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Southcoast HealthAccepted Insurance Carriers and ProductsFor Southcoast Hospitals and PhysiciansPlease call 844-297-2952 with any questionsAetnaProducts AcceptedAetna Select (Similar to POS)HMOQuality Point of Service (QPOS)Aetna Health Network Only (Similar to PPO)Aetna Open Access Elect Choice (Similar to PPO)Aetna Open Access HMOOpen Access Aetna Select (Similar to POS)Aetna Choice POSAetna Choice POS IIAetna Premier Care Network Choice POS(excludes SHN Neurology, Orthopedic, Cardiology, OBGYN, and General Surgery)Aetna Health Network Option (Similar to PPO)Aetna Open Access Managed Choice (Similar to PPO)Aetna Limited Benefits Insurance Plan (PPO)Open Choice PPOManaged Choice POSElect Choice EPOAetna Voluntary Group Medical Plan (Indemnity Plan)Traditional ChoiceMeritain HealthAetna Medicare Freedom (PPO) - patient can choose any non-par physicianAetna Medicare Plans (HMO/PPO)
Aetna of RISouthcoast Physicians Only - Rhode Island providersProducts Accepted:Aetna Select (Similar to POS)HMOQuality Point of Service (QPOS)Aetna Health Network Only (Similar to PPO)Aetna Open Access Elect Choice (Similar to PPO)Aetna Open Access HMOOpen Access Aetna Select (Similar to POS)Aetna Choice POSAetna Choice POS IIAetna Health Network Option (Similar to PPO)Aetna Open Access Managed Choice (Similar to PPO)Aetna Limited Benefits Insurance Plan (PPO)Open Choice PPOManaged Choice POSElect Choice EPOAetna Voluntary Group Medical Plan (Indemnity Plan)Traditional ChoiceProducts Not Accepted:Aetna Medicare Plans (HMO/PPO)
Blue Cross Blue Shield of MAProducts Accepted: Please note these products may not be accepted after December 31, 2019 ifBCBSMA does not agree to fair and equitable reimbursement for Southcoast HealthPPO/EPOHMO BlueHMO Blue Network with Hospital Choice Cost Sharing FeatureHMO Blue New EnglandHMO Blue New England Options v.4HMO Blue New England Options v.5HMO Blue New England Network with Hospital Choice Cost Sharing FeatureHMO Blue Options v.4HMO Blue Options v.5IndemnityMedicare HMO BlueMedicare PPO BluePPO Blue Options v.4PPO Blue Options v.5PPO Blue SelectPreferred Blue PPO v.4Preferred Blue PPO v.5Preferred Blue PPO Network with Hospital Choice Cost Sharing FeatureMedex ChoiceProducts Not Accepted:HMO Blue Select (Limited Network)
Blue Cross Blue Shield of RIProducts Accepted:Basic BlueBasic Blue DirectAccess Blue New EnglandBlueChipBlueChip Medicare (Lab Exclusion - Eastside Lab)Blue Chip AdvanceBlue Chip ExtraBlue Chip with FlexBlue Chip without FlexBlue Chip Value HMOBlue Choice New EnglandBlue SolutionsBlue Solutions for HASBlue Solutions Select RIClassic BlueHealthMate Coast to CoastHMO Blue New EnglandVantage BlueVantage Blue DirectVantage Blue Select RIPlan 65BlueChip for Medicare Advance - Specialists OnlyProducts Not Accepted:BlueChip Direct Advance - New Product 1/1/18BlueChip for Medicare Advance - PCPsBlueChip for Medicare Advance replaces BlueChip for Medicare Select
BMC Healthnet PlanProducts Accepted:MassHealth (Includes all new BMCHP Medicaid ACO Plans)MassHealth CarePlusConnectorCare Plan Types I, II, IIIQualified Health Plan (QHP) Silver WrapQualified Health Plan (QHP) Silver Non-WrapSenior Care Options (Effective 3/1/18)Special Kids Special Care Plan (SKSC)Products Not Accepted:Commercial or any Platinum, Gold or Bronze PlansCelticareSouthcoast PCPs no longer accept CelticareCan no longer enroll in Plans as of 3/1/2018MassHealth CarePlusQualified Health Plan (QHP) Wrap Plans (ConnectorCare/Ambetter)Qualified Health Plan (QHP) Non-Wrap Plans (All Metallic Tiers/Ambetter)Community Care Cooperative (C3)Not contracted but All Southcoast Hospitals and Specialists are accepting this plan.Referral and/or Auth will be required.FallonProducts Accepted:Direct CareSelect CarePreferred Care (PPO )Tiered Choice - Tier 1Navicare Effective 1.1.17Products Not Accepted:Senior PlansMassHealth Plans or any of the new Medicaid ACO PlansSteward Community CareTiered Choice * Currently only offered in Berkshire, Hampden, Hampshire & Worcester counties
Harvard PilgrimProducts Accepted:National Plans:Harvard Pilgrim Access America PlansChoice and Choice Plus for Passport ConnectChoice Plus and Options PPO PlansStudent Insurance Plan PPO PlanHMO Plans:Harvard Pilgrim ChoiceNet Best Buy HMO PlanHarvard Pilgrim Choice Net HMOHarvard Pilgrim HMO & Best Buy HMO Plans with Focus Network OptionFocus Network - MAFocus Network - MA LimitedHarvard Pilgrim HMO PlanHarvard Pilgrim HMO Plan LPHarvard Pilgrim Hospital Prefer HMOHarvard Pilgrim Core Coverage HMOHarvard Pilgrim GIC Primary Choice Plan HMOHarvard Pilgrim Best Buy HMO PlanHarvard Pilgrim Best Buy HSA HMO PlanHarvard Pilgrim Tiered Copay HMOHarvard Pilgrim Non-Group HMO PlanNet Option HMONet Option - LP HMOPOS Plans:Harvard Pilgrim POS PlanHarvard Pilgrim GIC POS PlanPPO Plans:Choice Net PPOHarvard Pilgrim ChoiceNet Best Buy PPO PlanHarvard Pilgrim PPO PlanHarvard Pilgrim PPO LPHarvard Pilgrim Hospital Prefer PPOHarvard Pilgrim Best Buy PPO PlanHarvard Pilgrim Best Buy HSA PPOHarvard Pilgrim Commonwealth Choice PlansSenior Plans:Medicare Advantage Stride HMO Effective 1.1.17Harvard Pilgrim Medicare Enhance PlanHarvard Pilgrim Medicare Supplement Plan
Harvard Pilgrim continuedPlans Administered by Health Plans, Inc:Health Plans, Inc.Employer Specific Plans:Health Plans, Inc. - Southcoast Health PlanAtrius Health SelectBIDMC Select HMOBIDMC Choice POSBMC Tiered HMOHP - Lahey Health Select HMOHPHC Plan for PartnersNorthstar Preferred CareDraper HMOReliant Select HMOProducts Not Accepted:New Hampshire Network HMOMaines ChoiceHP - Lahey Health Limited HMOBMC SelectElevate HealthStride of New Hampshire (HMO)Innovative Health PlanParticipating Provider - SHN (Hospitals and Physicians)MedicaidParticipating ProviderIndividual practices may have their own contract with the Plan.MedicareParticipating Provider
MultiplanNo Network wide contract.SHN Affiliate practices may have their own contract with the Plan.Southcoast Physicians Group is not contracted.Southcoast Hospitals Group is contracted.Neighborhood Health Plan of MAName Change Effective 1/1/2019: AllWays Health PartnersSouthcoast PCPs will accept NHP if patient is willing to switch to BMCHP.Participating Provider:Commercial HMO & PPOMassHealth – Transitioning to Medicaid ACO.Neighborhood Health Plan of RISouthcoast Physicians Group (Specialists Only) - Includes Integrity PlanNo Hospital Contract or PCP ContractPartners HealthCare ChoiceNot contracted but All Southcoast Hospitals and Specialists are accepting this plan.Referral and/or Auth will be required.Senior Whole HealthParticipating ProviderSteward Health ChoiceNot contracted but All Southcoast Hospitals and Specialists are accepting this plan.Referral and/or Auth will be required.TPAsPriority HealthLucent HealthGeneral Insurance Service CenterInnovative Health
Tufts Health Public Plans (Network Health)Southcoast PCP's will accept Tufts Health Together if patient is willing to switch toBMCHP.Products Accepted:Tufts Health Together (MassHealth) - Referral and/or Auth may be required for Hospital andSpecialty ServicesTufts Health Direct (Connector Plans - see below for list of Plan Names)*Tufts Health Direct ConnectorCare Plan Type I*Tufts Health Direct ConnectorCare Plan Type II*Tufts Health Direct ConnectorCare Plan Type III*Tufts Health Direct Platinum Zero*Tufts Health Direct Platinum 500*Tufts Health Direct Gold 500*Tufts Health Direct Gold 1000*Tufts Health Direct Gold 1500*Tufts Health Direct Gold 2000*Tufts Health Direct Silver*Tufts Health Direct Bronze*Tufts Health Direct CatastrophicTufts Health Extend (Medical Security Program for Unemployed)Products Not Accepted:Choice PlanTufts Unify Plan (Dual eligible 21-64)Tufts Health RITogether/RI Medicaid THPP Plan
Tufts Health PlanProducts Accepted:Standard Network Plans:HMO, POS, PPO, and EPO Basic, Value, and Premium PlansAdvantage HMO, and PPO, and SaverMedicare Complement PlanHealth Pact (RI) PlanTiered Provider Network Plans:Choice CopayYour Choice 2-Tier HMO, POS, PPO, and EPOYour Choice 3-Tier HMO, POS, PPO, and EPOLifespan Premier Choice 2 - Tier HMO, PPO, EPONavigator PPOGIC Plans:Navigator & Spirit (PPO, EPO)Medicare Plan:Tufts Health Plan Medicare PreferredTufts Health Plan Senior Care Options Effective 1.1.17National Network Plan:Carelink (MA and RI Plans)Limited Network Plans:Select HMO, EPO, and Advantage HMO SelectOther:Christie Student Health - Effective August 2015Products Not Accepted:Steward Community ChoiceTufts US Family - can accept patient if authorized by Payer
United HealthcareProducts Accepted:UHC Options PPOUHC SelectUHC Select HMOUHC Select PlusUHC Charter/Charter BalancedUHC Charter HMOUHC Charter PlusUHC ChoiceUHC Choice EPOUHC Choice PlusUHC Choice HMO/ Choice Plus HMOUHC All Savers PlansHarvard Pilgrim Options PPOHarvard Pilgrim ChoiceHarvard Pilgrim Choice PlusUHC CoreUHC Core EssentialUHC Core HMO/Core Essential HMOUHC Anchor Plans (for State of RI employees)UHC Heritage PlusUHC Heritage Select POS/HMO/EPOUHC Heritage Select AdvantageUHC Navigate PlusUHC Navigate/Navigate BalancedUHC Navigate HMO/Navigate Balanced HMO/Navigate Plus HMOUHC Navigate EPOUHC Passport Connect Options PPOUHC Passport Connect ChoiceUHC Passport Connect Choice PlusUHC Compass Plus (only if member holds an OPEN NETWORK PLAN - will pay to Choice Plus otherwise non-contracted)UHC Compass/Compass Balanced (only if member holds an OPEN NETWORK PLAN - will pay toChoice Plus - otherwise non-contracted)UHC Compass HMO/Compass Balanced HMO/Compass Plus HMO (only if member holds an OPENNETWORK PLAN - will pay to Choice Plus - otherwise non-contracted)Medica Choice with United HealthCare Choice PlusAARP MedicareComplete PlansUHC Medicare Advantage PlansUHC Nursing Home Plan PPO SNP
United Healthcare continuedUHC Senior Care Options HMO SNP (Evercare)UHC RI Medicaid (Ritecare) Product of Community PlansUHC Rhody Health Product of Community PlansUnited HealthOneProducts Not Accepted:UHC Oxford PlanUHC NHP HMO/POS/POS AccessSignature Value PlansUHC MD IPA/MD IPA PreferredPacifiCare Signature Elite Plus (TX & OK only)Optimum Choice HMOOptimum Choice Preferred POSUHC Compass Plans - see above for "Open Network" plansMedicare SelectMedicare Advantage Private Fee-For-Service PlansEmpireRI Compass Plan (Exchange Plan effective 1.1.15)UnicareProducts Accepted:Basic (Indemnity)Plus (PPO)Community Choice (PPO)
General Insurance Service Center Innovative Health . Tufts Health Public Plans (Network Health) Southcoast PCP's will accept Tufts Health Together if patient is willing to switch to BMCHP. Products Accepted: Tufts Health Together (MassHealth
