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Non-Medicare Eligible Retiree Health Plans
The Town of Wellesley offers two different health plan designs to Non-Medicare Eligible retirees. Information on the plan designs offered is below. To help assist in the process of picking the plan that is right for you, please consider reviewing one or both of the following documents.
Fallon will no longer be offered after 6/30/2022. If you are a non-Medicare eligible retiree who is currently on a Fallon plan, click HERE to see the contents of a recent mailing that was sent to you and what you need to do for open enrollment.
If you are a non-Medicare eligible retiree that does not have a Fallon plan, no action is required to keep your current health plan for 7/1/2022. Click HERE to see the recent mailing sent to non-Medicare eligible retirees who are not on a Fallon plan.
| Choosing a Health Plan - this document will walk you through some of the basic considerations when choosing a health plan. | What is a deductible? - starting on July 1, 2018, health plans offered by the Town of Wellesley will be deductible plans. This document explains what they are and how they work. |
Blue Cross Blue Shield (BCBS) - www.home.bluecrossma.com
Network coverage area includes MA, RI, CT, NH, ME & VT
For questions about BCBS coverage/participating doctors, retirees may call the dedicated Account Education Line any Tuesday night during the month of May between 5-7pm at 1-888-258-7908
| BCBS Benchmark Plan (HRA eligible) Group Number 00-4053588 | BCBS High Deductible Health Plan (HSA eligible) Group Number 00-4062729 |
|---|---|
| BCBS Benchmark Plan Summary | BCBS High Deductible Plan Summary |
| CanRx Program | BCBS Preventative Drug List - medications at co-pay level (deductible does not apply) |
| $9 Generic Drug List | |
| Blue Cross Prescription Formulary | Blue Cross Prescription Formulary |
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program |
| CanRx Program | |
| Find a Doctor* Tool Requires Dr. name, zip code and network Plan Name = Network Blue New England Deductible HMO Network = Network Blue New England with Hospital Choice Cost Share Feature Customer Service #: 800-262-2583 | Find a Doctor* Tool requires Dr. name, zip code and network Plan Name = Access Blue New England Saver Network = HMO Blue New England Customer Service #: 800-262-2583 |
*When searching the BCBS website for a doctor, be sure to use all the credentials listed above for the specific plan you are interested in. If your doctor does not appear in the online search tool, please call the customer service number listed above, give the group number of the BCBS option you are interested in and ask the representative to assist you in your doctor search.
Harvard Pilgrim Health Care (HPHC HMO) - www.harvardpilgrim.org
Network coverage area includes MA, RI, CT, NH, ME & VT
| HPHC Benchmark Plan (HRA eligible) Group Number 028848-0030 | HPHC High Deductible Health Plan (HSA eligible) Group Number 018992-0018 |
|---|---|
| HPHC Benchmark Plan Summary | HPHC High Deductible Plan Summary |
| CanRx Program | CanRx Program |
| Good Health Gateway Diabetes Program | HPHC Preventative Drug List - medications at co-pay level (deductible does not apply) |
| HPHC Hospital Tier Listing | Good Health Gateway Diabetes Program |
| Find a Doctor Plan Type = HMO Plan Category = Tiered/Limited Plans Tiered/Limited Plans = ChoiceNet HMO-2022 | Find a Doctor Plan Type = HMO Plan Category = Standard Plans Standard Plans = HMO or HMO Open Access |
Tufts Health Plan - www.tuftshealthplan.com
Network coverage area includes MA, RI, NH, and extended service areas in Southern ME, Eastern VT and just over the CT border
| Tufts Benchmark Plan (HRA eligible) Group Number 45843-130 | Tufts High Deductible Health Plan (HSA eligible) Group Number 57527-130 |
|---|---|
| Tufts Benchmark Plan Summary | Tufts HDHP Plan Summary |
| CanRx Program | Tufts Health Plan Preventative Drug List - medications at co-pay level (deductible does not apply) |
| Tufts Prescription Formulary | Tufts Prescription Formulary |
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program |
| CanRx Program | |
| Find a Doctor - Tufts Benchmark Plan | Find a Doctor - Tufts HDHP |
Harvard Pilgrim PPO (HPHC PPO) - www.harvardpilgrim.org
| HPHC PPO Enrollment Form | HPHC PPO Plan Summary |