Benefit Documents

Use the tabs below to find your plan's benefit documents.

The documents below are effective on January 1, 2019.

Select the correct Plan Type for your list of covered services and benefits. 

Plan Name

Member Handbook 

List of Covered Services and Benefits by Plan Type

BMC HealthNet Plan Community Alliance Member Handbook MassHealth Standard
MassHealth CarePlus
MassHealth Family Assistance
BMC HealthNet Plan Mercy Alliance
Member Handbook
MassHealth Standard
MassHealth CarePlus
MassHealth Family Assistance
BMC HealthNet Plan Signature Alliance
Member Handbook
MassHealth Standard
MassHealth CarePlus
MassHealth Family Assistance
BMC HealthNet Plan Southcoast Alliance Member Handbook
MassHealth Standard
MassHealth CarePlus
MassHealth Family Assistance
BMC HealthNet Plan MassHealth MCO Member Handbook
MassHealth Standard (including Special Kids Special Care)
MassHealth CarePlus
MassHealth Family Assistance

The documents below are effective on January 1, 2019.

Type Title Plan Type
2019 Evidence of Coverage for ConnectorCare & Qualified Health Plans
Individual
2019 Schedule of Benefits - ConnectorCare I
Individual
2019 Schedule of Benefits - ConnectorCare II
Individual
2019 Schedule of Benefits - ConnectorCare III
Individual
2019 Schedule of Benefits - Bronze
Individual
2019 Schedule of Benefits - Gold
Individual
2019 Schedule of Benefits - Low Gold
Individual
2019 Schedule of Benefits - Platinum
Individual
2019 Schedule of Benefits - Silver A
Individual
2019 Schedule of Benefits - Silver A II
Individual
2019 Schedule of Benefits - Silver B
Individual
2019 Schedule of Benefits - Zero and Limited Cost Share - SELECT
Individual
2019 Schedule of Benefits - Zero and Limited Cost Share - SILVER
Individual
2019 Evidence of Coverage for Employer Choice Direct
Small Business
2019 Schedule of Benefits - Bronze
Small Business
2019 Schedule of Benefits - Gold
Small Business
2019 Schedule of Benefits - Low Gold
Small Business
2019 Schedule of Benefits - Low Silver
Small Business
2019 Schedule of Benefits - Platinum
Small Business
2019 Schedule of Benefits - Silver A
Small Business
2019 Schedule of Benefits - Silver B
Small Business
List-of-Preventive-Care-Services_QHP and ConnectorCare
All
2019 Summary of Benefits and Coverage - Silver B
All
2019 Summary of Benefits and Coverage - ConnectorCare I
All
2019 Summary of Benefits and Coverage - Limited Cost Share
All
2019 Summary of Benefits and Coverage -ConnectorCare II
All
2019 Summary of Benefits and Coverage - ConnectorCare III
All
2019 Summary of Benefits and Coverage - Bronze
All
2019 Summary of Benefits and Coverage - Gold
All
2019 Summary of Benefits and Coverage - Low Gold
All
2019 Summary of Benefits and Coverage - Low Silver
All
2019 Summary of Benefits and Coverage - Platinum
All
2019 Summary of Benefits and Coverage - Silver A
All
2019 Summary of Benefits and Coverage - Silver A II
All
To request a printed copy of the Member Handbook, please contact Member Services.

Some procedures or services require prior authorization, or prior approval, from us. You or your doctor may confirm if the service requires a prior authorization by checking our Medical Procedure Code Lookup Tool or our Supplies and Services Code Lookup Tool.

We're always working to improve the quality of our services for members. If you're interested in learning more, you can read our Quality Improvement Work Plan Evaluation.

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