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    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.

    Get help renewing your coverage


    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

    Learn about our health quality and equity strategic plan

    What is an Accountable Care Organization (ACO)?

    ACO is short for Accountable Care Organization. An ACO is a team of doctors and other providers. Your primary care provider (PCP) is a part of this team. The team shares your health information to make sure they are meeting your care needs. This also helps avoid unnecessary duplication of services and saves time on paperwork.
     
    ACOs work with insurance companies to provide great healthcare. Together they set rules for the quality and cost of care. The goal of the ACO is to provide care that is high quality and low cost.

    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

    • 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.

      Click here to get started.

    • 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.

    Where to go for care

    Stethoscope

    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

     

    Hospital

    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. 

     

    Heart Health

    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.

     

    Wellness

    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.

    Portrait of a happy female student using laptop computer in university

    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.

    More information about your plan

    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.

    Have questions or need help?

    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.