Does my plan have a fitness and/or weight-loss benefit? What types of things are covered by that benefit?

Member for

4 years
Submitted by Linda.SimmonsBarrows on
We're dedicated to your well-being. Our fitness benefit and/or weight-loss benefit can save you and your family on qualified expenses annually.

To submit for reimbursement, use our online submission form.

To see what's covered by your plan, visit the Benefit Description tab.

What are my benefits for a routine physical/routine health checkup?

Member for

4 years
Submitted by Linda.SimmonsBarrows on
Your well-being is our top priority. Most of our plans cover routine physical exams and immunizations at no cost* to you when administered by your selected primary care physician contracted within your network. Click to view your Benefit Description details.

*Under certain conditions, costs may apply.

What are my benefits for a mammogram, colonoscopy?

Member for

4 years
Submitted by Linda.SimmonsBarrows on
Most preventive screenings are included in your plan at no additional cost.* If a service/procedure is ordered due to signs and/or symptoms, to check on an existing issue or to diagnose a health concern, cost share may apply.

Check your Benefit Description for more details.

*Under certain conditions, costs may apply.

Do I need a referral from my PCP to see a specialist? Will I have a co-pay?

Member for

4 years
Submitted by Linda.SimmonsBarrows on
HMO plans, like HMO Blue® and HMO Blue New England,SM require a PCP referral before seeing a specialist. Because your PCP knows your history and health care needs, they are best qualified to help you decide whether a specialist is needed.

Blue Choice® and Blue Choice New EnglandSM members have the option to self-refer for covered services but may incur a higher out-of-pocket cost.

Members on PPO plans do not require a referral to see a specialist.

Does my plan cover the shingles (flu, travel) vaccine?

Member for

4 years
Submitted by Linda.SimmonsBarrows on
Most plans cover recommended preventive and travel immunizations without cost share.* This includes but is not limited to: flu shots, travel immunizations, shingles (Shingrix) and meningococcal vaccine.

Members can get their immunizations from an in-network provider or at an outpatient clinic. Members with pharmacy benefits with us may also be able to receive immunizations at retail pharmacy locations affiliated with Express Scripts®′ that offer vaccines.

*Under certain conditions, costs may apply.

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Member for

4 years 8 months
Submitted by Michael.Prestoy on