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Pediatric Service Eligibility and Overview
A pediatrician is a medical doctor who manages the physical, behavioral, and mental health care for children. A pediatrician is trained to diagnose and treat a broad range of childhood illnesses, from minor health problems to serious diseases.
How to Search for a Pediatrician
- Visit Atrius Health to find a pediatrician
- Visit bcbsma.com to search for an in-network pediatrician in Massachusetts; select “PPO or EPO with Hospital Choice Cost Share Feature” as your plan’s network
- Visit bcbs.com/find-a-doctor to search for an in-network pediatrician nationwide; type “HVA” as your three-letter prefix
Out-of-Pocket Costs for Pediatric Care
Benefit Type | In-Network Blue Cross Blue Shield(BCBS) PPO Providers | Out-of-Network Providers that do not participate with BCBS PPO |
---|---|---|
Routine pediatric care – members aged 17 and younger | Covered in full | 30% coinsurance (after deductible is met) |
Medical/specialty visits – members aged 17 and younger | $0 copayment with Atrius providers $35 copayment with other BCBS providers | 30% co-insurance (after deductible is met) |
Note: Not all BCBS providers are in the BCBS PPO network. If you want the lowest out-of-pocket costs, be sure your pediatrician is in the BCBS PPO network.
Find an in-network dentist:
- If you are under the age of 19 and enrolled in the Student Health Insurance Plan, you are automatically covered for “Pediatric Essential Dental Benefits” as part of the medical plan. Review the Pediatric Essential Dental Benefits for more information.
- If you purchased the optional Dental Blue plan and need to find an in-network Dental Blue provider, go to: Find a Dentist or call Blue Cross Blue Shield at (800) 257-8141 for assistance.
Find an in-network ophthalmologist or optometrist:
- If you purchased the Harvard University Student Health Insurance Plan, you have vision benefits, limitations and exclusions may apply. Learn more about your vision benefits and how to find an in-network provider.