We’re here for you
Mass General Brigham Health Plan is proud to provide MassHealth insurance coverage to members of Mass General Brigham ACO.
Important information about changes to the network
Starting on July 1, 2024, Tufts Medicine specialists will no longer be part of our network for MassHealth members. This changes only applies to members who recieve specialty care at a Tufts Medicine facility. Access to primary care will not be affected. We will reach out to you with additional information if you have received ongoing care from a Tufts Medicine specialist or at a Tufts Medicine facility.
Tufts Medicine includes Tufts Medical Center, Lowell General Hospital, Melrose Wakefield Hospital, Lowell PHO, New England Quality Care Alliance (NEQCA), Tufts Medicine Home Infusion Services, and Circle Health Urgent Care.
What you need to know about MassHealth eligibility redeterminations
MassHealth needs to renew coverage for all members to make sure they are still eligible and receive the best benefit they qualify for. If you or the head of your household recently received a notice from MassHealth saying that you need to renew your coverage, you must respond by the due date on your renewal notice.
You should also report any changes to your mailing address if you have recently moved. Learn how to report these changes here.
Mass General Brigham ACO
Mass General Brigham ACO is a health plan for MassHealth members. This ACO offers the same benefits as MassHealth (the Massachusetts Medicaid program).
Our goal is to help you see the doctors you need to improve your health. A Mass General Brigham primary care provider will look after your care. You'll also have access to other benefits, support programs, and services
What is an Accountable Care Organization (ACO)?
Coverage for all MassHealth benefits
Doctor/specialist visits and urgent or emergency services
Mental health and substance use benefits
Prescription drugs and money-saving pharmacy benefits
Routine eye exams, as well as other benefits and discounts
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Your mental health and substance use benefits
Mental health and substance use services offered in partnership with Optum
Your benefits include counseling and treatment for:
- Substance use disorders
- Depression and postpartum depression
- Eating disorders
- Suicidal thoughts
- ADHD
- Many other mental health issues
You do not need a referral from your PCP to seek outpatient services. To contact Optum, call 800-462-5449 (TTY 711).
Access online resources and virtual care visits
Optum’s Live and Work Well website is the best place to go for behavioral health information. With liveandworkwell.com, you’ll have access to:
- Resources on topics like mental health, caregiving and parenting, and more.
- Virtual visits with a therapist who can test and treat many mental health conditions.
- Information specific to your account, including your claims information.
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Maternal health benefits and resources
MassHealth members can receive free doula services during pregnancy, birth, and after.
Doula services covered by MassHealth include:
- Support during labor and delivery or birth.
- Up to 8 total hours of visits during pregnancy and during the 12 months after the end of pregnancy. Work with your doula to decide when to have your visits.
- If you need more than 8 total hours of visits during this time, speak with your doula about MassHealth's prior authorization process, which determines if you can get coverage for more visits.
Learn more about the program and find a MassHealth doula provider at mass.gov/masshealthdoulas. You can also contact the MassHealth Customer Service Center for more information at (800) 841-2900, TDD/TTY 711.
Primary care
When you're sick or need routine care, your primary care provider (PCP) can help. To find your PCP's office or choose a new PCP, please use our provider search tool.
If you need help finding a new PCP, you can contact Customer Service or a Care Manager.
Phone: 1-800-462-5449 (TTY 711)
Email: HealthPlanCustomerService-Members@mgb.org
Urgent care
If you aren't able to see your PCP, you can go to an urgent care center for non-emergency care. You can go to any urgent care center near you. This includes urgent care outside the Mass General Brigham ACO network.
Specialty care
Your PCP will help connect you with specialists in the Mass General Brigham ACO network. You can also search for specialists using our provider search tool.
Mental health care
Do you need mental health or substance use support? Contact Optum using the number on the back of your member ID card. You can also learn more about your behavioral health benefits in the section above or find a provider using our provider search tool.
Public resources for health-related social needs
You can find helpful resources related to housing, food, transportation, utilities and education assistance on Mass.gov. For additional help in these areas, call customer service at 1-800-462-5449 (TTY 711) and ask to speak with a health coach. You can also email a health coach directly at HealthPlanHealthandWellness@mgb.org.
Fill out your Health Profile
This survey is quick and private. We use your answers to help you be healthy. Log in to your member portal or call 1-800-462-5449 and follow the prompts to the Health Profile.
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Resources and forms
Review your plan documents
Member guide: English | Español
Member handbook: English | Español
List of covered services: English | EspañolHelpful forms
Authorize a Personal Representative: English | Español
Fitness Reimbursement: English | Español
Appeal and Grievance Designation of Authorized Representative Form: EnglishFind a provider or covered medication
Find a Mass General Brigham ACO health care provider
Look up a covered medication on the MassHealth Drug List -
Find your plan details
Log in to our secure Member Portal to see everything you need to manage your plan any time of day. Not a member yet? It’s easy to register.
There you can:- Learn about your benefits and coverage
- Select or change your primary care provider
- Manage your pharmacy benefits
- Order or print an ID card
- Submit eligible expenses (like fitness reimbursement)
- Fill out your Health Profile
- Learn about perks that come with your plan — like a fitness benefit, discounts on child safety products, and more!
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Connect your health data to third-party apps
If you would like to connect your health data to a selection of third-party mobile apps, you can do so by creating an account on our secure app connection platform.
Learn how to create your account and connect your health data. -
Language assistance cards
Let your provider know your preferred language. Print a card and bring it with you to your next visit.
Waiting for your new member ID card to arrive?
If you're a new or soon-to-be member and haven’t received your member ID card in the mail, you can fill out the form at this link to access a digital ID card. You can then show providers your card on your phone or download a printable copy.
For questions about Mass General Brigham ACO
Contact Customer Service at Mass General Brigham Health Plan.
Phone: 1-800-462-5449 (TTY 711)
Hours: Monday through Friday, 8:00 AM to 6:00 PM and Thursdays 8:00 AM to 8:00 PM
Email: HealthPlanCustomerService-Members@mgb.org
Address:
Mass General Brigham Health Plan
399 Revolution Drive, Suite 810
Somerville, MA 02145
For questions about MassHealth benefits
Contact Customer Service at MassHealth.
Phone: 1-800-841-2900 (TTY users should call 1-800-497-4648)
Hours: Monday through Friday, 8:00 AM – 5:00 PM.
Website: mass.gov/MassHealth
To file an appeal or grievance with Mass General Brigham Health Plan
Phone: 1-800-462-5449 (TTY 711)
Hours: Monday through Friday, 8:00 AM to 6:00 PM and Thursdays 8:00 AM to 8:00 PM
Mailing address:
ATTN: Appeals and Grievance Department
399 Revolution Drive, Suite 810
Somerville, MA 02145
Do you need a health care advocate? Contact the My Ombudsman program
My Ombudsman will work with you to make sure you receive your benefits and exercise your rights within your health plan.
Phone: 1-855-781-9898 (Toll Free). For TTY users, use MassRelay at 711 to call the number above.
Email: info@myombudsman.org
Website: myombudsman.org
Are you a provider in the Mass General Brigham ACO network?
You can find a provider training video and list of frequently asked questions on our Mass General Brigham ACO for Providers page.