Terms of Use
Medicare and Medicaid
These Terms of Use ("Terms") apply to those mobile applications and websites that we operate (each an "Application") and that contain a link to these Terms. By using our Applications you are agreeing to these Terms. Please read them carefully.
Questions
If you have questions and comments, or if you believe that your confidentiality has been breached or that any of your communications have been intercepted, or you wish to notify us regarding a suspected violation of these Terms, please call Member Services at the toll-free number on your member ID card or log in to start a Live Chat.
Use of this application
The contents of this Application, whether the content is ours or is licensed to us by a third-party, are protected by copyright. We authorize you to view and download material on this Application solely for your own use. You may not sell or modify the material or otherwise use it for any commercial purpose.
Depending on your data plan, use of our Applications on a mobile device may incur data charges.
You will not use this Application in violation of any laws, including the fraud and abuse or anti-kickback provisions of the federal Medicare and Medicaid laws.
You will not, and will not permit anyone else to: (1) modify, adapt, alter, translate or create derivative works of this Application; (2) use or merge this Application, or any component or element of this Application, with other software, databases or services not provided by us; (3) sublicense, distribute, sell or otherwise transfer the Application to any other party; (4) use the Application as a service bureau, or lease, rent or loan this Application to any third party; (5) reverse engineer, decompile, disassemble or otherwise attempt to derive the source code or structure of this Application; (6) interfere in any manner with the operation of this Application; (7) circumvent, or attempt to circumvent, any electronic protection measures in place to regulate or control access to this Application; (8) create a database by systematically downloading and storing this Application; (9) use any robot, spider, site search/retrieval application or other manual or automatic device to retrieve, index, "scrape," "data mine" or in any way gather information from this Application or reproduce or circumvent the navigational structure or presentation of this Application.
Use of information and resources
We make this Application available for the purpose of providing information to consumers about our products and services, providing access to health-related resources, and providing our members access to their health plan information. Nothing on this Application is intended to be a substitute for professional medical advice or for the care that patients receive from their physicians. Nothing in this Application is intended to be used for medical diagnosis or treatment. You should not disregard medical advice, or delay seeking medical advice, because of something you read on this Application.
We are not responsible for information provided by health information content providers, third party sites linked to or framed by the Application, and we do not make any representations regarding the content, accuracy, or timeliness of any of such information.
Caregiver access
Your health plan allows you to authorize a designated individual to view and/or edit your member information as it appears on the Application (“Caregiver Access”). This ability is subject to your acceptance of the specific terms that accompany the Caregiver Access function (contained in the relevant section of this site).
Provider directory
While we make efforts to ensure that our lists of doctors and hospitals (i.e. providers) are up-to-date and accurate, it is important to understand that sometimes healthcare providers leave our networks without letting us know, or they switch networks, or they change employment with provider groups and hospitals. Depending on your plan, these changes may impact how much you pay out of your own pocket for services.
If you are a member, logging in is the most accurate way to search for providers in your plan network. You may also enter the first three letters of your member ID number, found on your ID card, to search for in-network healthcare providers based on your plan prefix.
Your doctor may refer you to another provider or facility for treatment. In-network providers are required to make best efforts to refer you to other in-network providers when possible. However, it is important to remind your doctor to refer you to in-network providers in order to avoid out-of-network costs and additional charges from the doctor by non-participating providers, also known as balance billing.
If you receive services from an in-network hospital, the hospital may have arrangements with emergency room physicians, anesthesiologists, radiologists, and/or other providers to assist in your care. These providers may not participate in your plan’s network. To avoid out-of-network costs and balance billing by non-participating providers, when you choose a hospital in your network be sure to look for messages within the hospital’s displayed information in the search results that identifies hospital-based providers not in your plan’s network.
If your health plan has out-of-network benefits, we may reimburse you up to the maximum allowed amount for covered services if you see a non-participating provider. The process and method used by us to determine reimbursement for non-participating providers depends on your health plan. However, because we do not have a contract with non-participating providers, they can bill you for services up to their full billed charges regardless of your insurance coverage of benefits, unless prohibited from doing so by your state.
Health plans vary. We recommend that you consult your benefit plan document and/or contact the member services number listed on the back of your ID card to confirm in advance that the desired service is covered. Keep in mind that most HMO plans do not have out-of-network benefits and therefore may not reimburse for any out-of-network services except in limited circumstances.
Discount offers and coupons
We have arranged with various third-party vendors to make product and service discounts and/or coupons available to our members. Access to these discounts and coupons is not part of your health plan, and the products, services and coupons offered by these discount vendors are not covered by your health plan. We are not responsible for the products, services, coupons or information provided by any discount vendor. Discount offers, coupons and vendors are subject to change without notice.
Medicare plans
The Medicare Advantage and Medicare Part D plans are health plans with a Medicare contract or a standalone prescription drug plan with a Medicare contract. The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed.
Important Information For Members With Medicare Part D Coverage
Your Evidence of Coverage shows what is covered and what you pay for your Part D prescription drugs.
The coverage gap begins after you and your Medicare Part D or Medicare Advantage Prescription Drug plan together have spent a certain amount for covered prescription drugs. You can check the Evidence of Coverage to find out the amount you pay to reach the Part D coverage gap phase. The cost share for the Part D coverage gap phase will continue as shown in your Evidence of Coverage until you and the Medicare Coverage Gap Discount Program together have spent the amount for covered Part D prescription drugs which reaches the threshold.
Important Information For Members With Medicare Part D Coverage Who Also Qualify For “Extra Help”
"Extra Help" is a Medicare program that works with a Medicare Part D plan or Medicare Advantage Prescription Drug plan to help people with limited income and resources pay Part D prescription drug costs.
If you qualify for the Medicare “Extra Help” Program and get covered drugs at network pharmacies in our plan, then you will pay either your subsidized low income copayment or your drug plan copayment (whichever is the lower amount).
If you qualify for “Extra Help,” you do not qualify for the Medicare Coverage Gap Discount Program.
If you have questions about your prescription drug costs, please review the Evidence of Coverage and contact Member Services.
Your Medicare plan may make coverage decisions using criteria from the clinical care guidelines provided by MCG Health. To access the criteria, please visit the MCG’s Medicare Coverage Guidelines website and follow the steps in their tool.
Claims
We process some claims with the assistance of our affiliate Legato Health Technologies, a licensed third-party administrator. Members can submit claims online by logging in to their account.
Passwords and accounts
If you are an authorized user your username and password (your "Login Information") will allow you to access certain information about you and your plan. You are solely responsible for controlling your Login Information and for authorizing, monitoring and controlling access to your account. You agree to notify us immediately of any unauthorized use of your Login Information or of any need to deactivate the Login Information associated with your account.
Anonymous IP addresses
We consider the protection of your health and personal information an important responsibility. Anonymous IP addresses are a technique known to be used by cyber criminals. Because of this, we do not allow for access to the secure member portal for users coming to the site with anonymous IP addresses. A blocked or anonymous IP address could be caused by your network, personal VPN, or other reasons. As a result, you may want to try to access the portal using a method that doesn’t block your IP address or, if you are using a work computer, talk to your employer about how their network displays IP addresses.
Use of email and fax
We may provide email and fax links to further facilitate communication for our members and their designees and caregivers. Information collected through email may be shared with our member services department, other associates, or third parties that perform services on our behalf. Unless otherwise noted, email through our website is not a completely secure and confidential means of communication. Non-encrypted email may be accessed and viewed by other Internet users without your knowledge and permission while in transit to us.
Also, if you request that we email or fax information about you to someone using the email and fax capabilities in this Application, that email or fax may not be completely secure. Please verify email addresses and fax numbers carefully before submitting such a request. If you request that we send a dependent’s card you are indicating to us you have the authority to do so.
Use of text
These Texting Terms and Conditions apply when you provide prior express consent to receive text messages from us or our affiliates, subsidiaries, agents, contractors, or vendors ("us" or "we" or "our'). Text messaging from us may include one-time or recurring texts related to your benefits, programs, products, services, and tools, and/or general health information. At enrollment for recurring texting programs, we specify the frequency of texts and information on how to unsubscribe and seek assistance. In all programs, you may text “STOP” to stop messaging for that program and "HELP" for help. Text messages will be sent to your mobile number using an automatic dialing system. Message and Data rates may apply.
Participation is optional. You are electing to receive PHI via text which makes the data transmitted available to your phone carrier and potentially others. We provide alternative means for communicating including phone. You understand you have these choices and have elected to opt-in for texting. We do not require that you agree to receive texts for this purpose to receive treatment, payment, or for benefits enrollment and eligibility.
If you no longer want to receive text messages from us, the sole and exclusive remedy is to end enrollment in the specific texting program.
Under no circumstances will we be liable for any direct or indirect, incidental, consequential, special, exemplary, or punitive damages arising out of or in connection with use of text messaging whether or not we have been advised of the possibility of such damages.
We do not guarantee the successful delivery of text messages by your wireless provider. Messages sent by text may not be delivered if the mobile device is not in range of a transmission site, or if sufficient network capacity is not available at a particular time. Even within a coverage area, factors beyond the control of wireless carriers may interfere with message delivery, including the terrain, proximity to buildings, foliage, weather, and the recipient's equipment. We will not be liable for losses or damages arising from (a) non-delivery, delayed delivery, or misdirected delivery of a text message; (b) inaccurate or incomplete content in a text message; or (c) use or reliance on the content of any text message for any purpose.
Please notify us immediately if your mobile number changes. We are not liable for any communication or transmission of information by text which happens because you did not report that your mobile number changed. Password-protecting mobile device(s) and enabling encryption, if available, is recommended.
Text messages may include protected health information (PHI). Since text messaging is unencrypted, there is a risk that this PHI could be intercepted or viewed by third parties, including others who access your device. When you choose to receive text messages from us, you do so at your own risk. Once texted, your information may no longer be regulated under HIPAA’s Privacy Rule.
Linking to other applications
From time to time we will provide links to websites not owned or controlled by us. We do this because we think the information might be of interest or use to you. We identify these links with this symbol to let you know you are leaving our site - . A link to a third party website does not constitute or imply endorsement by us. We cannot guarantee the quality or accuracy of information presented on third party websites. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of third party websites. We encourage you to review the privacy practices of any website you visit.
Appropriateness of content
This Application is not intended to attract children under the age of 13. We do not collect personal information from any user that we know is under the age of 13. Some of the content on this Application may not be appropriate for children. Parents or guardians are solely responsible for providing supervision of minors’ use of this Application.
Digital Millennium Copyright Act
We respect the intellectual property of others. If you believe that your copyrighted work has been copied in a way that constitutes copyright infringement and is accessible on or through this Application, you must provide the following information to us when providing notice of the claimed infringement:
- A physical or electronic signature of a person authorized to act on behalf of the copyright owner and identification of the copyrighted work that is infringed;
- Information reasonably sufficient to permit us to contact you, such as an address, telephone number and/or email address;
- A statement that you have a good faith belief that the use of the material in the manner complained of is not authorized by the copyright owner, its agent or law;
- A statement that the information in the notification is accurate and, under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.
The above information must be submitted in writing to us at 220 Virginia Avenue, Indianapolis, IN 46204, ATTENTION: LEGAL DEPARTMENT/DMCA COMPLAINT. This information should not be construed as legal advice. For further details on the information required for valid DMCA notifications, see 17 U.S.C. 512(c)(3).
No liability
NO LIABILITY. WE AND OUR LICENSORS AND SUPPLIERS (INCLUDING ALL PROVIDERS OF CONTENT FOR THIS APPLICATION) SHALL NOT BE LIABLE TO YOU, UNDER ANY CIRCUMSTANCES OR UNDER ANY THEORY OF LIABILITY OR INDEMNITY, FOR ANY DAMAGES OR PENALTIES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, INCIDENTAL INDIRECT, EXEMPLARY, PUNITIVE AND CONSEQUENTIAL DAMAGES, LOST PROFITS, OR DAMAGES RESULTING FROM LOST DATA OR BUSINESS INTERRUPTION) IN CONNECTION WITH THE USE OR INABILITY TO USE THIS APPLICATION OR THE CONTENT, EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. WE SHALL BE LIABLE TO YOU ONLY TO THE EXTENT OF ACTUAL DAMAGES INCURRED BY YOU. THE REMEDIES STATED FOR YOU IN THESE TERMS AND CONDITIONS ARE EXCLUSIVE AND ARE LIMITED TO THOSE EXPRESSLY PROVIDED FOR IN THESE TERMS AND CONDITIONS.
WE AND OUR LICENSORS AND SUPPLIERS ARE NOT RESPONSIBLE FOR ANY CLAIMS YOU MAY HAVE AGAINST ANY MEDICAL PROFESSIONALS, SUPPLIERS OF PRODUCTS OR OTHER PERSONS, INSTITUTIONS OR ENTITIES IDENTIFIED IN WHOLE OR IN PART THROUGH THIS APPLICATION.
NO WARRANTIES. THE APPLICATION AND ITS SERVICES, CONTENT AND INFORMATION ARE PROVIDED "AS IS." WE AND OUR LICENSORS AND SUPPLIERS DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF THIRD PARTIES RIGHTS OR FITNESS FOR A PARTICULAR PURPOSE.
Limitations
We are not licensed to sell products and services in all states. The descriptions of products and services contained on this Application may not contain all of the terms, conditions, limitations and exclusions that may be applicable. Before purchasing any health plan you should read the contract or explanation of benefits that contains all exclusions and limitations on coverage.
Termination
We may terminate any user’s right to use this Application at any time. We reserve the right to block, delete or stop the uploading of materials and communications that we find unacceptable for any reason. If your right to use this site ends, you shall make no further use of this site or any information obtained from this site.
Miscellaneous
We make no claims that the content and information included at this Application is appropriate or may be downloaded outside of the United States. Access to the content and information included at this Application may not be legal by certain persons or in certain countries. If you access this Application from outside the United States, you do so at your own risk and are solely responsible for compliance with the laws of your jurisdiction and any other applicable laws.
These Terms shall be governed and construed in accordance with the laws of the State of Indiana without regard to the choice of law provisions of any jurisdiction. We may without notice to you assign our rights and duties under these Terms to any party at any time. Failure to enforce or insist on strict performance of any provision of these Terms shall not be construed as a waiver of any provision or right. You agree that any legal action or proceeding between us and you in any way related to these Terms shall be brought exclusively in a court of a competent jurisdiction sitting in Indianapolis, Indiana. Any cause of action or claim you may have against or involving us must be commenced within one year after the claim or cause of action arises. Neither the course of conduct between the parties nor trade practice shall modify the provisions of these Terms. The invalidity or unenforceability of any provision shall not in any way affect the validity or enforceability of the rest of these Terms. These Terms constitutes the entire agreement between you and us regarding your use of this Application, and it supersedes all prior agreements, representations, proposals and other communications with respect this Application and its content.
This Application is produced by Wellpoint Insurance Company, Inc. and its affiliates at various locations. ©2022-2024 Wellpoint
Massachusetts Group Insurance Commission (GIC)
Legal
All information on this website may not reflect the most recent transactions or account balances.
Terms of Use
By using this website or any website owned and maintained by Wellpoint its subsidiaries (collectively, the "Website") you agree to abide by the following Terms of Use.
Use of Material
The contents of this Website are protected by copyright. The collective work of this Website may also include work that is the property of others, which work is also protected by copyright or other intellectual property laws. Unauthorized use may violate copyright, trademark, and other laws. Wellpoint authorizes you to view and download material on the Website solely for your own use. You must keep all copyright and other proprietary notices on any copies you make. You may not ell or modify the material or otherwise use it for any public or commercial purpose.
You will not use this Website, in violation of any laws including without limitation, those pertaining to the fraud and abuse or anti-kickback provisions of the federal Medicare and Medicaid laws. Any advertisement, links with other websites, co-hosts or references to third parties are not endorsements of such third parties' products or services and are not intended to result in any referrals or compensation to you or Wellpoint.
Use of Information and Resources
Wellpoint makes this site available for the sole purposes of providing general educational information on health-related issues and providing access to health-related resources. This site and its health-related information and resources are not intended to be a substitute for professional medical advice or for the care that patients receive from their physicians. Nothing in this site is intended to be used for medical diagnosis or treatment. Always seek the advice of your physician before beginning any new treatment or if you have any questions regarding a medical condition. You should not disregard medical advice, or delay seeking medical advice, because of something you read in this site.
This site and its health-related information and resources are not intended, and must not be taken, to be the rendering of medical, nursing, or professional health care advice or services, or the practice of medicine, nursing, or professional health care, in any jurisdiction. Additionally, Wellpoint is not responsible for information provided by health information content providers, third party sites linked to or framed by the website, or third-party sites, and does not make any representations regarding the content, accuracy, or timeliness of any of such information.
By health-related information, we mean the health-related, medical, and wellness information available through the website that includes, but is not limited to, text, graphics, video, and images; information created by health information content providers, licensors, suppliers, and other third parties; advertisements; and any other material, information or health information content accessible on third-party websites to which Wellpoint ay have links.
Provider Finder
Wellpoint has made reasonable efforts to validate that its lists of providers displayed are up to date and accurate. Please call the provider prior to scheduling an appointment to verify that the provider continues to be part of the network. Wellpoint shall not be liable for any losses, damages, or non-covered charges as a result of using the provider locator tool or receiving care from a provider listed in on our site.
Wellpoint’s Transparency Tool
Your health insurance benefits plan may not necessarily cover all of the services, treatments, drugs or tests discussed or recommended in the information provided in the tool. In addition, there may be requirements for precertification, or other criteria to determine your coverage. If you have any questions about particular coverage issues, simply call Wellpoint Members Services at 833-663-4176 (non-Medicare members) or 800-442-9300 (Medicare members).
Caregiver Access
Wellpoint allows you to authorize a designated individual to view and/or edit your Wellpoint member information as it appears on wellpoint.com "Caregiver Access"). This ability is subject to your acceptance of the specific terms that accompany the Caregiver Access function (contained in the relevant section of this website).
Discount Offers
Wellpoint has arranged with various third-party vendors to make product and service discounts available to our members. Access to these discounts is not part of your health plan, and the products and services offered by these discount vendors are not covered by your health plan. Wellpoint is not responsible for the products, services or information provided by any discount vendor. Discount offers and vendors are subject to change without notice.
Reimbursement for Non-Massachusetts Providers
It is important to understand how contracted providers outside Massachusetts may be able to help you save money. Wellpoint contracted doctors and other health care professionals outside Massachusetts have agreed in a contract with us to accept specific amounts for various covered services. Because there is no similar contract with non-contracted providers outside Massachusetts, absent a regulation or law, they may be able to bill you for the difference between what we pay and what they charge.
For services provided by doctors and other health care professionals who have not contracted to treat members ("Non-Contracted Providers"), the amounts that will be allowed for such services and processed for payment ("Non-Contracted Provider Reimbursement Amounts") are based on the member contracts. These amounts may be determined based on Medicare rates, fee schedules or a database produced by FAIR Health, Inc., as supported by member certificates, and also may be subject to deductibles, co-pays, and other limitations.
NOTICE: There are non-Massachusetts hospitals, health care facilities, physicians or other health care providers who are not contracted providers. Your financial responsibilities for payment of covered services may differ if you use a non-contracted provider or a non-participating provider. Please refer to the online Find Care tool to determine if a particular provider is listed as a Wellpoint contracted provider or contact Wellpoint Member Services for assistance.
Passwords and Account
Your username and password (collectively, the "Password") will allow you to access wellpoint.com and certain information about you or your Plan. Your Password is the exclusive property and confidential information of Wellpoint and may be used solely for your individual use of and access to the website. You are solely responsible for controlling your Passwords and for authorizing, monitoring and controlling access to your account. You are prohibited from distributing, providing or otherwise making available your Password to any third party and are responsible for all activities that occur under your Password. You agree to notify Wellpoint immediately of any unauthorized use of your Password or of any need to deactivate the Password(s) associated with your account.
Linking to Other Sites
We will provide links to other websites, not owned or controlled by Wellpoint. We do this because we think this information might be of interest or use to you or where, as a member, we can provide you with value added services. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of other sites. A link to a non-Wellpoint website does not constitute or imply endorsement by Wellpoint. Additionally, we cannot guarantee the quality or accuracy of information presented on non-Wellpoint website. We encourage you to review the privacy practices of any website you visit.
Appropriateness of Content
This website is not intended to attract children under the age of 13. We do not collect Personal Information from any person we know is under the age of 13. Some of the content on this website may not be appropriate for children. Parents or guardians are solely responsible for providing supervision of minors' use of the Wellpoint website.
Your Submissions
Generally, communications that you post to the website are not confidential. If particular web pages permit the submission of communications which will be treated by Wellpoint as confidential, that fact will be stated on those pages. You are responsible for your own communications and the consequences of such posting.
You may not:
- communicate material that is copyrighted, without the permission of the copyright owner;
- communicate material that reveals trade secrets, unless you have permission of the owner;
- communicate material that infringes on any other intellectual property rights of others or on the privacy or publicity rights of others;
- communicate material that is obscene, defamatory, threatening, harassing, abusive, hateful, or embarrassing to any person or entity;
- communicate a sexually explicit image;
- communicate chain letters or pyramid schemes;
- impersonate another person; or
- violate the Children's Online Privacy Protection Act.
Wellpoint does not represent or guarantee the truthfulness, accuracy, or reliability of any communications posted by other users or endorse any opinions expressed by other users. Any reliance on material posted by others is at your own risk.
Digital Millennium Copyright Act
Wellpoint respects the intellectual property of others and expects users of our services to do the same. If you believe that your copyrighted work has been copied in a way that constitutes copyright infringement and is accessible on this site or through this service, you must provide the following information when providing notice of the claimed infringement to Wellpoint:
- A physical or electronic signature of a person authorized to act on behalf of the copyright owner and identification of the copyrighted work that is infringed;
- Information reasonably sufficient to permit Wellpoint to contact you, such as an address, telephone number and/or electronic mail address;
- A statement that you have a good faith belief that the use of the material in the manner complained of is not authorized by the copyright owner, its agent or law;
- A statement that the information in the notification is accurate and under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.
The above information must be submitted as a written notification to Wellpoint through Wellpoint Member Services at 833-663-4176 (non-Medicare members) or 800-442-9300 (Medicare members), or by writing to us at: 120 Monument Circle, Indianapolis, IN 46204, ATTENTION: LEGAL DEPARTMENT/DMCA COMPLAINT. This information should not be construed as legal advice. For further details on the information required for valid DMCA notifications, see 17 U.S.C. 512(c)(3).
Privacy and Security
Wellpoint Privacy Statement describes the type of information Wellpoint and its licensors and suppliers collect from you when you visit the Website and how Wellpoint uses that information. You can review the Wellpoint Privacy Statement by clicking on the Privacy button on the Login Screen, or by going to wellpoint.com and selecting the Privacy link at the bottom of the page.
Liability of Wellpoint and Its Licensors and Suppliers
No Liability. WELLPOINT AND ITS LICENSORS AND SUPPLIERS (INCLUDING, FOR THE PURPOSES OF THIS ENTIRE SECTION, ALL PROVIDERS OF CONTENT FOR THIS WEBSITE) SHALL NOT BE LIABLE TO YOU, UNDER ANY CIRCUMSTANCES OR UNDER ANY THEORY OF LIABILITY OR INDEMNITY, FOR ANY DAMAGES OR PENALTIES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, INCIDENTAL INDIRECT, EXEMPLARY, PUNITIVE AND CONSEQUENTIAL DAMAGES, LOST PROFITS, OR DAMAGES RESULTING FROM LOST DATA OR BUSINESS INTERRUPTION) IN CONNECTION WITH THE USE OR INABILITY TO USE THIS SITE OR THE CONTENT, EVEN IF ANY OF THEM HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. WELLPOINT SHALL BE LIABLE TO YOU ONLY TO THE EXTENT OF ACTUAL DAMAGES INCURRED BY YOU. THE REMEDIES STATED FOR YOU IN THESE TERMS AND CONDITIONS ARE EXCLUSIVE AND ARE LIMITED TO THOSE EXPRESSLY PROVIDED FOR IN THESE TERMS AND CONDITIONS.
Wellpoint and its licensors and suppliers are not responsible for any claims you may have against any medical professionals, suppliers of products or other persons, institutions or entities identified in whole or in part through this website.
No Warranties. THE SITE, SERVICES, CONTENT AND INFORMATION ARE PROVIDED "AS IS." WELLPOINT, ITS LICENSORS AND SUPPLIERS DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF THIRD PARTIES RIGHTS OR FITNESS FOR A PARTICULAR PURPOSE.
WELLPOINT, ITS LICENSORS AND SUPPLIERS MAKE NO REPRESENTATIONS OR WARRANTIES THAT THE INFORMATION IN, OR LINKS OR SEARCHES CONDUCTED THROUGH THIS SITE IS COMPLETE, EXHAUSTIVE, RELIABLE, CURRENT OR ACCURATE. NO CLAIMS OR ENDORSEMENTS ARE MADE FOR ANY DRUG, HERB, SUPPLEMENT, COMPOUND, THERAPY, OR TREATMENT.
Limitations
The descriptions of Wellpoint products and services contained in the website are not offers to sell or solicitations for any product or service. Wellpoint is not licensed to sell products and services in all states. The descriptions of products and services contained on the website are offered as a convenience and do not contain all of the terms, conditions, limitations and exclusions that may be applicable.
Termination
Wellpoint may terminate any User's right to use this site at any time. Wellpoint reserves the right to block, delete or stop the uploading of materials and communications that it, in its sole discretion, finds unacceptable for any reason. Your right to use this site will end at the close of your Membership in the Wellpoint plan. If your right to use this site ends, you shall make no further use of this site or any information obtained from this site.
Changes to This Terms of Use Statement
Wellpoint may revise, modify or amend these Terms of Use at any time. Any such revision, modification or amendment shall be effective immediately upon either posting it to the website or otherwise notifying you.
Miscellaneous
Wellpoint is based in the United States of America and makes no claims that the content and information included at this site is appropriate or may be downloaded outside of the United States. Access to the content and information included at this site may not be legal by certain persons or in certain countries. If you access this site from outside the United States, you do so at your own risk and are solely responsible for compliance with the laws of your jurisdiction and any other applicable laws.
This User Agreement shall be governed and construed in accordance with the laws of the State of Indiana without regard to the choice of law provisions of any jurisdiction. Wellpoint may without notice to you assign its rights and duties under this Agreement to any party at any time. Failure to enforce or insist on strict performance of any provision of this Agreement shall not be construed as a waiver of any provision or right. You agree that any legal action or proceeding between Wellpoint and you in any way related to this Agreement shall be brought exclusively in a court of a competent jurisdiction sitting in Indianapolis, Indiana. Any cause of action or claim you may have against or involving Wellpoint must be commenced within one year after the claim or cause of action arises. Neither the course of conduct between the parties nor trade practice shall modify the provisions of this Agreement. The invalidity or unenforceability of any provision shall not in any way affect the validity or enforceability of the rest of this Agreement. This agreement constitutes the entire agreement between you and Wellpoint, and it supersedes all prior agreements, representations, proposals and other communications with respect to Wellpoint’s website and content.
Notices
To the extent that the law and/or any applicable regulation allows for the provision of notice electronically, and further provide that any group health plan agreement by which you are covered does not require notice by mail, you hereby agree to receive all such notices electronically, including but not limited to notices required by state or federal privacy laws, and all financial information pertinent to, or required in connection with the operation of, your account at this online health site. By accepting the terms of this Agreement, you are acknowledging receipt of all privacy notices linked to this site as a necessary step to obtaining the services in connection with this plan and health site.
Questions
If you have questions and comments, or if you believe that your confidentiality has been breached or that any of your communications have been intercepted, or you wish to notify us regarding a suspected violation of these terms, please call Wellpoint Member Services immediately at 833-663-4176 (non-Medicare members) or 800-442-9300 (Medicare members).
Wellpoint.com/mass is produced by Wellpoint & Life Health Insurance Company at P.O. Box 4095, Woburn, MA 01888. © 2024 Wellpoint. All rights reserved.
Individual and Family
These Terms of Use ("Terms") apply to those mobile applications and websites that we operate (each an "Application") and that contain a link to these Terms. By using our Applications you are agreeing to these Terms. Please read them carefully.
Questions
If you have questions and comments, or if you believe that your confidentiality has been breached or that any of your communications have been intercepted, or you wish to notify us regarding a suspected violation of these Terms, please call Member Services at the toll-free number on your member ID card or log in to start a Live Chat.
For people with disabilities, we offer free aids and services. For people whose primary language isn't English, we offer free language assistance services through interpreters and other written languages.
Please call the Member Services number on your member ID card, TTY/TDD 711, or log in to start a Live Chat.
Use of this application
The contents of this Application, whether the content is ours or is licensed to us by a third-party, are protected by copyright. We authorize you to view and download material on this Application solely for your own use. You may not sell or modify the material or otherwise use it for any commercial purpose.
Depending on your data plan, use of our Applications on a mobile device may incur data charges.
You will not use this Application in violation of any laws, including the fraud and abuse or anti-kickback provisions of the federal Medicare and Medicaid laws.
You will not, and will not permit anyone else to: (1) modify, adapt, alter, translate or create derivative works of this Application; (2) use or merge this Application, or any component or element of this Application, with other software, databases or services not provided by us; (3) sublicense, distribute, sell or otherwise transfer the Application to any other party; (4) use the Application as a service bureau, or lease, rent or loan this Application to any third party; (5) reverse engineer, decompile, disassemble or otherwise attempt to derive the source code or structure of this Application; (6) interfere in any manner with the operation of this Application; (7) circumvent, or attempt to circumvent, any electronic protection measures in place to regulate or control access to this Application; (8) create a database by systematically downloading and storing this Application; (9) use any robot, spider, site search/retrieval application or other manual or automatic device to retrieve, index, "scrape," "data mine" or in any way gather information from this Application or reproduce or circumvent the navigational structure or presentation of this Application
Use of Information and Resources
We make this Application available for the purpose of providing information to consumers about our products and services, providing access to health-related resources, and providing our members access to their health plan information. Nothing on this Application is intended to be a substitute for professional medical advice or for the care that patients receive from their physicians. Nothing in this Application is intended to be used for medical diagnosis or treatment. You should not disregard medical advice, or delay seeking medical advice, because of something you read on this Application.
We are not responsible for information provided by health information content providers, third party sites linked to or framed by the Application, and we do not make any representations regarding the content, accuracy, or timeliness of any of such information.
Caregiver access
Your health plan allows you to authorize a designated individual to view and/or edit your member information as it appears on the Application (“Caregiver Access”). This ability is subject to your acceptance of the specific terms that accompany the Caregiver Access function (contained in the relevant section of this site).
Provider directory
While we make efforts to ensure that our lists of doctors and hospitals (i.e. providers) are up-to-date and accurate, it is important to understand that sometimes healthcare providers leave our networks without letting us know, or they switch networks, or they change employment with provider groups and hospitals. Depending on your plan, these changes may impact how much you pay out of your own pocket for services.
If you are a member, logging in is the most accurate way to search for providers in your plan network. You may also enter the first three letters of your member ID number, found on your ID card, to search for in-network healthcare providers based on your plan prefix.
Your doctor may refer you to another provider or facility for treatment. In-network providers are required to make best efforts to refer you to other in-network providers when possible. However, it is important to remind your doctor to refer you to in-network providers in order to avoid out-of-network costs and additional charges from the doctor by non-participating providers, also known as balance billing.
If you receive services from an in-network hospital, the hospital may have arrangements with emergency room physicians, anesthesiologists, radiologists, and/or other providers to assist in your care. These providers may not participate in your plan’s network. To avoid out-of-network costs and balance billing by non-participating providers, when you choose a hospital in your network be sure to look for messages within the hospital’s displayed information in the search results that identifies hospital-based providers not in your plan’s network.
If your health plan has out-of-network benefits, we may reimburse you up to the maximum allowed amount for covered services if you see a non-participating provider. The process and method used by us to determine reimbursement for non-participating providers depends on your health plan. However, because we do not have a contract with non-participating providers, they can bill you for services up to their full billed charges regardless of your insurance coverage of benefits, unless prohibited from doing so by your state.
Health plans vary. We recommend that you consult your benefit plan document and/or contact the member services number listed on the back of your ID card to confirm in advance that the desired service is covered. Keep in mind that most HMO plans do not have out-of-network benefits and therefore may not reimburse for any out-of-network services except in limited circumstances.
Discount offers and coupons
We have arranged with various third-party vendors to make product and service discounts and/or coupons available to our members. Access to these discounts and coupons is not part of your health plan, and the products, services and coupons offered by these discount vendors are not covered by your health plan. We are not responsible for the products, services, coupons or information provided by any discount vendor. Discount offers, coupons and vendors are subject to change without notice.
Medicare plans
The Medicare Advantage and Medicare Part D plans are health plans with a Medicare contract or a standalone prescription drug plan with a Medicare contract. The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed.
Important Information For Members With Medicare Part D Coverage
Your Evidence of Coverage shows what is covered and what you pay for your Part D prescription drugs.
The coverage gap begins after you and your Medicare Part D or Medicare Advantage Prescription Drug plan together have spent a certain amount for covered prescription drugs. You can check the Evidence of Coverage to find out the amount you pay to reach the Part D coverage gap phase. The cost share for the Part D coverage gap phase will continue as shown in your Evidence of Coverage until you and the Medicare Coverage Gap Discount Program together have spent the amount for covered Part D prescription drugs which reaches the threshold.
Important Information For Members With Medicare Part D Coverage Who Also Qualify For “Extra Help”
"Extra Help" is a Medicare program that works with a Medicare Part D plan or Medicare Advantage Prescription Drug plan to help people with limited income and resources pay Part D prescription drug costs.
If you qualify for the Medicare “Extra Help” Program and get covered drugs at network pharmacies in our plan, then you will pay either your subsidized low income copayment or your drug plan copayment (whichever is the lower amount).
If you qualify for “Extra Help,” you do not qualify for the Medicare Coverage Gap Discount Program.
If you have questions about your prescription drug costs, please review the Evidence of Coverage and contact Member Services.
Your Medicare plan may make coverage decisions using criteria from the clinical care guidelines provided by MCG Health. To access the criteria, please visit the MCG’s Medicare Coverage Guidelines website and follow the steps in their tool.
Claims
We process some claims with the assistance of our affiliate Legato Health Technologies, a licensed third-party administrator. Members can submit claims online by logging in to their account.
Passwords and accounts
If you are an authorized user your username and password (your "Login Information") will allow you to access certain information about you and your plan. You are solely responsible for controlling your Login Information and for authorizing, monitoring and controlling access to your account. You agree to notify us immediately of any unauthorized use of your Login Information or of any need to deactivate the Login Information associated with your account.
Anonymous IP addresses
We consider the protection of your health and personal information an important responsibility. Anonymous IP addresses are a technique known to be used by cyber criminals. Because of this, we do not allow for access to the secure member portal for users coming to the site with anonymous IP addresses. A blocked or anonymous IP address could be caused by your network, personal VPN, or other reasons. As a result, you may want to try to access the portal using a method that doesn’t block your IP address or, if you are using a work computer, talk to your employer about how their network displays IP addresses.
Use of email and fax
We may provide email and fax links to further facilitate communication for our members and their designees and caregivers. Information collected through email may be shared with our member services department, other associates, or third parties that perform services on our behalf. Unless otherwise noted, email through our website is not a completely secure and confidential means of communication. Non-encrypted email may be accessed and viewed by other Internet users without your knowledge and permission while in transit to us.
Also, if you request that we email or fax information about you to someone using the email and fax capabilities in this Application, that email or fax may not be completely secure. Please verify email addresses and fax numbers carefully before submitting such a request. If you request that we send a dependent’s card you are indicating to us you have the authority to do so.
Use of text
These Texting Terms and Conditions apply when you provide prior express consent to receive text messages from us or our affiliates, subsidiaries, agents, contractors, or vendors ("us" or "we" or "our'). Text messaging from us may include one-time or recurring texts related to your benefits, programs, products, services, and tools, and/or general health information. At enrollment for recurring texting programs, we specify the frequency of texts and information on how to unsubscribe and seek assistance. In all programs, you may text “STOP” to stop messaging for that program and "HELP" for help. Text messages will be sent to your mobile number using an automatic dialing system. Message and Data rates may apply.
Participation is optional. You are electing to receive PHI via text which makes the data transmitted available to your phone carrier and potentially others. We provide alternative means for communicating including phone. You understand you have these choices and have elected to opt-in for texting. We do not require that you agree to receive texts for this purpose to receive treatment, payment, or for benefits enrollment and eligibility.
If you no longer want to receive text messages from us, the sole and exclusive remedy is to end enrollment in the specific texting program.
Under no circumstances will we be liable for any direct or indirect, incidental, consequential, special, exemplary, or punitive damages arising out of or in connection with use of text messaging whether or not we have been advised of the possibility of such damages.
We do not guarantee the successful delivery of text messages by your wireless provider. Messages sent by text may not be delivered if the mobile device is not in range of a transmission site, or if sufficient network capacity is not available at a particular time. Even within a coverage area, factors beyond the control of wireless carriers may interfere with message delivery, including the terrain, proximity to buildings, foliage, weather, and the recipient's equipment. We will not be liable for losses or damages arising from (a) non-delivery, delayed delivery, or misdirected delivery of a text message; (b) inaccurate or incomplete content in a text message; or (c) use or reliance on the content of any text message for any purpose.
Please notify us immediately if your mobile number changes. We are not liable for any communication or transmission of information by text which happens because you did not report that your mobile number changed. Password-protecting mobile device(s) and enabling encryption, if available, is recommended.
Text messages may include protected health information (PHI). Since text messaging is unencrypted, there is a risk that this PHI could be intercepted or viewed by third parties, including others who access your device. When you choose to receive text messages from us, you do so at your own risk. Once texted, your information may no longer be regulated under HIPAA’s Privacy Rule.
Linking to other applications
From time to time we will provide links to websites not owned or controlled by us. We do this because we think the information might be of interest or use to you. We identify these links with this symbol to let you know you are leaving our site - . A link to a third party website does not constitute or imply endorsement by us. We cannot guarantee the quality or accuracy of information presented on third party websites. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of third party websites. We encourage you to review the privacy practices of any website you visit.
Appropriateness of content
This Application is not intended to attract children under the age of 13. We do not collect personal information from any user that we know is under the age of 13. Some of the content on this Application may not be appropriate for children. Parents or guardians are solely responsible for providing supervision of minors’ use of this Application.
Digital Millennium Copyright Act
We respect the intellectual property of others. If you believe that your copyrighted work has been copied in a way that constitutes copyright infringement and is accessible on or through this Application, you must provide the following information to us when providing notice of the claimed infringement:
A physical or electronic signature of a person authorized to act on behalf of the copyright owner and identification of the copyrighted work that is infringed;
Information reasonably sufficient to permit us to contact you, such as an address, telephone number and/or email address;
A statement that you have a good faith belief that the use of the material in the manner complained of is not authorized by the copyright owner, its agent or law;
A statement that the information in the notification is accurate and, under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.
The above information must be submitted in writing to us at 220 Virginia Avenue, Indianapolis, IN 46204, ATTENTION: LEGAL DEPARTMENT/DMCA COMPLAINT. This information should not be construed as legal advice. For further details on the information required for valid DMCA notifications, see 17 U.S.C. 512(c)(3).
No liability
NO LIABILITY. WE AND OUR LICENSORS AND SUPPLIERS (INCLUDING ALL PROVIDERS OF CONTENT FOR THIS APPLICATION) SHALL NOT BE LIABLE TO YOU, UNDER ANY CIRCUMSTANCES OR UNDER ANY THEORY OF LIABILITY OR INDEMNITY, FOR ANY DAMAGES OR PENALTIES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, INCIDENTAL INDIRECT, EXEMPLARY, PUNITIVE AND CONSEQUENTIAL DAMAGES, LOST PROFITS, OR DAMAGES RESULTING FROM LOST DATA OR BUSINESS INTERRUPTION) IN CONNECTION WITH THE USE OR INABILITY TO USE THIS APPLICATION OR THE CONTENT, EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. WE SHALL BE LIABLE TO YOU ONLY TO THE EXTENT OF ACTUAL DAMAGES INCURRED BY YOU. THE REMEDIES STATED FOR YOU IN THESE TERMS AND CONDITIONS ARE EXCLUSIVE AND ARE LIMITED TO THOSE EXPRESSLY PROVIDED FOR IN THESE TERMS AND CONDITIONS.
WE AND OUR LICENSORS AND SUPPLIERS ARE NOT RESPONSIBLE FOR ANY CLAIMS YOU MAY HAVE AGAINST ANY MEDICAL PROFESSIONALS, SUPPLIERS OF PRODUCTS OR OTHER PERSONS, INSTITUTIONS OR ENTITIES IDENTIFIED IN WHOLE OR IN PART THROUGH THIS APPLICATION.
NO WARRANTIES. THE APPLICATION AND ITS SERVICES, CONTENT AND INFORMATION ARE PROVIDED "AS IS." WE AND OUR LICENSORS AND SUPPLIERS DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF THIRD PARTIES RIGHTS OR FITNESS FOR A PARTICULAR PURPOSE.
Limitations
We are not licensed to sell products and services in all states. The descriptions of products and services contained on this Application may not contain all of the terms, conditions, limitations and exclusions that may be applicable. Before purchasing any health plan you should read the contract or explanation of benefits that contains all exclusions and limitations on coverage.
Termination
We may terminate any user’s right to use this Application at any time. We reserve the right to block, delete or stop the uploading of materials and communications that we find unacceptable for any reason. If your right to use this site ends, you shall make no further use of this site or any information obtained from this site.
Miscellaneous
We make no claims that the content and information included at this Application is appropriate or may be downloaded outside of the United States. Access to the content and information included at this Application may not be legal by certain persons or in certain countries. If you access this Application from outside the United States, you do so at your own risk and are solely responsible for compliance with the laws of your jurisdiction and any other applicable laws.
These Terms shall be governed and construed in accordance with the laws of the State of Indiana without regard to the choice of law provisions of any jurisdiction. We may without notice to you assign our rights and duties under these Terms to any party at any time. Failure to enforce or insist on strict performance of any provision of these Terms shall not be construed as a waiver of any provision or right. You agree that any legal action or proceeding between us and you in any way related to these Terms shall be brought exclusively in a court of a competent jurisdiction sitting in Indianapolis, Indiana. Any cause of action or claim you may have against or involving us must be commenced within one year after the claim or cause of action arises. Neither the course of conduct between the parties nor trade practice shall modify the provisions of these Terms. The invalidity or unenforceability of any provision shall not in any way affect the validity or enforceability of the rest of these Terms. These Terms constitutes the entire agreement between you and us regarding your use of this Application, and it supersedes all prior agreements, representations, proposals and other communications with respect this Application and its content.
This Application is produced by Wellpoint Insurance Company, Inc. and its affiliates at various locations. ©2022-2024 Wellpoint