Financial & Billing Matters | Accepted Health Insurances | Boston Children's Hospital

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Boston Children’s Hospital and physicians are participating with the list of insurance plans below. Participation in these plans is not a guarantee of payment or coverage. Many insurance companies require a referral or prior-authorization for coverage of services. If you would like to verify coverage or have questions regarding out of pocket expenses we recommend that you call the member services number on your insurance card or contact your employee benefits program for more information. If you have a question as to whether Boston Children’s Hospital and its physicians participate in your insurance plan please contact 617-355-3397.

YOUR FINANCIAL RESPONSIBILITY: If you are enrolled in a tiered, high deductible or limited network your out of pocket expense will vary based on the provider and/or place of service (i.e. main campus vs. satellites), and provider of service. We recommend that you call your insurance carrier or your benefits office to determine your liability/out of pocket financial responsibility.

BEHAVIORAL HEALTH COVERAGE: Behavioral Health Benefits shouldalwaysbe verified with your health insurance company. Coverage of services can vary based on a variety of factors.

AETNA

AETNA CHOICE POINT OF SERVICE (POS)
AETNA MANAGE CHOICE
AETNA OPEN ACCESS MANAGE CARE
AETNA OPEN CHOICE PPO
AETNA HEALTH NETWORK
AETNA NETWORK OPTION PLANS
AENTA INDEMNITY PLANS
AETNA TRANSPLANT NETWORK
AETNA BEHAVIORAL HEALTH
安泰美国医疗组织
AETNA US HEALTHCARE PPO & INDEMNITY
AETNA BETTER HEALTH
INTERNATIONAL AETNA GLOBAL BENEFITS
INTERNATIONAL AETNA

BLUE CROSS BLUE SHIELD

The BlueCard program is a national program that enables members of a Blue Cross Blue Shield plan to get health care service benefits while traveling or living in another Blue plan’s service area. Benefits vary from plan to plan and state to state. Always check benefits and eligibility before rendering services.BlueCard members have a suitcase logo on their ID card.

BLUE CROSS MA PPO & INDEMNITY
蓝十字马HMO &蓝选择(POS)
BLUE CROSS MEDEX
BLUE CROSS BLUE SHIELD - FEDERAL
BLUE OPTIONS - HMO BLUE NEW ENGLAND OPTIONS
BLUE OPTIONS - PREFERRED BLUE PPO OPTIONS
BLUE BENEFIT ADMINISTRATORS
BLUE SELECT OPTIONS HMO & PPO
BLUE CROSS OUT-OF-STATE
BCBS BEHAVIORAL HEALTH

PLEASE NOTE – Boston Children’s Hospital and physicians DO NOT participate in the following plans:

BCBS MEDICAID PLANS

BEACON HEALTH STRATEGIES

BEACON - MASSHEALTH (MBHP)
BEACON - FALLON HEALTH
BEACON - GIC
BEACON - NEIGHBORHOOD HEALTH PLANS

CIGNA

Cigna’s LocalPlus Network plan will no longer be available at Boston Children’s effective January 1, 2018.

CIGNA CARELINK
CIGNA OPEN ACCESS PLUS
CIGNA NETWORK OPEN ACCESS & OPEN ACCESS PLUS
CIGNA HMO OPEN ACCESS & POS OPEN ACCESS
CIGNA LOCALPLUS ® HMO, POS, and HMO POS
CIGNA NETWORK & NETWORK POS, PPO or EPO
CIGNA LOCALPLUS® NETWORK FOCUS NETWORK
CIGNA OPEN ACCESS PLUS NETWORK
CIGNA NETWORKS IN THE US: PPO & AOP
CIGNA HEALTH PLAN-PPO & INDEMNITY
CIGNA MVP
CIGNA LIFESOURCE
CIGNA GREAT WEST LIFE
INTERNATIONAL CIGNA
CIGNA BEHAVIORAL HEALTH
LIFESOURCE

COVENTRY

COMMUNITY HEALTH OPTIONS

PPO MAINE FEDERAL EXCHANGE – MAINE COVERAGE ONLY

Community Advantage – Gold & Silver (ME)
Community Value – Silver (ME)
Community Value Plus Silver
Community Choice Silver
社区前ferred Silver
社区前ferred Plus Silver
Community Option Bronze
Community Plus Bronze
Community Option Bronze
Community Plus Bronze
Community Option HSA Bronze
Community Safe Harbor Catastrophic
社区前mier Platinum
Community Balance Silver

FALLON

SELECT CARE
HARRINGTON ADVANTAGE-PPO
FALLON ADVANTAGE PLAN- THE CITY OF WORCESTER – SELECT CARE TIER 2
FALLON HARRINGTON ADVANTAGE - PPO
FALLON CONNECTOR OPTIONS – SELECT CARE
FALLON TIERED CHOICE – TIER 3
FALLON PREFERRED CARE-PPO
FALLON – MASSHEALTH

PLEASE NOTE – Boston Children’s Hospital and physicians DO NOT participate in the following plans:

DIRECT CARE (CITY OF WORCHESTER-DIRECT)
STEWARD COMMUNITY CARE
HARRINGTON HHCS 2 ACA
THE CITY OF WORCESTER ADVANTAG – DIRECT PLAN
FALLON – COMMUNITY CARE
FALLON MEDICARE – NO PRODUCTS

HARVARD PILGRIM HEALTH CARE (HPHC)

HPHC-HMO
HPHC-PPO
HPHC CHOICE PLUS PASSPORT
HARVARD PILGRIM OPTIONS-PPO
HPHC STUDENT INSURANCE PL-PPO
HEALTH PLANS INC-PPO
HPHC NH HEALTHY KIDS
HPHC CHOICE NET - HMO
HPHC CHOICE NET - PPO
HPHC PRIMARY CHOICE (GIC)
HPHC INDEPENDENCE PLAN (POS)
HPHC FOCUS NETWORK – Authorized Access
HPHC HOSPITAL PREFER-HMO
HPHC HOSPITAL PREFER-PPO
HPHC SOUTHCOAST
HPHC NH ELEVATE HEALTH – Authorized Access
HPHC ELEVATE HEALTH OPTIONS

PLEASE NOTE – Boston Children’s Hospital and physicians DO NOT participate in the following plans:

HPHC LAWRENCE GENERAL
HPHC SIGNATURE HEALTHCARE
HPHC DARTMOUTH HITCHCOCK
HPHC BIDMC SELECT
HPHC BMC SELECT-HMO
HPHC BMC TIERED-HMO

HUMANA

CHOICE CARE NETWORK - PPO

PLEASE NOTE - Boston Children's Hospital and physicians DO NOT participate in the following plans:

HUMANA HMO

LIFETRAC TRANSPLANT NETWORK

MASSHEALTH – Mass Medicaid

MASSHEALTH-LIMITED
MASSHEALTH-NON-PCC
MASSHEALTH-PCC
MASS BEHAVIORAL HEALTH PLAN (MBHP)
MASSHEALTH STANDARD
MASSHEALTH COMMONWEALTH
MASSHEALTH CARE PLUS
MASSHEALTH FAMILY ASSIST
MASSHEALTH SMALL BUSINESS EMPLOYEE PREMIUM
CHILDREN’S MEDICAL SECURITY PLAN

MEDICAID – Out of State*

New Hampshire
Vermont
Maine
AETNA BETTER HEALTH

All Others please refer to 617-355-3397
*The Boston Children’s Hospital Network is enrolled with several out of state Medicaid plans. Please contact your Medicaid member services center to inquire about contractual agreements with BCH.

MEDICARE

MULTIPLAN/PHCS

Covers out of network benefits for patients.

NEIGHBORHOOD HEALTH PLAN (NHP)MASSACHUSETTS