Finding a Preferred Provider
A preferred or "in-network" provider is a doctor, hospital, or other health care provider that participates in the Blue Cross Blue Shield (BCBS) Blue Care Elect Enhanced Value (PPO) Network. The advantage to using a preferred provider is that you generally receive full coverage for most services from hospitals, physicians, and other providers in the Preferred Provider PPO Network, although for some outpatient services, you may pay a $20 copayment for each visit. You pay a $150 copayment per visit for in-network or out-of-network emergency room services.
To locate participating providers in the BCBS Blue Care Elect Enhanced Value (PPO) Network in Massachusetts or anywhere in the United States, go to gallagherstudent.com/Berklee and select "Find a Doctor" in the menu on the left. You may also visit BCBS National Doctor and Hospital Finder to locate healthcare providers within the U.S., Puerto Rico, and the U.S. Virgin Islands, or to find a doctor or hospital worldwide.
You can also obtain services from non-preferred providers, but your out-of-pocket costs will be higher. You receive the highest level of benefits and save money by staying in-network and seeing providers who participate in the BCBS Blue Care Elect Enhanced Value (PPO) Network. Most providers in the Boston area are preferred providers.
Note: If a preferred provider refers you to another provider for covered services (such as a lab or specialist), make sure the referred provider participates in the BCBS Blue Care Elect Enhanced Value (PPO) Network in order to receive benefits at the in-network level. If the provider you use is not a preferred provider, you're still covered, but your benefits, in most situations, will be covered at the out-of-network level, even if you were referred by a network provider.
Berklee maintains a relationship with Harvard Vanguard Medical Associates in Kenmore Square, which provides tailored health care services for our students. You will not have to pay on the spot when you visit Harvard Vanguard for primary care, including urgent/walk-in, internal medicine, and obstetrics/gynecology.
You get this benefit just by being a Berklee student. It does not matter what kind of insurance you have, but you will need to show your student ID card when you visit. To learn more, read Health Care Near Campus.