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, 2016

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:   $25
Tier 2:   $30                                        Tier 2:   $75
Tier 3:   $65                                        Tier 3:   $165

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, Worcester

Health New England MedPlus is available only in certain parts of the following state; contact the plan to find out if you live in the service area:  Connecticut

Health New England January 1, 2016 Amendment docx format of HNE_1_1_16notice.docx


FY16 Health New England MedPlus HMO Handbook doc format of HNE_Retiree_FY16handbook.doc
file size 1MB

FY16 Health New England MedPlus HMO Handbook pdf format of HNE_Retiree_FY16handbook.pdf
file size 1MB


This information provided by the Group Insurance Commission .