How Dependent Children Can Receive Coverage When Living Outside of Massachusetts

Effective January 1, 2021, coverage has been expanded for dependents living outside of Massachusetts. In addition to emergency and urgent care, covered dependents* in HMO, POS, and POS+ plans living outside the Massachusetts service area can receive in-network coverage for non-emergency medical and mental health care when they register with Blue Cross Blue Shield of Massachusetts. 


HERE'S WHAT YOU NEED TO KNOW:

Registration is required to receive in-network care outside the Massachusetts service area:

Dependents who live outside of the service area must register each calendar year (Jan-Dec) by calling Harvard University Group Health Plan (HUGHP) Member Services at 1-617-495-2008. The plan subscriber must register any dependent under the age of 18.

What services are covered when I register?

Services that aren’t usually covered when delivered outside the Massachusetts service area, such as:
  • Preventive care services
  • Outpatient medical care office visits
  • Mental health care
  • Follow-up care, when required, after leaving the emergency room or after an inpatient hospital stay

Will I need a PCP referral or BCBS authorization for services rendered outside of the service area?

Dependents who register as an out of area dependent are not required to get referrals from their PCP. However, an authorization may be required prior to select services such as:
  • CT scans, MRIs, PET scans, and nuclear cardiac imaging tests
  • Select outpatient surgeries and or procedures
  • Inpatient admissions
  • Home health care
  • Infertility treatment
  • Ambulance (non-emergency)
  • Chiropractor services (visits 13-18)

Authorization must be obtained prior to having the service(s).

Do I need to see a Blue Cross Blue Shield provider when seeking care outside of Massachusetts?

Yes, you must see a Blue Cross Blue Shield participating doctor when receiving eligible care outside of Massachusetts. To find a participating doctor, visit bcbs.com/find-a-doctor. To search, use the prefix located on the front of your ID card (XXS).
 
*Subscribers and spouses aren’t included as covered dependents.
 
 
URGENT AND EMERGENCY CARE ARE ALWAYS COVERED
 
Dependents are covered if they get sick or injured and need immediate medical care at an emergency room or urgent care center. For urgent care, please call Blue Cross Member Service within 48 hours for authorization.
 

Questions?

Call Harvard University Group Health Plan Member Services at 1-617-495-2008.