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    • Welcome to MyBlue!
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            • Over-the-Counter (OTC) Exclusions
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            • Step Therapy
            • Quality Care Dosing
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          • Screenings
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Health Care Reform for Individuals & Families

With the inauguration of President Donald Trump, the local and national health care landscape seems to be shifting on a daily basis, raising questions about the Affordable Care Act, Health Care Reform, and what it all means to our industry – you, and your family. While there has been nothing definitive yet, we do expect there to be changes to the ACA over time.

At Blue Cross Blue Shield of Massachusetts we want to ensure everyone in the state continues to have access to high–quality and affordable health care. We also want to ensure the marketplace remains competitive, affordable, and stable. We are committed to working in a spirit of shared responsibility to maintain what we have achieved.

As changes arise, we will continue to keep you informed and updated.


Related News

05/05/2017:    Response to May 4th House vote on the American Health Care Act

03/10/2017:    A recap of recent activity related to health care reform as of 03.10.17

03/07/2017:    Health Care Reform Activity - 3/7/17:

01/20/2016:    IRS Extends Due Dates for Filing 2015 Health Coverage Forms

More News 


Provisions That Apply to Individuals & Families

Here is an overview of important provisions in health care reform and when they will take effect.

  • 2018
  • 2017
  • 2016
  • 2015
  • 2014
  • 2013

Provisions Taking Effect in 2018

There are no provisions.

Provisions Taking Effect in 2017

There are no provisions.

Provisions Taking Effect in 2016

There are no provisions.

Provisions Taking Effect in 2015

There are no provisions.

Provisions Taking Effect in 2014

Provisions Taking Effect in 2013


Frequently Asked Questions

National health care reform affects just about everyone in the country, including brokers, employers and individuals. For answers to your questions about how it will affect you, click on the links below

What are the provisions for women's preventive health services?

The new law includes many provisions that are designed to improve women's health. The new law will eliminate cost sharing for certain preventive screenings and ensure direct access to obstetricians and gynecologists. Many additional benefits will be made available to women beginning in 2014, including:

  • Covering maternity services on all coverage
  • Eliminating pre-existing coverage exclusions for women who are pregnant, have had a previous cesarean, or are the victims of domestic violence
  • Eliminating gender rating in most policies that may cause women to pay more than men for insurance at certain ages
How will uninsured individuals be able to obtain coverage in the future?

Beginning in 2014, state health insurance exchanges will enable consumers to compare benefits, prices, and networks of health care providers, and to purchase coverage. In 2014, subsidies also will be made available (as noted in the following question on affordability).

How is a "policy year" defined?

"Policy year" means the 12-month period that is designated as the policy year in the individual health insurance coverage policy documents. For specific information related to the policy year, please check the coverage policy document.

If there is no designated policy year in the policy document (or no such policy document is available), then the policy year is the deductible or limit year used under the coverage. If deductibles or other limits are not imposed on a yearly basis, the policy year is the calendar year.

Please note that policy year is defined differently for group policies.

What does the law mean when referring to preventive services without any cost sharing?

For policies that are not grandfathered, beginning with the first renewal on or after September 23, 2010 (including new policies with an effective date on or after September 23, 2010), members will be able to receive certain preventive services without having to pay deductibles, copayments, or co-insurance. The types of services include several evidence-based cancer and disease screenings, as well as specific immunizations. Contact your account executive to find out what services are covered.

What are the provisions for emergency-related services?

For plans that are not grandfathered, the new law generally states that coverage for emergency department services must be provided without prior authorization of services. In addition, out-of-network emergency services must be covered and reimbursed the same as in-network emergency services, including cost-sharing requirements (i.e., copayments, co-insurance, etc.) for both in-network and out-of-network services.

More FAQ's


For More Information

Want to learn more about how health care reform will affect your business? Here are helpful links to the information you need.

The Health Connector

Massachusetts residents can visit the Health Connector to compare and purchase health insurance.

Subsidy Calculator

Use the subsidy calculator to find out if you qualify for lower cost insurance at an online exchange.

HealthCare.gov

If you live outside of Massachusetts, go to the Health Insurance Marketplace to find out how to purchase health insurance from an exchange.

AskBlue Health Care Reform

A personal guide to understanding health care reform basics.

Blue Cross Blue Shield of Massachusetts

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Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross and Blue Shield Association. ®´, ®´´, SM, TM Registered and Service Marks, and Trademarks are the property of their respective owners. © 2018 Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.

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ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia con el idioma. Llame al número de Servicio al Cliente que figura en su tarjeta de identificación llamada 1-800-472-2689 (TTY: 711 ).

ATENÇÃO: Se fala português, são-lhe disponibilizados gratuitamente serviços de assistência de idiomas. Telefone para os Serviços aos Membros, através do número no seu cartão ID chamar  1-800-472-2689 (TTY: 711 ).

ATTENTION : si vous parlez français, des services d’assistance linguistique sont disponibles gratuitement. Appelez le Service adhérents au numéro indiqué sur votre carte d’assuré appel 1-800-472-2689  (TTY : 711 ).

注意:如果您讲中文,我们可向您免费提供语言协助服务。请拨打您 ID  卡上的号码联系会员服务部 通话 1-800-472-2689(TTY  号码:711 )。

ATANSYON: Si ou pale kreyòl ayisyen, sèvis asistans nan lang disponib pou ou gratis. Rele nimewo Sèvis Manm nan ki sou kat Idantitifkasyon w lan (Sèvis pou Malantandan Rele 1-800-472-2689 TTY: 711 ).

LƯU .: Nếu quý vị n.i Tiếng Việt, c.c dịch vụ hỗ trợ ng.n ngữ được cung cấp cho quý vị miễn ph.. Gọi cho Dịch vụ Hội vi.n theo số tr.n thẻ ID của quý vị Cuộc gọi 1-800-472-2689 (TTY: 711 ).

ВНИМАНИЕ: если Вы говорите по-русски, Вы можете воспользоваться бесплатными услугами переводчика. Позвоните в отдел обслуживания клиентов по номеру, указанному в Вашей идентификационной карте вызов  1-800-472-2689 (телетайп: 711 ).

ការជូនដំណឹង៖ ប្រសិនប. ើអ្នកនិយាយភាសា ខ្មែរ សេ  វាជំនួយភាសាឥតគិតថ្លៃ គឺអាចរកបានសម្  រាប ់អ្នក។ សូមទូរស័ព្ទទ ៅផ ្នែ កសេ  វាសមា  ជិកតាមល េខន  ៅល.  ើប ័ណ្ណ សម្  គាល ់ខ្លួ ខ្លួ នរប ស់អ្នក ហៅ  1-800-472-2689 (TTY: 711) ។

ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativa chiamata  1-800-472-2689 (TTY: 711 ).

참고 : 한국어를 사용하는 경우 언어 지원 서비스를 무료로 사용할 수 있습니다. 신분증에있는 전화 번호 1-800-472-2689 (TTY : 711)로 회원 서비스에 연락하십시오.

ΠΡΟΣΟΧΗ: Εάν μιλάτε Ελληνικά, διατίθενται για σας υπηρεσίες γλωσσικής βοήθειας, δωρεάν. Καλέστε την Υπηρεσία Εξυπηρέτησης Μελών στον αριθμό της κάρτας μέλους σας (ID Card) κλήση 1-800-472-2689 (TTY: 711 ).

UWAGA: Osoby posługujące się językiem polskim mogą bezpłatnie skorzystać z pomocy językowej. Należy zadzwonić do Działu obsługi ubezpieczonych pod numer podany na identyfikatorze zadzwoń 1-800-472-2689 (TTY: 711 ).

ध्यान दें: य दि  आप ह िन् दी बोलते ह ैं, तो भा षा  सहाय  ता  सेवा एँ, आप के लि ए नि :शुल्क  उपलब्ध ह ैं। सदस्य  सेवा ओं को आपके आई.डी. कार  ्ड पर दि ए गए नंबर पर कॉल करें  कॉल 1-800-472-2689 ( टी .टी .वा ई.: 711).

ધ્યાન આપો:  જો તમે ગુજરા તી બોલતા  હો, તો તમને ભા ષા કીય  સહાય  તા  સેવા ઓ વિ ના  મૂલ્યે  ઉપલબ્ધ છે. તમા રા  આઈડી કાર  ્ડ પર આપેલા  નંબર પર Member Service  ને કૉલ કરો કૉલ કરો 1-800-472-2689 (TTY: 711).

PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag 1-800-472-2689 (TTY: 711 ).

お知らせ:日本語をお話しになる方は無料の言語アシスタンスサービスをご利用いただけます。ID カードに記載の電話番号を使用してメンバーサービスまでお電話ください 呼び出す 1-800-472-2689(TTY: 711 )。

ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen 1-800-472-2689 (TTY: 711 ).

ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Call 1-800-472-2689 (TTY: 711).

ຂໍ້ຄວນໃສ່ໃຈ: ຖ້າເຈົ້າເວົ້າພາສາລາວໄດ້, ມີການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາໃຫ້ທ່ານໂດຍບໍ່ເສຍຄ່າ. ໂທ ຫາ ຝ່າຍບໍລິການສະ ມາ ຊິກທີ່ໝາຍເລກໂທລະສັບຢູ່ໃນບັດຂອງທ່ານ ໂທ 1-800-472-2689 (TTY: 711).

BAA !KOHWIINDZIN DOO&G&: Din4 k’ehj7 y1n7[t’i’go saad bee y1t’i’ 47 t’11j77k’e bee n7k1’a’doowo[go 47 n1’ahoot’i’. D77 bee an7tah7g7 ninaaltsoos bine’d44’ n0omba bik1’7g7ij8’ b44sh bee hod77lnih call 1-800-472-2689 (TTY: 711).