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HMO/POS

We offer several different types of HMO Plans: 

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HMO Blue Plans

We offer the following types of HMO plans:

  • Blue Select Plans
    Members select a primary care provider (PCP) in the HMO Blue Select Network (a limited, Massachusetts-based network).
  • HMO Blue Plans
    Members select a PCP in the HMO network. The PCP coordinates the member's care and refers the member to a network specialist, if necessary.
  • HMO Blue New England Plans
    Members of our HMO Blue New England health plans must choose a PCP from any of the provider networks in the six New England states (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont).
  • HMO Deductible Plans
    Members must select a PCP in the HMO network. They also pay a deductible before they receive benefits under these plans.
  • Access Blue
    These plans give members the option to go directly to a specialist or any doctor in the network without a referral. Authorizations maybe required for some services. Members must choose a PCP from any of the provider networks in the six New England states (Connecticut, New Hampshire, Maine, Rhode Island, and Vermont).
Blue Choice (Point-of-Service/POS) Plans

Our Blue Choice (POS) plans offer managed care networks while giving members the freedom to seek care from either an in-network provider, or from an out-of-network provider with higher out-of-pocket costs. Through Blue Choice plans, members have:

  • A primary care provider (PCP) to coordinate all PCP/Plan Approved Benefits care
  • The flexibility to self-refer to any Blue Cross participating provider (at a higher cost). Please note that Blue Choice 2 plans allow members to self-refer to any licensed, covered provider.

Please note these plans may require the member to pay a cost share (deductible, copayment, or co-insurance) for covered services.

We recommend providers check member eligibility and benefits before rendering services.