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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 Harvard Vanguard 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 Harvard Vanguard 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.
View the HUSHP Summary and/or HUSHP Handbook for full benefit information.
