guide:

  1. Enter your search criteria. As you type in the procedure, a list of options will appear just below. 
  2. Choose from the search results. Select the procedure you’re looking for from options below, or search from an alphabetical list of available tests and procedures. 
  3. Find estimated costs. When you select a procedure, you will be shown a list of providers in your area with the expected total cost and your estimated personal out-of-pocket cost (if available). Click each provider to see the breakdown of how your cost is calculated. 

Note: Before receiving treatment, confirm that the facility you choose is in your network, that the procedure is covered under your plan, and that you get proper preauthorization, when necessary. Cost estimation is not available to all members.

You can narrow your search results in the basic filters section on the results page. Choose the male, female, or any gender option. You can also see a professional’s gender on his or her profile page.

You can narrow your hospital affiliation search results by going to the affiliations filter section, and selecting the hospital you’re looking for. You can also see a complete list of a provider’s hospital affiliations on the provider’s profile page.

You can narrow your search results to providers affiliated with a specific medical group by going to the affiliations filter section, and selecting the medical group you’re looking for. You can also see a complete list of a provider’s medical group affiliations on the provider’s profile page.

Each provider’s profile page shows whether they’re accepting new patients for the network being searched. The provider may be accepting new patients in some networks but not others.

You can narrow your search by language using the basic filters section. Choose from the list of available languages (other than English). Your search results will only display providers who speak the language selected. You can also see a full list of languages spoken by the provider on the provider’s profile page.

Urgent care centers provide medical care when your doctor is not available and you don’t have a true emergency. They can help with sprains, X-rays, and minor cuts and injuries. You can usually go to an urgent care center in the evening and on weekends. Typically, visits to urgent care centers result in lower out-of-pocket costs, compared to visits to emergency rooms.

Your plan may not cover services provided by all types of providers listed. Review your benefits to see how services are covered under your plan. If you have additional questions about your coverage, please call the Member Service number on the front of your ID card.

Because Find a Doctor is updated weekly, it will be more current than printed directories. However, before you receive services, you should always contact the individual provider to make sure that he or she is still participating in the network.

The information within Find a Doctor is updated weekly. However, before you receive services from providers, you should always contact them to make sure they are still participating in the network and that their information is up-to-date.

We try our best to keep Find a Doctor accurate and up-to-date. However, if your provider was not listed in your search results, you may need to widen or narrow your search criteria. Return to the main search area and adjust your criteria. 

Tips: 

  • Enter fewer letters if you are unsure of the spelling. 
  • Your provider may not be in your specific network of doctors. 
  • Providers who have recently contracted with us may not appear in our online network listings just yet. Call the Member Service number located on the front of your member ID card to see if they are in your network.

Call Member Service at the number on the front of your ID card.

Choose the Dental Blue network.

Dental Blue Freedom members can find participating dental providers from either the Dental Blue or the Dental Blue PPO network. Dental Blue Freedom plans have access to both dental networks.

The BlueCard Worldwide® program provides eligible members with access to a network of hospitals and doctors around the world. Check the BlueCard Worldwide website to find participating providers and other information that is important to know before you travel. You can also verify your out of country benefits by logging into Member Central to view your benefits or calling the Member Service number on the front of your ID card.

You can report suspected fraud with complete confidentiality to the Blue Cross and Blue Shield National Anti-fraud Hotline number: 1-877-327-BLUE (2583).

Hospital Quality Methodology

The Find a Doctor & Estimate Costs tool presents two types of hospital quality scores:

  1. Patient Experience: Hospital scores come from the Hospital Consumer Assessment of Health Plans Survey (HCAHPS). These scores are displayed within the Ratings & Reviews module on a hospital's profile page.
  2. Safety and Effectiveness: Hospital scores are based on data submitted by hospitals to the Centers for Medicare and Medicaid Services (CMS). These scores are displayed as one to three ribbons within the Quality module on a hospital's profile page.
    • One ribbon means the hospital's performance on this measure was below expectations 
    • Two ribbons means the hospital's performance meets expectations 
    • Three ribbons means the hospital's performance exceeds expectations

Lower scores may mean that a hospital doesn't perform as well in specific procedures, but it doesn't necessarily mean that the hospital doesn't provide acceptable overall care. Additionally, a hospital may have scores for some measures and not have scores for other measures. Scores may be missing because a valid, reliable measure for a medical procedure isn't available, or because there isn't enough data to objectively calculate performance scores.

Results for hospital quality scores are updated quarterly and reflect the most recent data.

 

Frequently Asked Questions

Patients provide feedback on topics such as communication, pain management, and the cleanliness and quietness of the hospital environment. Find a Doctor displays hospitals' scores on ten patient experience measures from HCAHPS:

  • Overall rating of hospital 
  • Willingness to recommend hospital to family and friends 
  • How often nurses communicated well with patients 
  • How often doctors communicated well with patients 
  • How often staff explained medicines before giving them to patients 
  • Whether patients were given information about what to do during their recovery at home 
  • How often patients' rooms and bathrooms were kept clean 
  • How often the area around patients’ rooms was kept quiet at night 
  • How often patients received help quickly from hospital staff 
  • How often patients' pain was well controlled

HCAHPS is a national, standardized survey administered to a random sample of hospital patients, 18 years of age and older, within 48 hours to 6 weeks after discharge from the hospital. The survey aims to gather the patient's thoughts on care, and how they feel about the care they received. The survey's results can help you compare patients' experiences among various hospitals and against state and national benchmarks.

CMS is responsible for overseeing the survey and makes the results available to the public. The data displayed on the Find a Doctor & Estimate Costs tool represents patient feedback captured by these surveys. The results are updated quarterly and reflect the most recent four quarters of data. More information is available at hcahpsonline.org/.

CMS adopted a standard set of performance measures for recommended hospital care for certain conditions such as heart attacks, heart failure, and pneumonia. Hospitals are evaluated on how well they follow the recommended processes of care for each condition. Hospitals are also evaluated on how well they are able to avoid medical and surgical complications for their patients.

The Find a Doctor & Estimate Costs tool displays scores for up to eight quality measures:

Four process measures: 

  • Acute myocardial infarction (heart attack) 
  • Heart failure 
  • Pneumonia 
  • Overall surgical care infection

Four outcomes measures: 

  • Medical complications 
  • Surgical complications 
  • All patient mortality 
  • Length of stay

Patient Review System Terms of Use

The Blue Cross Blue Shield of Massachusetts’ Patient Review System (PRS) is offered to you on condition of your acceptance without modification of all of the terms, conditions and notices set forth below (collectively the “agreement”). By accessing or using the Blue Cross Blue Shield of Massachusetts’ PRS in any manner, you agree to be bound by the agreement. Please read the agreement carefully.

The Blue Cross Blue Shield of Massachusetts’ PRS is not a referral service and does not recommend nor endorse any particular health care provider. Rather, the Blue Cross Blue Shield of Massachusetts’ PRS is a resource that provides information on health care providers. The information on the website is presented in summary form, is general in nature, and is provided only for informational purposes. Blue Cross Blue Shield of Massachusetts or any of its related, affiliated or member licensee companies does not offer advice regarding the quality or suitability of any particular health care provider for any condition, including specific treatments or health conditions through this PRS. No information on the Blue Cross Blue Shield of Massachusetts’ PRS should be interpreted as medical, treatment and/or health advice.

The Blue Cross Blue Shield of Massachusetts’ PRS, and the information within, include statements of opinion of the healthcare provider’s patients —not statements of fact or recommendations to utilize the services of any specific health care provider. You should obtain any additional information necessary to make an informed decision prior to selecting and using any specific health care provider.

Always seek the advice of your physician or other qualified health care provider for answers to any questions you may have regarding treatment or a medical condition. Neither the information provided in the PRS, nor any other service offered by or through the Blue Cross Blue Shield of Massachusetts’ PRS is intended to diagnose or treat any medical condition. Never disregard medical advice or delay in seeking treatment because of something you have read on the website.

You agree to assume all responsibility in connection with choosing any health care provider, whether or not you obtained information the healthcare provider on or through the Blue Cross Blue Shield of Massachusetts’ PRS.

Blue Cross Blue Shield of Massachusetts and any of its related, affiliated, wholly owned and/or wholly controlled companies or member licensee companies do not assume responsibility or liability for any advice, treatment or other services rendered by any health care provider, or for any malpractice claims and other claims that may arise directly or indirectly from any such advice, treatment or other services.

The Blue Cross Blue Shield of Massachusetts’ PRS and the content may include technical inaccuracies and/or typographical errors. Blue Cross Blue Shield of Massachusetts may make changes or improvements at any time without notice. The Blue Cross Blue Shield of Massachusetts’ PRS and its content are provided “as is” and without warranties or conditions of any kind either expressed or implied. Blue Cross Blue Shield of Massachusetts denies, to the fullest extent permitted under applicable law, all warranties and conditions expressed or implied, including without limitation, warranties of merchantability, fitness for a particular purpose, title and non-infringement, and any warranties concerning the availability, accuracy, reliability, completeness, currency, quality, performance or suitability of this site, the content, or any products, services or results obtained on or through the Blue Cross Blue Shield of Massachusetts’ Patient Review System.

The Blue Cross Blue Shield of Massachusetts does not represent or warrant the availability of the site, that the Blue Cross Blue Shield of Massachusetts’ PRS and your use of it will be uninterrupted or error-free, that defects will be corrected, or that the Blue Cross Blue Shield of Massachusetts’ PRS or the server that makes it available are free of viruses or other harmful components. Blue Cross Blue Shield of Massachusetts does not warrant or make any representations regarding the use of, the result of, or the use of the Blue Cross Blue Shield of Massachusetts’ PRS and/or the content in terms of their correctness, accuracy, timeliness, reliability, applicability or otherwise. You (and not the Blue Cross Blue Shield of Massachusetts) assume the entire cost of all necessary servicing, repair or correction. The above exclusion may not apply to you, to the extent that applicable law may not allow the exclusion of implied warranties. In addition to the previously stated, you agree that your use of the Blue Cross Blue Shield of Massachusetts’ PRS and the content is at your own risk.

Blue Cross Blue Shield of Massachusetts makes no representations or warranties of any kind, express or implied, that the Patient Review System or any of the content will assist you in identifying a suitable health care provider or for any other purpose. Blue Cross Blue Shield of Massachusetts disclaims any and all responsibility and liability with respect to any agreements you may make with health care providers or with third parties who offer products or services on or through this site, and you agree to look solely to such health care providers and third parties with respect to any and all claims arising out of such agreements and/or such products or services.

The opinions and or views expressed on the PRS represent the thoughts of individual bloggers and online communities, and not those necessarily of Blue Cross Blue Shield of Massachusetts or any of its affiliated, related, wholly owned and/or wholly controlled companies or any of their respective directors, officers, and employees. The opinions and views expressed on these pages do not in any way reflect the views of the site they are posted on, other sites affiliated with the site, the staff involved with maintaining the site or any members of the site.

While Blue Cross Blue Shield of Massachusetts makes reasonable efforts to monitor and/or moderate content posted on PRS, we do not moderate all comments and cannot always respond in a timely manner to online requests for information.

Blue Cross Blue Shield of Massachusetts reserves the sole right to review, edit and/or delete any comments it deems are inappropriate. Comments including but not limited to the following may be deleted or edited by the moderators:

  • Off-topic and redundant comments (this includes promotion of events, groups, pages, Web sites, organizations and programs not related to the PRS); 
  • Comments that use foul language or “hate speech” (for example, including but not limited to racial, ethnic or gender bashing language); 
  • Comments that are abusive, illegal, disruptive or otherwise objectionable at the sole discretion of Blue Cross Blue Shield of Massachusetts; or 
  • Comments that violate an individual’s privacy, including documenting your name on the review. You will be given the option to create a screen name for yourself, and your screen name will be associated with your Submission. As such, you should refrain from including personally identifiable information in your screen name or otherwise in your submissions as reviews with member’s names will not be displayed.

By submitting content to the PRS, you understand and acknowledge that this information is available to the public and that Blue Cross Blue Shield of Massachusetts and others may use this information for internal and external purposes. Please note that other participants may use your posted information beyond the control of Blue Cross Blue Shield of Massachusetts. If you do not wish to have the information you have made available via this site used, published, copied and/or reprinted, please do not post on this page.

Important Disclosures and Terms of Use About Cost Estimates

Cost estimates provided in this tool are for active Blue Cross Blue Shield of Massachusetts members. These terms of use are an agreement between Blue Cross Blue Shield of Massachusetts, their members and all users of the site. This tool is intended to assist members in researching the cost of a procedure in order to get an estimate for the amount a procedure or service will cost.

Your use of this tool is conditioned on your acceptance of the terms, conditions and notices contained herein. Your use of this tool constitutes your agreement to all such terms, conditions, and notices, and by using the Site, you are agreeing to be bound by the terms and conditions. Unless otherwise specified, the information on this tool is for your personal and non-commercial use. Unauthorized copying, reproduction, republishing, uploading, downloading, posting, transmitting or duplicating any of the material on this site is prohibited without BCBSMA prior written permission. You may download or copy any downloadable materials displayed on the tool for home, noncommercial and personal use only. Use of information or communications available on this tool for any commercial or research related purpose is strictly prohibited. You agree that you will not use the information on this tool for any purpose that is unlawful or prohibited by these terms, conditions, and notices.

Cost Estimates May Not Reflect Your Actual Cost

This tool calculates the estimated cost of certain medical services. Cost estimates reflect average amounts paid to providers for services; they are not intended to reflect your out of pocket cost. Available coverage and the actual cost you incur will be determined by your health plan rules and benefits. Check your health plan benefits to find out exactly what is covered. In the event there is a difference between the website and your Blue Cross MA plan documents, your plan documents will control. Your actual cost may include deductibles (amounts you must pay before your health plan pays anything) and co-insurance or co-payments (your share of costs). Cost estimates do not represent a guarantee of payment or prior approval for any service.

Cost estimates do not account for services provided in the emergency room. In addition, cost estimates may not include costs associated with additional services beyond the specific service identified in the estimate (for example, lab tests and x-rays performed before or after a specific medical procedure may not be included in the estimate). Please note that in some cases these additional costs can be quite high, and you may be financially responsible for them depending on your health plan benefits.

Cost estimates and any amounts applied to your deductible and out of pocket maximum are based on the information available to Blue Cross Blue Shield of Massachusetts at the time the estimate is provided. Although we make every effort to keep this information current, estimates are subject to change.

For certain plans, this website provides an out of pocket estimate. This is an estimate of the amount of money you may have to spend "out of pocket" for a specific service. An out of pocket estimate does not guarantee coverage. Each admission, procedure, or service must be a medically necessary covered benefit and meet medical policy guidelines. In addition, all prior authorizations and referrals must be obtained, if necessary.

Out of pocket estimates are based on the information available to Blue Cross Blue Shield of Massachusetts. Although we make every effort to keep this information current, estimates are subject to change. Should information change or should unforeseen services arise out of the proposed admission, procedure, or service, the actual amount you will be responsible for may vary. If additional services or claims are received between the time an estimate is provided and the time the member receives the service, the level of benefits may change. For example, the amount applied toward a member's deductible or out of pocket maximum may change.

The cost estimator is not intended to provide you with medical or financial advice. Each person’s health care and financial needs are different and the costs calculated are only estimates. The purpose of the cost estimator is to assist you with understanding your coverage options and provide an estimate for the inquired upon procedure or service. Therefore, you should exercise independent judgment about your health and financial information before relying solely on the information provided from the website.

Please note: Cost Estimates are provided with the assumption that Blue Cross MA is the primary insurance coverage. If Blue Cross MA is your secondary insurance coverage, we encourage you to contact your primary insurance carrier for a cost estimate.

Consult With Your Provider About Your Medical Condition

You should consult with your own doctor or other health care provider about your particular medical condition. The information on this website is not medical advice and should not be viewed as a recommendation or endorsement of any particular health care provider or its services. Only you and your health care provider can decide which medical decision is best for you. Do not avoid getting health care or make health care decisions based on the cost estimates displayed on this website. Use this information to talk to your doctor or other health care provider when making medical decisions.

Blue Cross Blue Shield of Massachusetts does not guarantee that services will be available or will be of any particular quality or cost. The quality of health care services you receive can be different depending on the hospital or doctor's office you choose.

What's Not Included

A cost estimate represents an estimate of the average cost of a service offered by a given provider. Cost estimates may not be generated for every service or for every health care provider that offers a given service. In addition, cost estimates may not take into account all available cost data for a given health care provider. For instance, cost estimates do not account for Medicare claims, emergency cases or complications, or unusually high or low costs for a certain service.

For HMO Blue New England members, no cost data is available for health care providers outside of Massachusetts.

Future Modification to Terms of Use

Blue Cross Blue Shield of Massachusetts reserves the right to change the terms of this policy at any time, for any reason, with or without notice. If material changes are made to the policy a notification will be placed on the login screen of the website notifying you of such changes.

Show diabetes who’s boss

Whether you’ve just been diagnosed with diabetes, have been managing it your entire life, or somewhere in between, you’ve got backup when it comes to taking charge of your treatment and handling day-to-day challenges.

Sign in to see your diabetes benefits. 

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Be sure to touch B.A.S.E. with your provider

Managing your condition means partnering with your health care provider and care team to help monitor:

 

Blood pressure

Help keep blood pressure under 140/90 by using a digital blood pressure cuff at home.

 

A1C testing

A1c is your average blood glucose level. You can monitor your daily changes in blood sugar using a glucometer.

 

Statin medication

Statin medication may prevent cardiovascular disease in people with diabetes.

 

Eye exam

Be sure to schedule a routine retinal eye exam with an eye doctor.

PUT YOUR HEALTH PLAN TO WORK FOR YOU

Your plan may come with some unique benefits and programs to help keep diabetes in check.

Your pharmacy benefits may include additional offerings to help manage diabetes, such as:

Image of health living leafy vegetables and blueberries. Image of health living leafy vegetables and blueberries.

It’s more than checking your blood sugar

A total health approach that includes dental, vision, and preventive measures is a smart strategy. A few things to consider:

 

Give your smile some extra love

High blood sugar can impact your teeth, so preventive measures are crucial. Dental Blue® provides checkups and cleanings every three months.

Learn more about Dental Blue

 

Cover your eyes

With a Blue 20/20 vision plan, you get two diabetic eye exams and diagnostic testing each year, in addition to the routine eye exam included in your medical plan.

Learn more about Blue 20/20

 

Never miss your medication

Consistency is key. With the mail service pharmacy, you’ll often save money without missing a beat. There’s even a Medication Lookup tool to show you what’s covered, plus cost-friendly alternatives, if available.

See pharmacy coverage

 

Find a new provider or specialist

Your diabetes care should be as individual as you are. Our search tool will help you find a primary care provider, nutritionist, podiatrist, endocrinologist, or other health care professional you may need as part of your diabetes care team.

Search now

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Get Team Blue working for you

Connect with a Team Blue Care Manager, a health care expert who can help coordinate all the moving parts of your diabetes care, at no additional cost.

Call 1-800-392-0098 Monday through Thursday from 8:30 a.m. to 8:00 p.m. ET, and Friday from 8:30 a.m. to 4:30 p.m. ET.

Image of salad, avocado, mushrooms and other vegetables. Image of salad, avocado, mushrooms and other vegetables.

A Recipe For Better Health

Health experts explain how the foods you eat can help you manage your diabetes.

Read on

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Reap rewards year-round

With Blue365®, you get great discounts and deals on sportswear, nutrition, travel, fitness equipment, and more.

Find deals

Image of a glucose monitor and cell phone. Image of a glucose monitor and cell phone.

TAKE ACTION ON PREDIABETES

Discover how healthy lifestyle changes and online resources can help you stop prediabetes from progressing into diabetes.

LEARN MORE

We'll Help You Make the Most
of Every Dollar

The financial tools in your health plan can have a big impact on your health care experience. We’re here to help you feel more prepared for expenses, as well as help you understand the types of financial accounts your employer offers and what they mean for you.

Health Financial Accounts: What Are the Differences?

 

HSA

Health Savings Account

HRA

Health Reimbursement Arrangement

FSA

Flexible Spending Account
How does it work? Pre-tax dollars you contribute from your paycheck automatically go into an HSA, which is used to pay out-of-pocket health care costs. Your employer has the option of contributing. Your employer contributes tax-free funds to help you pay for health expenses. Pre-tax dollars you contribute from your paycheck automatically go into an FSA, which is used to pay out-of-pocket health care costs. Your employer has the option of contributing.
What can I use it for?

HSA-eligible expenses, as defined by the Internal Revenue Service (IRS), including deductibles, copays, prescription and non-prescription medications, dental and vision care, and more.

 Out-of-pocket medical expenses your employer decides are eligible, such as deductibles, and medical and prescription copays.

FSA-eligible expenses, including deductibles, copays, prescription and non-prescription medications, dental and vision care, and more.
Why should I consider it? This may be a smart choice, whether you want to pay for health care expenses now or want to save for down the road and into retirement. You may want to take advantage of tax-free funds to help pay for your health care expenses. This may be a wise choice if you know you'll have health expenses this year and want to budget for them.
How much can I contribute to my account? Refer to Internal Revenue Service (IRS) for the maximum contribution amount for the current tax year. This is determined by your employer. Refer to Internal Revenue Service (IRS) for the maximum contribution amount for the current tax year.
Who owns the account?

You.

Your HSA stays with you if you change jobs.

 Your employer (if you leave the company, the money stays with your employer). Your employer.
What are the tax benefits? Tax-free contributions and withdrawals, tax-deferred growth. Money contributed by your employer is tax-free to you. Tax-free contributions.
What are other benefits?

Your savings build and earn tax-free interest (interest isn't tax-free for residents of NJ).

After age 65, you can withdraw HSA funds for any use without penalty.

Your employer helps cover your expenses.

You decide how much money to set aside in your FSA for the year.

Your full FSA balance is available to you at the start of your plan year.
Do unused funds roll over at the end of a year? Yes, your funds roll over annually. They may not. Your employer chooses whether to allow funds to carry over each year. They may. Your employer determines whether unused FSA funds up to $570 a year can roll over.
When are funds available? Once your account is open and a deposit has been made, you can start using your HSA. Your employer decides how and when you can use your HRA funds. You may need to pay an out-of-pocket minimum before funds become available. You have access on the first day of your plan year to the total amount you elected to save in your FSA, even if you haven't yet contributed the full amount.
Can funds be invested?  Yes  No  No

Know your health financial accounts

Health Reimbursement Arrangements

Let’s lay it all out

First, HRA stands for health reimbursement arrangement.

It means your employer will help pay for some of your out of pocket costs. Great, right? Here’s how it works.

Think of an HRA like an extra pocket of money your employer gives you for health expenses.

So if your deductible is 2,000 dollars, and your employer gives you 1,000 dollars…

Now you have to cover 1,000 dollars less out of your own pocket.

You may be able to use your HRA to pay for health expenses like prescription copays, dental cleanings, or even physical therapy.

Check with your employer to see what they cover. No matter what, your HRA is always tax free. So no surprise costs at the end of the year.

Now that you’ve got your HRA down, sign in to MyBlue or download the MyBlue app to learn even more about your plan.

Health Savings 
Account

 

Let’s lay it all out.

HSA is shorthand for health savings account.

And just like it sounds, it will help you save and pay for health care expenses tax free.

You can contribute money to your HSA to pay for health expenses like x-rays, broken ankles, and even everyday health stuff like sunscreen. As long as your current balance covers the expense, you can spend it!

Your HSA is your own personal financial account, so money you don’t use will rollover every year, and your account stays with you, even if you change employers.

You can even invest the money to help pay for health costs later in life.

And, like we said, there’s no federal income tax on your contributions or your investment earnings.

You can spend tax-free too, as long as you’re paying for health care expenses.

Now that you’ve got a handle on your HSAs, sign in to MyBlue or download the MyBlue app to make the most of your health plan.

 

 

Flexible Spending 
Account

Let’s lay it all out

FSA stands for flexible spending account.

It’s a health care account you might get through your employer.

And it’s tax free!

You can use your FSA to pay for certain eligible expenses like dental bills, prescriptions and even taxis to medical visits. Here’s how it works.

First, you’ll tell your employer how much you want to put into your FSA for the plan year, up to the IRS limit. Let’s say it’s 1,000 dollars.

That 1,000 dollars will be available on the first day of your plan year. Woo hoo! You can use all of it right away.

Your employer will take money of out of your paychecks until it adds up to 1,000 dollars.

It’s all pre-tax too!

FSAs are typically use it or lose it, but you may be able to rollover some of it, so check with your employer.

Now that you’re up on FSAs, sign in to MyBlue or download the MyBlue app to discover even more about your plan and stay one step ahead.

 

Image of a phone with the MyBlue app. Image of a phone with the MyBlue app.

Keep tabs on your medical tab

Track your deductible, spending account balance, discounts and more — all in one place, all on your phone. Sign in or create a MyBlue account to see your personal Year-to-Date Summary. It’ll keep you two steps ahead.

Key Terms

The information within Find a Doctor is updated daily. However, before you receive services from providers, you should always contact them to make sure they are still participating in the network and that their information is up to date. These key terms and definitions are specific to Find a Doctor to help your provider search experience.

Accepting New Patients

Shows whether a doctor is accepting new patients in a specific network or not. A doctor who is not accepting new patients should still be able to see you if you are already their patient. This information is submitted directly by doctors when they apply to join our network. Blue Cross Blue Shield of Massachusetts makes changes to provider data as we are made aware of them. We outreach to providers each quarter, asking them to validate their data and encouraging them to notify us of any changes to their information.

Accreditation

Accreditation is a certification that indicates a hospital meets certain standards. In order to be accredited, a hospital must undergo an evaluation process based on a set of quality standards set by organizations such as The Joint Commission. The Joint Commission surveys and evaluates accredited hospitals at least once every three years for reaccreditation, using guidelines that ensure patients receive the highest quality care possible. The status of accredited hospitals is verified during the initial credentialing process. We update the accreditation status whenever we’re notified of changes and re-confirm it routinely every two years. For more information on specific hospitals, please go to http://www.qualitycheck.org/consumer/searchQCR.aspx.

Acute Residential Treatment for Children and Adolescents

Acute Residential Treatment for Children and Adolescents refers to the following services for patients under 19:

● Community-based acute treatment for children and adolescents

● Web-based Intensive community-based acute treatment for children and adolescents

These services are an alternative to acute inpatient care providing treatments in a sub-acute setting.

Board Certified

Board-certified doctors have completed additional clinical training in their area of expertise. To receive this designation, they have passed oral and/or written examinations that document their competency in a given specialty. This is not applicable to ancillary doctors (examples: diagnostic, therapeutic, and custodial care providers). For more information, please see Certification Matters™. Doctors report their board-certification status to us when they apply to join our network. We verify the status with the appropriate board and reconfirm every two years. We also update the information whenever we’re notified of any changes.

Community-Based Acute Treatment for Children and Adolescents

Community-Based Acute Treatment for Children and Adolescents is a residential program that provides intensive therapeutic services in a secure setting. The program may be an alternative to inpatient behavioral health services. For help finding the right care for you or your child, call 1-800-821-1388.

Electronic Medical Records

Indicates your doctor has an immediately accessible electronic version of your medical record, including diagnoses, medications, allergies, test results, and your medical history.

e-Prescriber

Allows your doctor to send an electronic prescription directly to your pharmacy.

Family Support and Training for Children and Adolescents

Family Support and Training provides medically necessary services to a parent or other caregiver of a child so the caregiver can better meet the child’s emotional or behavioral needs. The support and training may include teaching the caregiver how to navigate services to get help for the child and how to find informal services and community support, including parent support and self-help groups. For help finding the right care for you or your child, call 1-800-821-1388.

Fee-for-service

We pay some health care providers on a fee-for-service basis, meaning we pay them each time you get care.

Gender

Shows whether a health care professional is a man or a woman. This information is submitted by health care professionals when they apply to join our network. Blue Cross Blue Shield of Massachusetts makes changes to provider data as we are made aware of them. We outreach to providers each quarter, asking them to validate their data and encouraging them to notify us of any changes to their information.

Hospital Affiliations

Health care professionals sometimes have a relationship with a hospital, allowing them admitting and attending privileges. We encourage you to compare the cost and quality of the hospitals as results may differ. Hospital affiliations are submitted by health care professionals when they apply to join our network. We update the information whenever we’re notified of changes and reconfirm it every two years.

In-Home Behavioral Services for Children and Adolescents

In-Home Behavioral Services include monitoring and assessing a child or adolescent’s behavior as well as therapy to address behaviors that may get in the way of the child or adolescent’s everyday life. A team of providers works with the child or adolescent and their family to develop and implement a plan for improving the child’s behavior. For help finding the right care for you or your child, call 1-800-821-1388.

In-Home Therapy for Children and Adolescents

In-Home Therapy provides in-home therapeutic support to a child or adolescent with their social skills and behavioral health needs, as well as improve their family’s ability to provide effective emotional support to the child. For help finding the right care for you or your child, call 1-800-821-1388.

Intensive Care Coordination for Children and Adolescents

Intensive Care Coordination helps coordinate the services provided to children or adolescents with serious emotional or behavioral needs. That way all providers are working together to meet the medical, behavioral health, and social needs of the child and their family. For help finding the right care for you or your child, call 1-800-821-1388.

Intensive Community-Based Treatment for Children and Adolescents

Intensive Community Based Treatments (in-home outpatient services) for Children and Adolescents refer to the following services for patients under 19:

● Intensive care coordination,

● In-home behavioral services

● In-home therapy

In-home behavioral services include behavioral management monitoring and behavioral management therapy. In-home therapy includes therapeutic clinical intervention and ongoing therapeutic training and support. For help finding the right care for you or your child, call 1-800-821-1388.

Intensive Community-Based Acute Treatment for Children and Adolescents

Intensive Community-Based Acute Treatment for Children and Adolescents is a residential program that provides intensive therapeutic services in a secure setting. Intensive Community-Based Acute Treatment for Children and Adolescents provides the same services as Community-Based Treatment for Children and Adolescents but of a higher intensity, including more staffing and evaluations. The program may be an alternative to inpatient behavioral health services. For help finding the right care for you or your child, call 1-800-821-1388.

Languages Spoken

Health care professionals list the languages they speak on their credentialing application. They can also supply interpreter services for their patients. This information is submitted by health care professionals when they apply to join our network. Blue Cross Blue Shield of Massachusetts makes changes to provider data as we are made aware of them. We outreach to providers each quarter, asking them to validate their data and encouraging them to notify us of any changes to their information.

Medical Group

A group of doctors who manage a practice and are contracted with Blue Cross to provide services to our members. This information is submitted by doctors when they apply to join our network. Blue Cross Blue Shield of Massachusetts makes changes to provider data as we are made aware of them. We outreach to providers each quarter, asking them to validate their data and encouraging them to notify us of any changes to their information.

Mobile Crisis Intervention

Mobile Crisis Intervention provides urgent care for behavioral health. It is a short-term, mobile, on-site, face-to-face therapeutic response service that is available 24 hours a day, 7 days a week to patients experiencing a behavioral health crisis. Mobile Crisis Intervention is used to identify, assess, treat and stabilize a situation, to reduce the immediate risk of danger to the patient or others, and to make referrals and linkages to all medically necessary behavioral health services and supports and the appropriate level of care. For help finding the right care for you or your child, call 1-800-821-1388.

Name

The name that appears on the provider’s professional license. For facilities, it’s the legal name or “doing business as” name from the provider’s contract. This information is submitted by providers when they apply to join our network. We update the information whenever we’re notified of changes and reconfirm it every two years.

Performance-based incentives

Doctors are rewarded based on positive patient outcomes, rather than solely reimbursing them for the number of services they provide. Doctors can earn higher payments based on how well they perform on a set of nationally recognized, clinical-quality measures. They are also responsible for managing the total cost of care for their Blue Cross patients.

Phone Number

The provider’s practice phone number, whether located in an office, a hospital, or another medical facility. This information is submitted by providers when they apply to join our network. Blue Cross Blue Shield of Massachusetts makes changes to provider data as we are made aware of them. We remind providers each quarter to validate their directory data and encourage them to notify us of any changes to their information.

Provider

A provider is a licensed health care facility, program, agency, doctor, or other health professional that delivers health care services. Providers may also be certified and recognized under state law.

Provider Location

The provider’s practice address, whether located in an office, a hospital, or another medical facility. This information is submitted by providers when they apply to join our network. Blue Cross Blue Shield of Massachusetts makes changes to provider data as we are made aware of them. We remind providers each quarter to validate their directory data and encourage them to notify us of any changes to their information.

Relative Price

Relative price is a calculated metric that measures provider price variation in the Massachusetts health care market. It compares different provider prices within a payer’s network for a standard mix of insurance products (e.g. HMO, PPO, and Indemnity) to the average of all providers’ prices in that network. For more information on Relative Price, please go to http://www.chiamass.gov/relative-price-and-provider-price-variation/.

Specialty

Providers may limit their practice to a specific branch of medicine or surgery, such as internal medicine, orthopedics, or gastroenterology. This is known as a “specialty.” This information is submitted by providers when they apply to join our network. We update the information whenever we’re notified of changes and reconfirm it every two years. Community mental health centers and behavioral health hospitals may have additional information pertaining to services they offer listed as a specialty, but this information is self-reported. Other self-reported information includes ages treated, treatment methods, disorders treated, and subspecialties/areas of expertise for behavioral health providers, lactation counseling services, telehealth services, disability access, TTY availability, accessibility by public transportation, and the availability of evening and weekend office hours. You should always confirm this information with the provider before making an appointment.

Standard Quality Measure Set

The Massachusetts Statewide Quality Advisory Committee (SQAC), which was established by Chapter 288 of the Acts of 2010 and reestablished by Chapter 224 of the Acts of 2012, is comprised of various experts in the health care industry and is tasked with recommending a Standard Quality Measure Set (SQMS). The SQMS covers a variety of clinical areas, such as preventive health, chronic disease management, pediatric, maternal and neonatal health, mental health, and substance abuse, and also includes measures mandated by the State Legislature. For more information on the SQMS, please go to https://www.chiamass.gov/sqms/.

Telehealth

A live video visit with a health care provider using a smartphone, tablet, or computer. It offers a convenient way to have a brief visit with a doctor or therapist, simply and easily.

Therapeutic Mentoring Services for Children and Adolescents

Therapeutic Mentoring Services provide medically necessary services to help a child learn and practice social and communication skills so the child can relate appropriately to other children and adolescents and to adults. For help finding the right care for you or your child, call 1-800-821-1388.

Total Medical Expense

Total Medical Expense (TME) represents the full amount paid to providers for health care services delivered to a payer’s member population, expressed on a per member per month (PMPM) basis. TME includes the amounts paid by the payer and patient cost-sharing, and covers all categories of medical expenses and all non-claims related payments to providers, including provider performance payments. For more information on TME, please go to http://www.chiamass.gov/thce-tme-apm/.

Urgent Care Center

Urgent care centers can provide medical care when your provider is not available and you don’t have a true emergency. They can help with sprains, X-rays, and minor cuts and injuries. You can usually go to an urgent care center in the evenings and on weekends. Typically, visits to urgent care centers result in lower out-of-pocket costs, compared to visits to emergency rooms.

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

The flu shot is available at no additional cost from an in-network provider or care location.**

 

 

 

Retail pharmacy

Schedule your flu shot at a pharmacy near you. 

Find a pharmacy

 

 

Primary care 
provider’s office 

If you don’t have a PCP, use our Find a Doctor tool. 

Find a doctor

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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.

phone with find a doctor page on screen phone with find a doctor page on screen

* 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.

Smiling person with hand on hip. Smiling person with hand on hip.

Dental and Vision Coverage

When it comes to your benefits, we’re here to support your whole health.

Dental Blue®

Dental Blue gives you access to more than 93% of practicing dentists in Massachusetts, as well as over 520,000 provider locations nationwide. 

Instead of coverage for a routine dental cleaning every six months, you get two checkups per year, which include cleanings — and you don’t have to wait six months between visits.

Dental Blue now provides complete coverage for kids under the age of 13, with no cost and no deductible for covered dental services up to the calendar-year benefit maximum. This excludes orthodontic services. 

Preventive and diagnostic care: 100% coverage

Example: bi-annual cleanings

Basic restorative: 80% coverage

Examples: fillings, root canals, extractions

Major restorative: 50% coverage

Examples: caps, crowns

Orthodontics (adults and kids): 100% ($1,500 lifetime maximum)

Examples: braces, retainers

Deductible: $50 per member or $150 per family

Calendar-year benefit maximum: $1,500 per member

  • Individual: $5.70
  • Individual +1: $11.57
  • Family: $16.71
Cup with two toothbrushes Cup with two toothbrushes
pair of folded eyeglasses pair of folded eyeglasses

Blue 20/20 PLUS

Get great coverage with eye-opening savings, plus new, enhanced benefits for kids under 19 at no additional cost.

Members enjoy a $0 copay for exams, and additional perks, including: 

  • Savings on a second pair of glasses, non-prescription sunglasses, laser vision correction, and eye care supplies

  • An additional $50 frame allowance when you visit a PLUS provider, with no brand restrictions 

  • More flexibility and choice when selecting vision care, with easy access to thousands of PLUS providers

To make sure kids get the vision care they need, we’ve added the following coverage at no additional cost:

  • Two fully covered eye exams at $0 copay per benefit frequency 

  • One pair of replacement lenses (subject to a prescription change) per benefit frequency 

  • Fully covered blue-light prescription lenses treatment 

  • Fully covered standard polycarbonate lenses

  • Individual: $3.05
  • Individual +1: $5.49
  • Family: $8.55

1. For part-time plan rates, download 2025 part-time rates.

Individual in a sweater with hand on chin. Individual in a sweater with hand on chin.

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.

Get Started

 

Get a Personalized View
of Your Plan

It’s never been faster, easier, or more convenient to stay on top of your coverage.

DOWNLOAD THE NEW MYBLUE APP