Plan Changes

CategoryAY2024: 8/1/2023 – 7/31/2024AY2025: 8/1/2024 – 7/31/2025
No changes
CategoryAY2024: 8/1/2023 – 7/31/2024AY2025: 8/1/2024 – 7/31/2025
Routine adult physical exams(Age 18 and older) 
Note: These exams are also covered at HUHS through the Student Health Fee
No coverage outside of HUHS.In-network: Covered in full
Out-of-network: Not covered

Note: Immunizations are only covered at HUHS or a participating retail pharmacy. They are not covered as part of a visit with a medical provider, even if that provider is in-network.
Mental health wellness examNo coverage through March 30, 2024.Starting March 31, 2024, Blue Cross will cover an annual mental health wellness exam at no cost to the member. This exam may be conducted as part of the annual preventive visit with a primary care provider (PCP), or as a standalone visit with a PCP or licensed mental health professional. Because the mental health wellness exam is considered preventive care, there is no out-of-pocket cost for members in most plans.
 
The annual mental health exam is covered as required by the Act Addressing Barriers to Care (ABC Act) to improve mental health care across Massachusetts.
Clinic and doctor’s office visits Diagnostic/specialist/sick;
Adult (18 and older)
12-visit limit (combined in-and-out-of-network)
through January 31, 2024.
No visit limit; applicable cost sharing still applies.
This change was made effective February 1, 2024.
Outpatient visits for mental health services and psychopharmacology52-visit limit (combined in- and out-of-network)
through January 31, 2024.
No visit limit; applicable cost sharing still applies.
This change was made effective February 1, 2024.
CategoryAY2024: 8/1/2023 – 7/31/2024AY2025: 8/1/2024 – 7/31/2025
Pediatric dental benefitsThe same dental benefits apply for all members under age 19.For all covered in-network dental services (except for any orthodontic benefits that may be covered under this plan), enrolled members under the age of 13 will not pay anything until their annual dental benefit maximum has been met. Standard limitations and exclusions apply.

July 1 changes: Blue Cross Blue Shield of MA reviews its standard prescription drug formulary for changes on July 1 and January 1. As part of this update, certain medications may no longer be covered, may switch copay (the cost you pay) tiers, or may now require authorization. Communication will take place in early June with members who are impacted.