Plan Overview
Health New England MedPlus is a Medicare HMO plan that provides coverage through the plan’s network of doctors, hospitals, and other providers. Members must select a Primary Care Physician (PCP) to manage their care; referrals to network specialists are not required.
Contact the plan to see if your doctors and hospitals are in the network.There are no out-of-network benefits, with the exception of emergency and urgent care.
Your Responsibility
Do your doctors and hospitals participate in Health New England MedPlus?
Contact the plan.
Plan Contact Information
Contact the plan for additional information on
participating providers and benefits.
Health New England MedPlus 1.800.842.4464
Copays Effective July 1, 2013
Physician Office Visit
$10 per visit
Preventive Services
Covered at 100% - no copay
Retail Clinic
$10 per visit
Outpatient Mental Health and Substance Abuse Care
$10 per visit
Inpatient Hospital Care
Covered at 100% - no copay
Inpatient and Outpatient Surgery
Covered at 100% - no copay
Emergency Room
$50 per visit (waived if admitted)
Prescription Drug
Retail up to 30-day supply: Mail Order up to 90-day supply:
Tier 1: $10 Tier 1: $20
Tier 2: $25 Tier 2: $50
Tier 3: $50 Tier 3: $110
Who is Eligible?
Retirees, GIC Retired Municipal Teachers (RMTs), Elderly Governmental Retirees (EGRs), Survivors, and their eligible dependents with Medicare Part A and Part B are eligible.
Where You Live Determines Which Plan You May Enroll In:
Health New England MedPlus is available in the following Massachusetts counties:
Berkshire, Franklin, Hampden, Hampshire
Health New England MedPlus in available only in certain parts of the following Massachusetts county; contact the plan to find out if you live in the service area:
Worcester
Health New England MedPlus FY13 Handbook 
Health New England MedPlus FY13 Handbook 
file size 1MB
This information provided by the Group Insurance Commission.
