aboutus secondary header

About Us

Top 5 Medicaid Plan

Boston Medical Center HealthNet Plan, one of America's top five Medicaid plans, according to the National Committee for Quality Assurance (NCQA) Medicaid Health Insurance Plan Rankings 2014–2015.

BMC HealthNet Plan and Well Sense Health Plan are 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 nearly 280,000 members across three product lines: MassHealth (Medicaid), Commonwealth Care, and commercial (Commonwealth Choice). We are the largest Medicaid health plan in Massachusetts.

In 2012, Well Sense Health Plan was selected by the New Hampshire Department of Health and Human Services to be one of three health coverage providers – and the only non-profit – to offer managed care coverage for the first time to that state’s Medicaid recipients. We are proud to have received the highest technical score during the bidding process. To learn more about our company, expand the links below.

+ Local presence

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 offices in Boston (corporate), New Bedford and Springfield. 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 to offer education about health and wellness topics, as well as health insurance coverage options.

+ Recognized for quality

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 MassHealth plan is ranked in the top 5 nationally among Medicaid plans from the National Committee for Quality Assurance (NCQA) in its Medicaid Health Insurance Plan Rankings 2013–2014. In addition, BMC HealthNet Plan has maintained Excellent Accreditation from NCQA for its Massachusetts Medicaid plan since its initial accreditation in 2009. We bring this same quality commitment to Well Sense Health Plan, which is not yet eligible for NCQA accreditation.

Successful care management programs have led BMC HealthNet Plan (our Massachusetts Medicaid health plan) to be in the top 10% of all Medicaid HMO plans* in these HEDIS performance measures:

  • Breast, cervical and chlamydia screening rates
  • Lead screening rates in children
  • Appropriate testing for children with pharyngitis
  • Follow-up after hospitalization for mental illness
  • Timeliness of prenatal care
  • Well care visits <15 months for children and adolescents
  • Child access (ages 2-19) to primary care
*Based on data submitted by over 130 Medicaid HMO plans to the National Committee for Quality Assurance (NCQA) and published in the NCQA HEDIS 2012 Quality Compass.

+ Extensive network of healthcare providers

To serve our MassHealth and Commonwealth Care members, BMC HealthNet Plan contracts with nearly 60 hospitals, 15,000 health care providers, and 1,000 pharmacies throughout most of Massachusetts. For our commercial (Commonwealth Choice) plan, we currently offer a network of selected healthcare providers in eastern Massachusetts.