Network Blue New England Options

A few highlights of your plan:

  • A primary care provider (PCP) who is your "regular" doctor and provides referrals for specialists
  • Providers within an extensive regional network—Rhode Island, Massachusetts, Connecticut, New Hampshire, and Maine.
  • $0 for many preventive services, such as your annual physical, when you see a network provider
  • PCPs, radiologists, and hospitals that are grouped into Standard and Enhanced levels. See below to learn why this is important.

View plan documents

Enhanced level providers can save you money

The PCPs, radiologists, and hospitals within the Network Blue New England Options network have been reviewed and placed in one of two levels, Standard or Enhanced. Providers in each group deliver the quality you’d expect from a BCBSRI network. Some, however, go above and beyond. We call this group Enhanced because they offer an enhanced experience, both in terms of quality of care and cost savings. You can see which level each provider is in when you log in and use the Find a Doctor tool. Below are examples of hospitals in each level.

  Standard Enhanced
Rhode Island
Rhode Island Kent Hospital Rhode Island Hospital (including Hasbro)
Roger Williams Hospital Women & Infants Hospital
Landmark Medical Center The Miriam Hospital
Our Lady of Fatima Hospital Newport Hospital
Westerly Hospital South County Hospital
Massachusetts
Massachusetts Massachusetts General Hospital Brigham and Women's/MGH Foxboro
Beth Israel Deaconess Medical Center Tufts Medical Center
Dana Farber Cancer Center Newton-Wellesley Hospital
UMass Memorial Medical Center St. Anne's Hospital
Boston Children's Hospital St. Vincent's Hospital

This list is subject to change. For up-to-date information about hospitals included in the Options network and whether they are Standard or Enhanced, please use our Find a Doctor tool or contact Customer Service.

Options for care mean more control over costs

You get more from Enhanced-level providers than an enhanced experience. You also gain more control over the costs you pay. There are two ways you can save.

First, you will have a lower copay when you see an Enhanced provider than a Standard provider. Depending on the service, the difference could be hundreds of dollars.

Second, the deductible doesn’t apply when you see an Enhanced provider. What does that mean? When you see an Enhanced provider, you pay a copay. That’s it. You don't have to worry about meeting your deductible.

Here are some common services that will have a lower copay for Enhanced providers:

  • PCP visits
  • Hospital stays
  • Outpatient visits
  • High-end radiology

Your New England network

  • 11,000+ PCPs
  • 30,000+ specialists
  • Close to 200 hospitals

Find doctors and hospitals throughout New England

Do you need a referral?

Your healthcare in this plan is based on referrals from your PCP, but some types of care, like emergency and mental health services, don’t require a referral.

What requires a referral?

PCPs explained

Think of a primary care provider (PCP) as your regular doctor, the one you see for a checkup and when you have a medical concern.

Find a doctor

Earn rewards just for making healthy choices

If your employers offers the BCBSRI wellness program, it will keep you stepping, tracking, and having fun while improving your health.

Learn about rewards and the easy-to-use app

See a doctor online

You can use Doctors Online when you can’t get to your own doctor’s office. Set up your account now so it's ready for you when you need it.

Register for Doctors Online

Doctors Online is a telemedicine service provided by American Well®, an independent company that administers Doctors Online on behalf of Blue Cross & Blue Shield of Rhode Island.

$0 for prevention

You can make a big difference in your health by getting the preventive care you need. Annual physicals, routine tests, and many more services may cost you nothing out-of-pocket.

Know the basics

Learn more basic terms

The amount you pay before your health plan starts to pay for certain medical bills. It resets every calendar year or plan year.

A specific dollar amount you pay when you get healthcare. Example: A doctor might charge $100 for a visit. If your health insurance has a $20 copay, you would pay the doctor $20 and your insurance would pay the doctor $80.

The percentage of the total medical bill that you have to pay after you’ve met your deductible. For example, some plans have a 20% coinsurance charge for physical therapy. So if the total bill is $100, the coinsurance would be $20.

The maximum amount you would pay out-of-pocket for covered health care services each year, including deductible, copays, and coinsurance. After the out-of-pocket is met, in-network covered services are paid at 100% by Blue Cross & Blue Shield of Rhode Island.

An order from your primary care provider (PCP) for you to receive care from another doctor, specialist, or medical facility.

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