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Summary of Benefits and Coverage: What this Plan Covers

WebAll copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies. $30 copay/visit Deductible does not …

Actived: 2 days ago

URL: https://dnnm9z9xy.blob.core.windows.net/portals/0/Documents/2021_SG_PPO_Core_2000_Copay_National_SBC.pdf?sv=2017-04-17&sr=b&si=DNNFileManagerPolicy&sig=hPfKFeAtVnmm107OoDBLPMIJjH%2B9WgHGT8SBMReC3ak%3D

HDHP HMO SUMMARY OF BENEFIT CHART

WebPediatic Dental Services Out-of-Pocket Maximum: $350 per child / $700 per family. Total Out-of-Pocket Maximum: $7,500 per individual / $15,000 per family. Benefit. …

Category:  Health Go Health

Claims Submission and Reimbursement

WebClaims Submission and Reimbursement Effective 1/1/2021 | Rev. 11/1/2023 | Health New England 2 CLAIMS SUBMISSION Claims Procedure HNE accepts the …

Category:  Health Go Health

HMO Silver A II Connector

WebHMO Benefit Chart. This chart provides a summary of key services offered by your plan. Consult your Member Agreement for a full description of your plan’s benefits …

Category:  Health Go Health

Coordination of Benefits and Subrogation

WebCoordination of Benefits and Subrogation Effective 1/1/2021 | Rev. 11/1/2023 | Health New England 4 HNE guidelines should always be followed by a member even if …

Category:  Health Go Health

HNE Products and Benefits

WebHNE Products and Benefits Effective 1/1/2021 | Rev. 1/1/2021 | Health New England 4 Massachusetts Health Connector Plans HNE also offers health benefit plans …

Category:  Health Go Health

UTILIZATION MANAGEMENT

WebUTILIZATION MANAGEMENT Effective 1/1/2021 | Rev. 9/1/2021 | Health New England 4 Inquiring about the Status of a UM Decision Practitioners have direct …

Category:  Health Go Health

Web Portal powered by WebMD ONE Healthy Directions

WebHealthy Directions Portal. EXPERT HELP AND GOAL SETTING. A one-stop wellness shop for Health New England members, the Health New England Healthy …

Category:  Health Go Health

HMO Thrive Gold 2000 SG

WebHMO Thrive Gold 2000 SG (VR) - 1/1/21 Page 3 of 4 . Benefit Your Cost Infertility Services Some Infertility services are covered only for Massachusetts and …

Category:  Health Go Health

HNEDirect Provider Online Services

WebHNEDirect Provider Online Services Effective 1/1/2021 | Rev. 1/1/2021 | Health New England 2 HNE Providers can now view up-to-date information online …

Category:  Health Go Health

Pharmacy Services

WebPharmacy Services Effective 1/1/2021 | Rev. 1/1/2021 | Health New England 5 Step Therapy Program Step Therapy is an approach to medication management and is …

Category:  Health Go Health

Provider Appeal Guidelines

WebProvider Appeal Guidelines Effective 1/1/2021 | Rev. 11/1/2023 | Health New England 3 Appeals after Submission to an Alternate Payer HNE may grant an exception …

Category:  Health Go Health

Behavioral Health

WebBehavioral Health Effective 1/1/2021 | Rev. 1/1/2021 | Health New England 2 This section applies to Commercial and Medicare Advantage members only. HNE has …

Category:  Health Go Health

HMO Thrive Bronze Connector

WebAs indicated in the chart below, some services are not subject to the Deductible. $3,500 per individual / $7,000 per family. Out-of-Pocket Maximum: The most …

Category:  Health Go Health

HMO ConnectorCare 3

WebThis Out-of-Pocket Maximum does not include your cost sharing for pharmacy benefits. $1,500 per individual / $3,000 per family. Pharmacy Out-of-Pocket …

Category:  Health Go Health

Professional Credentialing & Recredentialing

WebUse the links below for assistance in getting started with the credentialing process or for more information if you are recredentialing. You also may contact the HNE …

Category:  Health Go Health

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Category:  Health Go Health

PPO Essential 500 National LG

WebPPO Essential 500 National LG (I6) – 1/1/24 Page 2 of 7 Benefit Your Cost In-Plan Providers Your Cost Out-of-Plan Providers Inpatient Care

Category:  Health Go Health

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