Silver Medical Plan

Effective Date: 8/1/2023 – 7/31/2024

Your Health Plan

Your health benefit plan consists of a fully insured plan, written by Blue Cross Blue Shield of Massachusetts (BCBS).  Your BCBS plan is a PPO (Preferred Provider Organization).

You are covered for services rendered by In-Network and Out-of-Network health care providers.

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Your Benefits

Please review Medical Plans Summary.

Your plan Summary of Benefits and Coverage is also available by clicking here. This is a regulatory document that helps to compare plans, however the Summary of Benefits above best describes your plan and how it works.

For more information about your base plan with Blue Cross Blue Shield, including useful BCBS links and information about additional benefits and discounts, please review your BCBS e-kit here.

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Prescription Drugs

After your deductible has been met, BCBS covers 100% of approved In-Network prescription drugs at participating retail or mail order pharmacies, subject to the following copays, for which you are responsible:

• Tier 1 drugs: $10 retail (up to a 30-day supply), $20 mail order (up to a 90-day supply)
• Tier 2 drugs: $25 retail (up to a 30-day supply), $50 mail order (up to a 90-day supply)
• Tier 3 drugs: $45 retail (up to a 30 day supply), $135 mail order (up to a 90-day supply)

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Selecting a Health Care Provider

You may use any in-network doctor or hospital of your choice, anywhere, anytime. Look up an In-Network Provider.

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AHealthyME Rewards

With Ahealthyme Rewards, you get the tools, guidance, and motivation for a happier, healthier you. As you work toward your personal health and wellness goals, compete with friends, family, and coworkers, and reach new milestones, you can earn points to redeem up to $400 annually.

Click here, to learn more about Ahealthyme Rewards program.

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Partners Healthcare Online Second Opinions

As a Benemax member, you are entitled to a second opinion consultation from a Harvard Medical School faculty member through Partners Healthcare Online Specialty Consultations. To take advantage of the program visit our Benemax Wellness® site. Once you and your doctor have submitted all necessary information to Partners, you should expect to receive a second opinion in about five business days.

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Benemax Wellness®

As a Benemax member, you have access to everything Benemax Wellness® has to offer to get fit, stay healthy and use health care wisely. Check your symptoms, find the right physician or hospital, learn about Complementary Alternative Medicine, obtain a second opinion, keep a personal fitness journal, learn how to make informed healthcare decisions and much more. Whatever you health mission may be, Benemax Wellness® can help you accomplish it.

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Please refer to your policy or plan document for more specific information about your coverage, or contact a Benemax Independent Member Advocate at 800-528-1530, prompt 3 or at benemax.service@onedigital.com.