Network Blue New England Options
Network Blue New England Options is a health plan that lets you decide. From choosing a primary care provider (PCP) to deciding where to go for tests to selecting the facility that best meets your needs, you have options. That means control and flexibility. And peace of mind.
A few highlights of your plan:
- A primary care provider (PCP) who is your “regular” doctor and provides referrals for specialists as needed
- 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
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.
The following services have a lower copay for Enhanced providers:
- PCP visits
- Hospital stays
- Outpatient visits
- High-end radiology
Your plan's network
- 11,000+ PCPs
- 30,000+ specialists
- Close to 200 hospitals
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.
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.
$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.
Find a doctor and see the cost
Know the basics
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 healthcare 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.