Medicare Advantage details for providers

Mass General Brigham Health Plan offers a Medicare Prescription Payment Plan to all members. The Medicare Prescription Payment Plan is a voluntary payment option that works with a member’s current Medicare Part D prescription drug coverage, and it helps members manage their out-of-pocket drug costs by spreading them across monthly payments that may vary throughout the plan year (January – December). This payment option may help members manage their expenses, but it doesn’t save money or lower their drug costs.

If a member selects this payment option, each month they’ll continue to pay their plan premium (if they have one), and they’ll get a bill to pay for their prescription drugs (instead of paying the pharmacy). There’s no cost to for members to participate in the Medicare Prescription Payment Plan and participation is voluntary. Members must voluntarily opt into the Medicare Prescription Payment Plan to participate. To maximize this payment option, members should opt-in to this payment option prior to filling their prescriptions.

For more information about the program, please see the following resources:

Mass General Brigham Health Plan MPPP page

Medicare.gov fact sheet

Medicare.gov MPPP site

Mass General Brigham Medicare Advantage will:

• Deliver a better patient experience through rich benefit offerings and integrated care delivery
• Deploy a value-based care model that will foster population health innovation
• Contribute to a sustainable source of revenue and investment for primary care

Yes, our Medicare Advantage members can call 855-833-3668 for Customer Service. Our hours are:

October 1 – March 31, 8 AM-8 PM ET, Mon-Sun  
April 1 – September 30, 8 AM-8 PM ET, Mon-Fri

Providers can continue to utilize the existing Provider Services line by calling 855-444-4647.

• Mass General Brigham Advantage (PPO) 
• Mass General Brigham Advantage Secure (HMO/POS) 
• Mass General Brigham Advantage Premier (PPO) 

Mass General Brigham Health Plan offers a Medicare Prescription Payment Plan to all members. The Medicare Prescription Payment Plan is a voluntary payment option that works with a member’s current Medicare Part D prescription drug coverage, and it helps members manage their out-of-pocket drug costs by spreading them across monthly payments that may vary throughout the plan year (January – December). This payment option may help members manage their expenses, but it doesn’t save money or lower their drug costs.

If a member selects this payment option, each month they’ll continue to pay their plan premium (if they have one), and they’ll get a bill to pay for their prescription drugs (instead of paying the pharmacy). There’s no cost to for members to participate in the Medicare Prescription Payment Plan and participation is voluntary. Members must voluntarily opt into the Medicare Prescription Payment Plan to participate. To maximize this payment option, members should opt-in to this payment option prior to filling their prescriptions.

For more information about the program, please see the following resources:

Mass General Brigham Health Plan MPPP page

Medicare.gov fact sheet

Medicare.gov MPPP site

 

 

You can confirm your participation by utilizing our online provider directory or by calling 855-444-4647.

You can also visit the Medicare Advantage Provider Directory.

Authorizations will be required where applicable. 

You can view the Medicare Advantage prior authorization and notification guidelines here: Medicare Advantage Prior Authorization and Notification Guidelines.

There is no change for paper claim submission. Providers should refer to the following claims landing page: MassGeneralBrighamHealthPlan.org/Providers/Claims