For Patients & Families | Accepted Health Insurances

Boston Children’s Hospital and its affiliated providers are participating providers with the health plans listed below. Participation in these plans is not a guarantee of payment or coverage. Many health plans require a referral or prior-authorization for coverage of services and not all services are covered depending on your health plan. If you would like to verify coverage or have questions regarding out of pocket expenses we recommend that you call the member services number on your health plan card for more information. You may also contact us at 617-355-3397, if you have a question regarding Boston Children’s Hospital’s or its providers’ participation status with your health plan.

YOUR FINANCIAL RESPONSIBILITY: If you are enrolled in a tiered, high deductible or limited network your out of pocket expense will vary based on the provider and/or place of service (i.e. main campus vs. satellites). We recommend that you call your health plan to determine your liability/out of pocket financial responsibility.

BEHAVIORAL HEALTH COVERAGE: Behavioral Health Benefits should always be verified with your health plan.

NON-PARTICIPATION: If you do not see your health plan listed below, please contact member services at your health plan to inquire about coverage for care provided at Boston Children’s Hospital or you may contact us with questions at 617-355-3397.

AETNA

• AETNA CHOICE POINT OF SERVICE (POS)
• AETNA MANAGE CHOICE
• AETNA OPEN ACCESS MANAGE CARE
• AETNA OPEN CHOICE PPO
• AETNA HEALTH NETWORK
• AETNA NETWORK OPTION PLANS
• AENTA INDEMNITY PLANS
• AETNA TRANSPLANT NETWORK
• AETNA BEHAVIORAL HEALTH
• AETNA US HEALTHCARE HMO
• AETNA US HEALTHCARE PPO & INDEMNITY
• AETNA BETTER HEALTH
• INTERNATIONAL AETNA GLOBAL BENEFITS
• INTERNATIONAL AETNA

BLUE CROSS BLUE SHIELD

The BlueCard program is a national program that enables members of a Blue Cross Blue Shield plan to get health care service benefits while traveling or living in another Blue plan’s service area. Benefits vary from plan to plan and state to state. Always check benefits and eligibility before rendering services. BlueCard members have a suitcase logo on their ID card.

• BLUE CROSS MA PPO & INDEMNITY
• BLUE CROSS MA HMO & BLUE CHOICE (POS)
• BLUE CROSS MEDEX
• BLUE CROSS BLUE SHIELD - FEDERAL
• BLUE OPTIONS - HMO BLUE NEW ENGLAND OPTIONS
• BLUE OPTIONS - PREFERRED BLUE PPO OPTIONS
• BLUE BENEFIT ADMINISTRATORS
• BLUE SELECT OPTIONS HMO & PPO
• BLUE CROSS OUT-OF-STATE
• BCBS BEHAVIORAL HEALTH

BEACON HEALTH STRATEGIES

• BEACON - MASSHEALTH (MBHP)
• BEACON - FALLON HEALTH
• BEACON - GIC
• BEACON - NEIGHBORHOOD HEALTH PLANS

CIGNA

• CIGNA CARELINK
• CIGNA OPEN ACCESS PLUS
• CIGNA NETWORK OPEN ACCESS & OPEN ACCESS PLUS
• CIGNA HMO OPEN ACCESS & POS OPEN ACCESS
• CIGNA NETWORK & NETWORK POS, PPO or EPO
• CIGNA OPEN ACCESS PLUS NETWORK
• CIGNA NETWORKS IN THE US: PPO & AOP
• CIGNA HEALTH PLAN-PPO & INDEMNITY
• CIGNA MVP
• CIGNA LIFESOURCE
• CIGNA GREAT WEST LIFE
• INTERNATIONAL CIGNA
• CIGNA BEHAVIORAL HEALTH
• LIFESOURCE

COVENTRY

COMMUNITY HEALTH OPTIONS

PPO MAINE FEDERAL EXCHANGE – MAINE COVERAGE ONLY

• Community Advantage – Gold & Silver (ME)
• Community Value – Silver (ME)
• Community Value Plus Silver
• Community Choice Silver
• Community Preferred Silver
• Community Preferred Plus Silver
• Community Option Bronze
• Community Plus Bronze
• Community Option Bronze
• Community Plus Bronze
• Community Option HSA Bronze
• Community Safe Harbor Catastrophic
• Community Premier Platinum
• Community Balance Silver

FALLON

• SELECT CARE
• HARRINGTON ADVANTAGE-PPO
• FALLON ADVANTAGE PLAN- THE CITY OF WORCESTER – SELECT CARE TIER 2
• FALLON HARRINGTON ADVANTAGE - PPO
• FALLON CONNECTOR OPTIONS – SELECT CARE
• FALLON TIERED CHOICE – TIER 3
• FALLON PREFERRED CARE-PPO
• FALLON – COMMUNITY CARE

HARVARD PILGRIM HEALTH CARE (HPHC)

• HPHC-HMO
• HPHC-PPO
• HPHC CHOICE PLUS PASSPORT
• HARVARD PILGRIM OPTIONS-PPO
• HPHC STUDENT INSURANCE PL-PPO
• HEALTH PLANS INC-PPO
• HPHC NH HEALTHY KIDS
• HPHC CHOICE NET - HMO
• HPHC CHOICE NET - PPO
• HPHC PRIMARY CHOICE (GIC)
• HPHC INDEPENDENCE PLAN (POS)
• HPHC FOCUS NETWORK – Authorized Access
• HPHC HOSPITAL PREFER-HMO
• HPHC HOSPITAL PREFER-PPO
• HPHC SOUTHCOAST
• HPHC NH ELEVATE HEALTH – Authorized Access
• HPHC ELEVATE HEALTH OPTIONS

HUMANA

• CHOICE CARE NETWORK - PPO

LIFETRAC TRANSPLANT NETWORK

MASSHEALTH – ACCOUNTABLE CARE ORGANIZATION (ACOS)

• COMMUNITY CARE COOPERATIVE (C3)
• MASS GENERAL BRIGHAM
• MY CARE FAMILY
• STEWARD HEALTH CHOICE
• TUFTS HEALTH TOGETHER WITH ATRIUS HEALTH
• TUFTS HEALTH TOGETHER WITH BIDCO
• TUFTS HEALTH TOGETHER WITH BOSTON CHILDREN’S ACO
• TUFTS HEALTH TOGETHER WITH CHA
• WELLFORCE CARE PLAN
• WELLSENSE COMMUNITY ALLIANCE
• WELLSENSE MERCY ALLIANCE
• WELLSENSE SIGNATURE ALLIANCE
• WELLSENSE SOUTHCOAST ALLIANCE

MASSHEALTH – Mass Medical

• MASSHEALTH-LIMITED
• MASSHEALTH-NON-PCC
• MASSHEALTH-PCC
• MASS BEHAVIORAL HEALTH PLAN (MBHP)
• MASSHEALTH STANDARD
• MASSHEALTH COMMONWEALTH
• MASSHEALTH CARE PLUS
• MASSHEALTH FAMILY ASSIST
• MASSHEALTH SMALL BUSINESS EMPLOYEE PREMIUM
• CHILDREN’S MEDICAL SECURITY PLAN

MEDICAID – Out of State

• New Hampshire
• Vermont
• Maine
• AETNA BETTER HEALTH
• AMERIHEALTH CARITAS NEW HAMPSHIRE

MEDICARE

MGB Health Plan (formerly known as Allways Health Partners)

MULTIPLAN/PHCS

Covers out of network benefits for patients.

TUFTS HEALTH PLAN TOGETHER – MASSHEALTH PLAN

• Care Plus
• Commonwealth Care

TUFTS HEALTH PLAN DIRECT – CONNECTORCARE (QHP)

• Subsidized - PLAN TYPE 1-3 (CC1 CC2 & CC3)
• Nonsubsidized – PLATINUIM, GOLD, SILVER, BRONZE, AND CATASTROPHIC
  • Gold silver & bronze out of pocket expense

TUFTS

• TUFTS HEALTH PLAN - HMO
• TUFTS BENEFIT ADMIN - PPO
• LIBERTY
• NAVIGATOR
• CARELINK-TUFTS
• TUFTS HEALTH PLAN - POS
• TUFTS NAVIGATOR (GIC)
• TUFTS YOUR CHOICE - HMO
• TUFTS YOUR CHOICE - PPO
• TUFTS STEWARD - DPO
• TUFTS UNIFORM SERVICE
• TUFTS STEWARD - EPO
• TUFTS SPIRIT PLANS
• TUFTS SELECT NETWORK PLANS
• TUFTS STEWARD COMMUNITY CHOICE PLANS
• TUFTS ADVANTAGE HMO SELECT
• TUFTS GIC SELECT PRODUCTS (GIC)
• TUFTS SPIRIT PRODUCTS
• TUFTS STEWARD COMMUNITY CHOICE

UNICARE

• UNICARE – GIC
• UNICARE – COMMUNITY CHOICE (GIC)
• UNICARE – INDEMNITY PLANS (GIC)
• UNICARE – PLUS (GIC
• UNICARE – CLASSIC (PPO & HMO)

UNITED HEALTH CARE

• AMERICHOICE
• UNITED PASSPORT
• UNITED HEALTHCARE - HMO, PPO, POS
• OXFORD HEALTH PLANS
• OPTUM TRANSPLANT
• UNITED BEHAVIORAL HEALTH
• INTL UNITED HEALTHCARE

Patients may contact their carriers for specific benefit information.

For further information, please call Patient Financial Services at 617-355-3397.