Consider enrolling in a Limited Network Plan to Save Money Every Month on Your Premiums!
Limited network plans help address differences in provider costs. You will enjoy similar benefits to wider network plans, but will save money because limited network plans have a smaller network of providers (not every doctor and hospital). Your savings depend on:
- The plan you are switching from,
- The plan you select,
- Your premium percentage contribution, and
- Whether you have individual or family coverage.
See the Municipal Health Plan Rate page to determine what the savings would be for the plans you are considering.
Find out if your hospital is in a GIC limited network plan
Attached is a side-by-side comparison of the six limited network plans and their participating hospitals
For participating physician and other provider details, contact the individual plans by phone or visit their website: Municipal Health Plan Pages.
The GIC’s limited network plans are:
- Fallon Community Health Plan Direct Care - an HMO based at physician practices throughout central Massachusetts, Metro West, Middlesex Valley, the North Shore and the South Shore. The plan includes 25 area hospitals and another five “Peace of Mind” hospitals in Boston that provide second opinions and care for very complex cases.
- Harvard Pilgrim Primary Choice Plan - an HMO with a network of 57 hospitals. The plan is available throughout Massachusetts, except for Martha’s Vineyard, Nantucket and parts of Berkshire County and Cape Cod..
- Health New England - A western Massachusetts-based HMO that also covers parts of Worcester County and includes 18 Massachusetts hospitals.
- NHP Care (Neighborhood Health Plan) - an HMO with a provider network that includes community health centers, independent medical groups and hospital group practices, as well as 67 hospitals. NHP Care is available across most of the state except for Berkshire, Franklin, Hampshire, and parts of Plymouth County.
- Tufts Health Plan Spirit – an EPO (HMO-type) plan with a network of 53 hospitals. The plan is available throughout Massachusetts, except for Martha’s Vineyard and Nantucket and parts of Berkshire County.
- UniCare State Indemnity Plan/Community Choice - a PPO-type plan with a network of 49 hospitals. All Massachusetts physicians participate. The plan is available throughout Massachusetts, except for Martha's Vineyard and Nantucket.
! Your Responsibility Before You Enroll in a Plan
- Be sure to check if your doctors participate in the plan
- Find out if the doctors’ affiliated hospitals are in the plan
- Keep in Mind: Doctors and hospitals can leave a plan during the year, usually because of health plan and provider contract issues, practice mergers, retirement or relocation. Once you choose a plan you, cannot change health plans during the year, unless you move out of the plan’s service area. If your doctor or hospital leaves your health plan, you must find a new participating provider.
This information provided by the Group Insurance Commission.