Finding a Preferred Provider
A preferred provider or "in-network" provider is a doctor, hospital, or other health care provider that participates in the Blue Cross Blue Shield 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 Blue Cross Blue Shield (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. Or visit Blue National Doctor and Hospital Finder to locate healthcare providers within the U.S., Puerto Rico, and 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 and you must pay a policy-year deductible of $250 per person for most services received from an out-of-network provider.
You can go to any provider; however, 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.
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.
For students who are new to the Boston area or who do not have an existing relationship with a doctor, there are a number of group practices in the Back Bay - Fenway - Downtown area that are close by and easy to get to. Here are three that are preferred providers in the BCBS Blue Care Elect Enhanced Value (PPO) Network:
Massachusetts General Hospital (MGH) - Back Bay
388 Commonwealth Avenue, Boston, MA 02215
Phone: 617 267-7171
Conveniently located on Commonwealth Avenue, MGH Back Bay offers primary care services by appointment. A nurse is also available by telephone or email (Patient Gateway) to answer specific health questions.
Hours of Operation
Monday through Friday, 8:30 a.m. – 5:00 p.m. by appointment
Harvard Vanguard Medical Associates
133 Brookline Avenue, Boston, MA 02215
Phone: 617 421-1000
A multi-specialty group practice offering a wide range of medical and surgical specialties. Conveniently located in Kenmore Square, Harvard Vanguard also offers urgent care hours for sudden illnesses "after hours" and during evenings and weekends.
Hours of Operation
Monday through Friday, 8:00 a.m. to 5:00 p.m.
Urgent care hours: Monday through Friday, 8:00 a.m. to 8:00 p.m.; Saturday, 10:00 a.m.–5:00 p.m. and Sunday, 12:00 p.m.–5:00 p.m. Holiday: varied hours
Massachusetts General Hospital - Medical Walk-In Unit
Wang Ambulatory Care Center, Suite 108
15 Parkman Street, Boston, MA 02114
Phone: 617 726-2707
An alternative to the emergency room, the Medical Walk-In Unit provides urgent care for adults (18 years and over). Patients are seen on a first-come, first-served basis, with extremely urgent cases receiving priority attention.
Hours of Operation
The Medical Walk-In Unit is open every day except for Thanksgiving and Christmas:
Monday through Friday, 8:30 a.m. to 8:00 p.m.
Weekends and holidays, 9:30 a.m. to 4:00 p.m.