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PLUS

About PLUS

Use Tier 1 doctors and hospitals in Massachusetts

PLUS is a flexible, lower-premium, PPO-type plan for members who live in New England. In Massachusetts, you are free to use any provider, but your out-of-pocket costs are always lowest when you use Tier 1 doctors and hospitals.

Massachusetts hospital tiers

Use contracted providers in other states

If you live in another New England state, contracted providers are covered at 100% (after any applicable copay and deductible) – and contracted providers will not balance bill you. Non-contracted providers are covered at 80% and are free to balance bill you if the plan payment doesn’t cover the whole bill.

Choose PLUS if:

You live in one of the six New England states: Massachusetts, New Hampshire, Rhode Island, Maine, Vermont, or Connecticut.

You usually receive medical care near home but want the choice to use other providers too.

You want the option to use Boston-area teaching and research hospitals and are willing to pay more out of pocket if you do.

You’re comfortable with a mid-range premium to ensure broader access to providers.

Welcome to your Wellpoint health plan (effective 7/01/2024)

Plan benefits summary (effective 7/01/2024)

Massachusetts hospitals (effective 7/01/2024)

Member handbook (effective 7/01/2024)

Summary of Benefits and Coverage (effective 7/01/2024)

Plan change notice (effective 7/01/2024)

Preventive care schedule (effective 7/01/2024)

When to get preapproval (effective 7/01/2024)

Formulary for non-specialty drugs (effective 7/01/2024)

Formulary for specialty drugs (effective 7/01/2024)

Bill Checker Form (to report an error on a bill)

Claim Form (to file a claim yourself)

Continuity/Transition of Care Request Form (if your doctor is no longer contracted)

Designation of Representation/Authorization (to give someone access to your protected health information)

Diabetes Prevention Program Reimbursement (if you have completed a diabetes prevention program)

Fitness Reimbursement (to get reimbursed for fitness activities)

Other Health Insurance Form (if you have other health insurance)

Request for PHI Records Form (to get copies of your health records)

Tobacco Cessation Counseling Reimbursement instructions (to get reimbursed for counseling)

Find out more …

Find a provider

How PLUS compares to our other plans