[http://www.bmchp.org 'Boston Medical Center (BMC) HealthNet Plan'is a not-for-profit managed care organization serving more than 240,000 members across Massachusetts. Founded in 1997 by Boston Medical Center, BMC HealthNet Plan’s 400 employees work in the Boston headquarters or in regional offices in Springfield and New Bedford. The health plan serves members across three product lines: MassHealth, Commonwealth Care, and commercial (Commonwealth Choice/Employer Choice).
BMC HealthNet Plan is committed to quality and has achieved Excellent Accreditation status four times in a row from the National Committee for Quality Assurance (NCQA). BMCHP is one of America’s top five Medicaid health plans, according to NCQA’s Medicaid Health Insurance Plan Rankings 2011-2012.
To serve its MassHealth and Commonwealth Care members, BMC HealthNet Plan contracts with nearly 60 hospitals, 15,000 health care providers, and 1,000 pharmacies across the state (except for Martha’s Vineyard and Nantucket). For its Commonwealth Choice/Employer Choice plans, BMC HealthNet Plan currently offers a network of selected healthcare providers in eastern Massachusetts.
Each BMC HealthNet Plan member chooses a personal primary care provider (PCP) who delivers or arranges for the member’s care. The Plan also offers special care management programs for members who are pregnant or who have asthma, diabetes, or other medical conditions.
Since 1997, BMC HealthNet Plan has offered high-quality, affordable health insurance coverage through its MassHealth product to low-to-moderate-income individuals in Massachusetts qualifying for free health care coverage through the state’s MassHealth (Medicaid) program.
In 2006, BMC HealthNet Plan began participating in the state’s Commonwealth Care program, a program launched to make subsidized, comprehensive, affordable health insurance coverage available to eligible Massachusetts residents.
Beginning in November 2011, the Plan began enrolling individuals and their families and small businesses in its Commonwealth Choice/Employer Choice commercial products, which meet the state mandate for health insurance coverage. Offering this non-subsidized commercial product allows the Plan to expand its extensive managed care expertise to Massachusetts residents who don’t qualify for subsidized coverage through the state’s MassHealth or Commonwealth Care program. This suite of six products gives employers and individuals a variety of cost-sharing options to choose from. For example, some plans have a lower premium but have a higher deductible while others have a higher monthly premium but a lower or no deductible. (updated 4 January 2011)
Headquartered in Boston with offices in New Bedford and Springfield, the Plan knows and is committed to supporting the Massachusetts communities it serves. Through its community outreach team, the Plan partners with its healthcare providers and local organizations to educate Massachusetts residents about health and wellness topics, as well as their affordable healthcare coverage options.
Members have access to BMC HealthNet Plan’s customer care representatives for questions about their benefits and how to get the most out of their coverage. Interpreters are available to assist them in any language, and the Plan employs TTY numbers for members with hearing loss. BMC HealthNet Plan also offers members a 24/7 Nurse Advice phone line for medical concerns and a 24/7 behavioral health phone line for mental health and substance abuse concerns.
In addition, members can use the Plan’s online self-service portal – 24/7 – to electronically submit address changes and PCP requests or to look up claims history.