HEALTH INSURANCE
Eligible employees may choose between HMO or PPO plans through MIIA/Blue Cross Blue Shield of Massachusetts. The City contributes the majority share of the cost of the premium. To enroll, you will need names, social security numbers, dates of birth and primary care physician names (PCP required for HMO only) for you any dependents you wish to add to your coverage.
Your Cost share: City Pays 75% / You Pay 25%
Your E-kit has full benefit details, information & summery plan descriptions:
https://planinfo.bluecrossma.com/ekit/2024-miiacityofnewburyport-en_US.pdf
Which Plan is Right for Me? HMO or PPO?
The annual deductible for the HMO and the PPO are IDENTICAL
The covered services for in network care for the HMO and the PPO are IDENTICAL
Urgent care/Emergency room care is fully covered outside of New England for BOTH
The main differences between HMO & PPO are that PPO has….
Higher monthly premiums
No referrals for primary care doctor or specialists
Can go to providers outside of the Blue Cross Network and New England (20% coinsurance after deductible)
Questions to ask yourself regarding whether you need to be on the PPO Plan:
Do you or your family need to go out of the network for health care?
Are you aware going out of network you are responsible for paying 20% of the cost of care after deductible?
Do you realize urgent/emergency care is fully covered under the HMO when you or your family is traveling?
If an HMO fits your needs, the SELECT HMO plan at 8% lower may be right for you:
Are all of my providers in MASSACHUSETTS?
Do I typically see the same providers in the same small network?
Am I comfortable having a limited number of hospitals available to me? Visit www.bluecrossma.com/hospitalchoice for a full listing of available hospitals.
If you answered YES to all the questions, then SELECT HMO at 8% less may be right for you. Visit https://member.bluecrossma.com/fad and select “HMO Blue Select” to make sure your provider is in this plan.
Summary of Plan Benefits & Rates
Account Management
Prescription Cost-Share Assistance Program
Save Money on Eligible Medications with the Cost-Share Assistance Program. You shouldn’t have to go out of your way to get savings. The Cost-Share Assistance Program provides financial assistance, using coupons from manufacturers of medication, to cover most or all of your out-of-pocket costs for eligible medications. To get the savings, all you need to do is enroll. You don’t have to change anything about your prescriptions, including how or where you fill them. It’s that easy. Click HERE to see how the Cost-Share Assistance Program works or enroll.
SmartShopper Program
Get a cash reward for your next medical procedure. Choose high-quality, convenient, in-network locations for common medical care and earn a cash reward every time you save. Healthy You, Healthy Wallet! Costs vary for medical procedures between locations. With SmartShopper, you can find a location, earn a cash reward and save money, too! Click HERE for more information on how to enroll in this program!
Find Important Forms
Required Notices
- HIPAA Privacy Notice
- Newborns' & Mothers' Health Protection Act
- Women's Health & Cancer Rights Act