Not sure which plan you're in? Your plan name can be found on the front of your member ID card, under the ID number.
Pay particular attention to how your benefits differ between contracted and non‑contracted behavioral health providers and medical providers outside of Massachusetts. Using contracted providers protects you from some very costly surprise bills.
Preferred vendors are any contracted vendor with UniCare. To find a preferred/contracted vendor, please visit Find Care. You can access Find Care by logging into the member portal or visiting as a guest directly from UniCare’s home page. Once you are in the Find Care app, you can search for the type of vendor/provider you need, such as “durable medical equipment”.
Specialized Health Facilities
UniCare contracts with various types of health facilities in Massachusetts that agree to provide services to plan members at negotiated rates. These facilities include:
Find primary and specialty care medical providers and discover which tier your Massachusetts specialist is designated as. When you or your dependents use the non-Massachusetts contracted providers shown in the Find Care tool, you won't be balance billed.
Our Find Care tool is for non-Medicare members only. Medicare members should use Medicare participating providers to receive the highest benefit.
Quality Centers and Designated Hospitals for Transplants
If you or a family member need a transplant, you will save on out-of-pocket costs when you use certain hospitals. Contact UniCare Member Services for more information.
- Use Carelon Behavioral Health contracted providers. For the highest benefits coverage, use contracted behavioral health providers in the Carelon Behavioral Health Provider Directory. When you use Carelon Behavioral Health contracted providers, you'll avoid higher copays as well as balance billing with non-Massachusetts providers.
- Community Choice members, be sure to check that the specialist you'd like to see will refer you to a Community Choice hospital for services if needed. You'll have lower copays and 100% coverage after the deductible when you use Community Choice hospitals.
- PLUS members living in Massachusetts, be sure to check that the specialist you'd like to see will refer you to a Tier 1 or Tier 2 hospital for services if needed. You'll have lower copays at these hospitals than at a Tier 3 hospital.
- Orthopedic Hip and Knee Replacement Surgeries. New England Baptist Hospital (NEBH) is designated as a Center of Excellence for UniCare’s commercial plans. Our members who utilize NEBH for orthopedic hip and knee replacement surgeries will have the surgical facility copay (deductible and coinsurance if applicable) waived. The deductible will apply to the professional charges such as the surgeon and anesthesiologist.
As a PLUS or Community Choice member, you pay a lower copay for primary care when you see providers in Massachusetts.
- PLUS Members – Check our Acute Care Medical Hospitals in Massachusetts list to find the tier assignment of a Massachusetts acute care hospital. You pay lower copays when you use a Tier 1 or Tier 2 hospital.
- Community Choice Members – Review our Acute Care Medical Hospitals in Massachusetts list to see which hospitals you can use at the lower copays and 100% coverage, as a Community Choice plan member.