Please note there are plan changes for 2026-2027 for Bay Path and former Cambridge College students.

For complete details, please refer to the plan documents. Below is a summary of the in-network benefits. The plan also includes out-of-network coverage, which is subject to higher member cost-sharing.

In-Network Benefit Summary

• Annual Deductible: $500
• Primary Care Physician (PCP) Office Visit: $25 copay, no deductible
• Mental Health Therapy Visit: $25 copay, no deductible
• Specialist Office Visit: $50 copay, no deductible
• Urgent Care Visit: $50 copay, no deductible
• Emergency Room: $250 copay, no deductible
• Diagnostic Lab, X-ray, Imaging: deductible, 25% member coinsurance
• Day Surgery: deductible + $250 copay per visit
• Inpatient Hospitalization: deductible, 25% member coinsurance

Prescription Drugs (30 day retail supply)

• Tier 1 - $15 copay
• Tier 2 – 20% member coinsurance, no deductible
• Tier 3 – 20% member coinsurance, no deductible
• Tier 4 – 20% member coinsurance, no deductible
• Tier 5 – 20% member coinsurance, no deductible

Important: Members who take high-cost specialty medications may experience higher out-of-pocket expenses under this plan and may wish to consider an alternative plan option.

I have read and acknowledge the above statement and would like to enroll

Prescription Drug Search

Your plan uses the Blue Cross Blue Shield of Massachusetts Formulary — Focused

The Focused Formulary does not cover GLP-1 medications approved for weight loss, including but not limited to Saxenda, liraglutide, Wegovy, and Zepbound.

GLP-1 medications that are FDA-approved to treat diabetes will continue to be covered.

To search for medications, click HERE.

Step 1: Select the Blue Cross Blue Shield of Massachusetts Formulary.

Step 2: Search for your medication by name and select the 3-Tier Plan.