Provider Benefits List
The following is a list of the provider summary of benefits documents available to you on this site.
Summary of Benefits and Coverage
TIER 1 BENEFIT
TIER 2 BENEFIT
Network Blue® New England Options – Schedule of Benefits (PDF Document Format)
Network Blue® New England Options – Benefit Description (PDF Document Format)
Dental Blue – Benefit Description – For Active Members (PDF Document Format)
Dental Blue Freedom For Retired Members (PDF Document Format)
Dental Blue Freedom PPO (PDF Document Format)
Prescription Drug Benefit
Coverage Changes to BCBSMA Medical and Pharmacy Benefit (PDF Document Format)
NOTE: For Envision Benefits, please consult with the SMM dated October 30, 2014, where effective January 1, 2015. Pharmacy Benefits will now be administered by BCBS MA for BCBS members
HIPAA Notice of Privacy Practice
This notice describes how medical information about you may be used and disclosed and how you get access to this information.
View the latest privacy notice