Brigham and Women’s Hospital (BWH) accepts most health insurance and managed care plans, including Medicare, Medicaid, and all Medigap (Medicare Supplement) plans.

The plans that we accept are listed below. This list is updated periodically and subject to change, so please check with your health plan to verify coverage.

Here are some things to keep in mind about your health care coverage:

  • If your plan is listed, a referral from your primary care doctor may be required in order to see our specialists.
  • If your plan is not listed, you may still be able to receive care at BWH by obtaining a qualified referral from your primary care physician or authorization from your health plan.
  • Some health insurance plans now have a tiered network benefit structure for certain services. This means that your out-of-pocket costs for such services will be higher for a hospital in a higher tier. However, we may be able to help lower these costs by relocating your appointment to one of our affiliate institutions in a lower tier. Check with your health plan to determine whether they use a tiered network benefit structure and what that means for you. Visit our Health Insurance — Tiered Networks page to learn more.

We’ve broken down our list of accepted plans into three categories — Managed Care Plans, Managed Care Senior Plans, and for plans that use a separate company to manage their mental health benefits, Contracted Mental Health Companies.

Managed Care Plans

Aetna Health Management, Inc.

  • HMO/QPOS, POS, EPO, PPO

Beech Street Corporation PPO

Blue Cross and Blue Shield of Massachusetts, Inc.*

  • All commercial products except Select Blue PPO and Select Blue EPO*

CeltiCare Health Plan of MA, Inc. *

  • Commonwealth Care HMO
  • BWH is not contracted for Commonwealth Choice plans. *

Children’s Medical Security Plan

CIGNA HealthCare of Massachusetts, Inc. 

  • HMO, POS & PPO

Commonwealth Indemnity Plan *

  • Unicare State Indemnity Plan Basic and Unicare State Indemnity Plan PLUS
  • BWH is not contracted for Unicare State Indemnity Plan Community Choice. Members can receive services but will incur higher out-of-pocket costs. *

Comprehensive Benefits Administrator, Inc. PPO

Coventry Healthcare PPO

Fallon Community Health Plan, Inc. *

  • PPO
  • HMO plans using Select Care Network
  • HMO plans not using Select Care Network – specialty care only, and plan authorization required*

First Health PPO

ForMost, Inc. 

Harvard Pilgrim HealthCare, Inc. *

  • All commercial products – HMO, POS, and PPO, except GIC Primary Choice HMO Plan and HPHC Focus*

Humana Choice Care 

  • PPO
  • National POS- Open Access

Multiplan PPO

Neighborhood Health Plan of Massachusetts, Inc.

  • Commercial, Commonwealth Care and Medicaid HMO products

Network Health *

  • Medicaid HMO
  • BWH is not contracted for the Commonwealth Care HMO product. *

Private HealthCare Systems, Inc. PPO

Tufts Associated Health Plan *

  • All commercial products – HMO, POS, and PPO, except Tufts HMO Select and Tufts Health Plan Spirit *

United HealthCare of New England, Inc. *

  • PPO, POS, EPO, Direct Access
  • BWH is not contracted for the HMO product. *

* Indicates a plan where BWH is out of network for certain products, or where BWH is only contracted for certain levels of care.


Managed Care Senior Plans

We accept all Medicare supplement (Medigap) plans.

Aetna Health Management, Inc.

  • Medicare Advantage HMO, POS and PPO

Blue Cross Blue Shield of Massachusetts *

  • Managed Blue for Seniors
  • Medicare Advantage HMO Blue (specialty care only) *
  • Medicare Advantage PPO Blue (specialty care only) *

Evercare

  • Medicare Advantage HMO
  • Senior Care Options
  • Erickson Advantage

Secure Horizons HMO

Tufts Associated Health Plan *

  • Medicare Preferred HMO – tertiary care only; specialist services require referral from PCP. *

UnitedHealthcare

  • AARP Medicare Complete
  • Medicare Complete
  • Nursing Home Plan
  • Senior Care Options

* Indicates a plan where BWH is out of network for certain products, or where BWH is only contracted for certain levels of care.
 

Contracted Mental Health Companies

Beacon Health Strategies, LLC

Cenpatico Behavioral Health

Massachusetts Behavioral Health Partnership (MBHP)

United Behavioral Health



This page was last modified on 4/9/2013