Members can request a cost estimate if they meet eligibility guidelines and are currently enrolled in the health plan. Please note that an estimate does not guarantee coverage, and each admission, procedure, or service must be a medically necessary covered benefit and meet medical guidelines. In addition, all prior authorization and referrals must be obtained, if necessary.
There are two options for receiving an estimate of your financial responsibility for an upcoming service or procedure.
Estimates from Your Insurance Plan
Visit the Blue Cross Blue Shield of Massachusetts website and log into MyBlue or call 800-257-8141 for assistance. To help get you started, use the Blue Cross Blue Shield checklist form, which provides guidelines on what information you need in order to receive an estimate. Once you are logged into MyBlue, you can also do the following:
- View claims online
- Monitor your deductible and out-of-pocket maximum
- Request a written estimate
Estimates from Your Provider
All providers are now required to provide cost estimates for service they provide. Talk to your provider about obtaining an estimate prior to receiving services.