Plan Information

Boston Medical Center BMC HealthNet Plan logo
Customer Service
800-792-4355
Members: 855-833-8120
711 (TTY)

Boston Medical Center HealthNet Plan

BMC HealthNet Plan is a non-profit managed care organizations committed to providing the highest quality healthcare coverage to underserved populations. In Massachusetts, BMC HealthNet Plan is the business name for Boston Medical Center Health Plan, Inc.; outside Massachusetts, Well Sense Health Plan is the business name.

BMC HealthNet Plan serves Massachusetts residents across four product lines: MassHealth (Medicaid), ConnectorCare, Qualified Health Plans, and Senior Care Options. We are the largest Medicaid health plan and the lowest cost Qualified Health Plan in 6 out of 7 regions* in Massachusetts.

We are committed to the communities we serve and we want to focus on the unique health needs and resources particular to those communities. That’s why BMC HealthNet Plan has its corporate office in Boston and teleworkers located throughout the state. In New Hampshire, Well Sense Health Plan’s office and staff are located in Manchester.

Key to forming relationships with the populations we serve is our Community Outreach team. Each team member partners with local organizations and healthcare providers across the state to offer education about health and wellness topics, as well as health insurance coverage options. We work to connect members with resources they need for better health; whether that’s food, diapers, or healthcare resources. See how we’re helping in the community.

Quality is first and foremost to us as we strive to make a meaningful impact on the lives and communities we serve. BMC HealthNet Plan’s Medicaid plan has achieved Excellent Accreditation from the National Committee for Quality Assurance (NCQA) and is rated 4.5 out of 5 in NCQA’s Medicaid Health Insurance Plan Ratings 2016-2017. Our Qualified Health Plan maintains Accredited status from NCQA, which is currently the highest status available for Qualified Health Plans.

To serve our members, BMC HealthNet Plan contracts with hospitals, health care providers, and pharmacies throughout most of Massachusetts.

*We’re lowest cost in the Boston, Cape Cod, Central, Northeast, Western, and Southeast regions.

From “About Us”

2017 Plan Information

NCQA Rating

Overall
3 out of 4 stars
This is the health insurer’s accreditation score from NCQA. NCQA evaluates the insurer’s quality measures and ongoing improvement.
Access and Service
3 out of 4 stars
NCQA evaluates how well the insurer provides access to needed care and with good customer service. To evaluate these activities, NCQA reviews the insurer’s appeals and denials, interviews the insurer’s staff and grades the results from consumer surveys.
Qualified Providers
3 out of 4 stars
NCQA evaluates the insurer’s efforts to confirm that each doctor is licensed and trained to practice medicine and that the health plan’s members are happy with their doctors. To evaluate these activities, NCQA uses records of doctors’ credentials, interviews the insurer’s staff, and grades the results from consumer surveys.
Staying Healthy
3 out of 4 stars
NCQA evaluates the insurer’s activities that help people maintain good health and avoid illness. To evaluate these activities, NCQA reviews the insurer’s records, grades independently verified clinical data and reviews materials sent to members.
Getting Better
3 out of 4 stars
NCQA evaluates health plan activities that help people recover from illness. To evaluate these activities, NCQA reviews the insurer’s records and interviews the insurer’s staff.
Living with Illness
3 out of 4 stars
NCQA evaluates health plan activities that help people manage chronic illness. NCQA grades independently verified clinical data and interviews the insurer’s staff.

About these ratings:
NCQA LogoThe National Committee for Quality Assurance (NCQA) is a private non-profit dedicated to improving health care quality. NCQA accredits and certifies health care organizations and recognizes physicians in key clinical areas. Visit www.ncqa.org to learn more.

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