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  • Summary of Benefits and Coverage

    As required by federal health care reform, this document provides a summary of a GIC plan’s benefits and cost-sharing requirements.  View and print all GIC SBCs.
  • Deductible Changes and - Questions & Answers

    All GIC Employee and Non-Medicare Retiree/Survivor health plans include a deductible. This is a fixed dollar amount you must pay before your health plan begins paying benefits for you or your covered dependent(s). The deductible will transition to a fiscal year to make it easier for members to change health plan carriers at Annual Enrollment.
  • Fallon Health Direct Care HMO

    Fallon Health Direct Care is an HMO that requires members to select a Primary Care Physician (PCP) to manage their care and obtain referrals to specialists. The plan offers a selective network of doctors, hospitals and other providers. There are no out-of-network benefits, with the exception of emergency care. The plan offers a selective network based in a geographically concentrated area.
  • Fallon Health Select Care HMO

    Fallon Health Select Care is an HMO that requires members to select a Primary Care Physician (PCP) to manage their care and obtain referrals to specialists. The plan offers a selective network of doctors, hospitals, and other providers. There are no out-of-network benefits, with the exception of emergency care. Members pay lower copays when they see Tier 1 or Tier 2 physicians.
  • Harvard Pilgrim Independence Plan POS

    In keeping with the Centered Care Initiative, Harvard Pilgrim Independence Plan will become Point-of-Service (POS) plans.  With a POS Plan, members must select a Primary Care Provider (PCP) to manage their care and obtain referrals to specialists to receive care at the in-network level of coverage. Members who get care from specialists without a PCP referral will have higher out-of-pocket costs. Current members of these plans will stay in the plan if they do not switch plans during Annual Enrollment and will receive additional details of this transition from their plan.

  • Harvard Pilgrim Primary Choice Plan HMO

    The Harvard Pilgrim Primary Choice Plan, administered by Harvard Pilgrim Health Care, is an HMO plan that provides coverage through the plan’s network of doctors, hospitals and other providers. Members must select a Primary Care Provider (PCP) to manage their care, including referrals to specialists.
  • Health New England HMO

    Health New England is an HMO that provides coverage through the plan’s network of doctors, hospitals, and other providers.  Members must select a Primary Care Provider (PCP) to manage their care; referrals to network specialists are not required. 

  • NHP Prime - Neighborhood Health Plan HMO

    NHP Prime, administered by Neighborhood Health Plan, is an HMO that provides coverage through the plan’s network of doctors, hospitals, and other providers.  Members must select a Primary Care Provider (PCP) to manage their care and obtain referrals to specialists.  

  • Tufts Health Plan Navigator POS

    In keeping with the Centered Care Initiative, Tufts Health Plan Navigator will become Point-of-Service (POS) plans.  With a POS Plan, members must select a Primary Care Provider (PCP) to manage their care and obtain referrals to specialists to receive care at the in-network level of coverage. Members who get care from specialists without a PCP referral will have higher out-of-pocket costs. Current members of these plans will stay in the plan if they do not switch plans during Annual Enrollment and will receive additional details of this transition from their plan.

  • Tufts Health Plan Spirit EPO (HMO-type)

    Tufts Health Plan Spirit is an Exclusive Provider Organization (EPO) plan that provides coverage through the plan’s network of doctors, hospitals and other providers.  The plan encourages but does not require members to select a Primary Care Provider (PCP). The mental health benefits of this plan are administered by Beacon Health Options.

  • UniCare State Indemnity Plan/Basic

    The UniCare State Indemnity Plan/Basic offers access to any licensed doctor or hospital throughout the United States and outside of the country. The Plan determines allowed amounts for out-of-state providers; you may be responsible for a portion of the total charge.  To avoid these additional charges, if you use non-Massachusetts doctors or hospitals, contact the plan to find out which providers in your area participate in UniCare's National Network.  Mental health benefits administered by Beacon Health Options include network providers with a copayment or out-of-network providers at higher out-of-pocket-costs.  Prescription drug benefits are administered by CVS/caremark.  

  • UniCare State Indemnity Plan / Community Choice PPO-Type

    The UniCare State Indemnity Plan/Community Choice is a PPO-type plan with a hospital network based at community and some tertiary hospitals at 100% coverage, after a copayment.  Or, you may seek care from an out-of-network hospital for 80% coverage of the allowed amount for inpatient care and outpatient surgery, after you pay a copay. Ontact the plan to see if your hospital is in the network. The plan offers access to all Massachusetts physicians and members are encouraged but not required to select a Primary Care Provider (PCP).  The mental health benefits of this plan, administered by Beacon Health Options, offer you a choice of using network providers and paying a copayment, or seeking care from out-of-network providers at higher out-of-pocket costs.  Prescription drug benefits are administered by CVS/caremark.

  • UniCare State Indemnity Plan / PLUS PPO-Type

    The UniCare State Indemnity Plan/PLUS is a PPO-type plan that provides access to all Massachusetts physicians and hospitals and out-of-state UniCare providers at 100% coverage, after a copayment.  Out-of-state non-UniCare providers have 80% coverage of allowed charges. Members are encouraged but not required to select a Primary Care Provider (PCP). The mental health benefits of this plan, administered by Beacon Health Options, offer you a choice of using network providers and paying a copaymrrnt or seeking care from out-of-network providers at higher out-of-pocket costs.  Prescription drug benefits are administered by CVS/caremark.

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