• Support for members who are Compass Medical patients

    Mass General Brigham Health Plan is closely monitoring the closure of Compass Medical practices. We are committed to assessing the impacts to our members, and we will share more information as soon as it becomes available.

    While we wait to learn more from Compass Medical about transition plans to create continued access to their providers, we are supporting members who contact us with information about their benefits, coverage, and options for care.

    Compass Medical is continuing to update their website with more information, including how patients can access medical information and local urgent care resources. Patients are encouraged to check back regularly for the latest updates at www.compassmedical.net.

    Members are encouraged to contact us for assistance at 866-414-5533 or at the number on the back of your member ID card. You can also email us or start a live chat with a Customer Service Professional. We are available Monday through Friday, 8:00 AM to 6:00 PM and 8:00 AM to 8:00 PM on Thursdays.  

New to Mass General Brigham Health Plan?

Visit the online transition center for answers to common questions we hear from new members. There, you can also find and fill out a Transition of Care Form if you need access to ongoing care during your switch to Mass General Brigham Health Plan.

 

Contact the nurse advice line

Call the customer service number on the back of your member ID card to contact a Registered Nurse 24/7 to get nursing advice on any subject. There’s no limit on calls or emails. Contact them as often as you need. Nurses speak English and Spanish, and translation services are available for other languages too. Your call, your health records, and what you discuss with the nurse are all private.

Download a form

Below you'll find links to download our member forms. Note that reimbursement forms can be filled out online at Member.MassGeneralBrighamHealthPlan.org or through the Mass General Brigham Health Plan Member app.

 

  • Bike helmet reimbursement form

    When you buy safety helmets for toddlers, children, and adults, Mass General Brigham Health Plan will reimburse 50% of the purchase price of one new helmet, per member, per calendar year up to a $15.00 reimbursement.


    Bike Helmet Reimbursement Form (PDF)

  • Breastfeeding support form

    Breastfeeding support classes are also available free of charge at many primary care sites and hospitals. These classes are a support group for pregnant women, and they provide information about the benefits of breastfeeding, along with helpful tips, resources, and ways to manage common breastfeeding challenges.

    Speak to the provider caring for you during your pregnancy, or the facility where you plan to deliver, about enrolling. If they do not offer a breastfeeding support program, Mass General Brigham Health Plan will reimburse you for the full cost of these classes. A Breastfeeding Support Form must be submitted to obtain the reimbursement.
    Breastfeeding Support Form (PDF)

  • Childbirth education reimbursement form

    Childbirth education classes, plus parenting and infant CPR classes, are available to you and your partner or support person free of charge at many primary care sites and hospitals.

    Speak to the provider caring for you during your pregnancy or the facility where you plan to deliver about enrolling. If they do not offer a childbirth education program, Mass General Brigham Health Plan will reimburse you for the cost of these classes up to $130 per pregnancy. You can combine multiple classes up to the $130 limit per pregnancy. A Childbirth Education Form must be submitted to obtain the reimbursement.
    Childbirth Education Reimbursement Form (PDF)

  • Continuity of care at cancer and pediatric facilities notification form

    Members newly enrolled through a small employer group who began an active course of treatment for a serious illness prior to enrolling in an Easy Tier Hospital Network plan may be eligible to continue treatment at the lowest member cost sharing tier (Tier 1). Click here to determine if you are eligible.

    If eligible, the Continuity of Care at Cancer and Pediatric Facilities Notification Form (PDF) must be submitted prior to the start of treatment in the tiered network plan.

  • Fitness benefit reimbursement form

    The fastest way to submit a reimbursement request for your fitness benefit is on the member portal, Member.MassGeneralBrighamHealthPlan.org. You can also download the form below and follow the instructions to submit your reimbursement request. The fitness benefit varies by plan. Please check Member.MassGeneralBrighamHealthPlan.org for details about your plan.


    Fitness Benefit Coverage Form and Instructions (PDF)
     

    Qualifying fitness facilities, programs/subscriptions or activities

    The list includes, but is not limited to the following:

    • Abington Athletic Club
    • Anytime Fitness
    • Beachbody On Demand
    • Beverly Athletic Club
    • Boost Fitness
    • Boston Athletic Club
    • Boston Sports Club
    • Bowflex Subscriptions
    • Cambridge Athletic Club
    • Choice Fitness
    • ClassPass memberships 
    • Club eX Fitness & Nutrition
    • Core Yoga Subscriptions
    • Crossfit
    • Curves
    • DDP Yoga Subscriptions
    • Equinox
    • Get in Shape for Women
    • Gold’s
    • GymIt
    • Healthtrax Fitness & Wellness
    • Healthworks Fitness
    • KoKo Fitclub
    • LA Fitness 
    • Latitude Sports Club
    • Mike’s Fitness
    • Mirror Subscriptions
    • Orange Theory
    • Peloton Subscriptions
    • Planet Fitness
    • Pro-Fitness Plus
    • Quincy Athletic Club 
    • Salem Fitness Center
    • Shipley Fitness Center
    • SplitFit
    • The Clubs at Charles River Park
    • Title Boxing Club 
    • Today’s Fitness
    • VIP Fitness 
    • Weymouth Club
    • Women’s Fitness of Boston
    • Work Out World
    • Worlds Gym
    • YMCA

    Please note: Aerobic exercise studios (Pilates, yoga, Zumba, etc.) and virtual fitness subscriptions* are also included in this benefit.

    Non-eligible facilities, programs or activities include, but are not limited to, country clubs and social clubs, spas, and 1 on 1 sessions. DVDs, equipment, and YouTube subscriptions are not covered.

    *Effective immediately

  • Medical release of records authorization request

    Use this form to authorize Mass General Brigham Health Plan to release your Protected Health Information (PHI) to a designated recipient.

    Authorization to Release Protected Health Information (PDF)

  • Member behavioral health reimbursement claim form

    Use the Member Reimbursement Claim form to file an eligible behavioral health reimbursement. See form for details and instructions.

    Member Behavioral Health Reimbursement Claim Form

  • Member medical reimbursement claim form

    Use the Member Reimbursement Claim form to file an eligible medical reimbursement. See form for details and instructions.

    Member Medical Reimbursement Claim Form

  • Member record request form

    Use this form to request your member record from Mass General Brigham Health Plan.

    Member Record Request Form (PDF)

  • Prescription drug reimbursement form

    Use the Prescription Drug Reimbursement Form to file an eligible prescription drug claim reimbursement. See form for instructions.

    Prescription Drug Reimbursement Form (PDF)

  • Personal representative designation form

    You have the right to choose one or more persons to act on your behalf with respect to the protected health information that pertains to you. If you would like to exercise this right, please complete and return this form to us.

    For Commercial members

    Authorize a Personal Representative: EnglishEspañol

    For MassHealth/Mass General Brigham ACO members only

    Authorize a Personal Representative: English Español

  • Travel benefit reimbursement form

    Travel Benefit Reimbursement Form

    This form can be used by members whose plans include a travel benefit from their employer. The travel benefit helps cover certain costs for members who need to travel in order to obtain services covered under their plan when state law does not allow a provider to administer such coverage in the state that the member resides.


    See form for details on eligibility and instructions for reimbursement.

    Travel Benefit Reimbursement Form (PDF)

  • Weight loss reimbursement form

    The fastest way to submit a reimbursement request for your weight loss benefit is on the Member portal or our Member app. You can also download the form below and follow the instructions to submit your reimbursement request. The weight loss benefit varies by plan. Please check Member.MassGeneralBrighamHealthPlan.org for details about your plan.


    Weight Loss Program Benefit Form and Instructions (PDF)
     
    Qualifying weight-loss programs

    • Weight Watchers (WW)
    • Jenny Craig
    • Noom- Effective for 1/1/2022

     
    Please note: The weight loss program benefit does not cover food, nutritional supplements, or enrollment/registration fees.

More about Mass General Brigham Health Plan

Service approval guidelines

Need to know if a service or treatment requires a prior authorization or referral? Check the Service Approval Guidelines (PDF).
For Medicare Advantage members: Medicare Advantage Prior Authorization and Notification Guidelines (PDF).

 

Information about surprise billing

You may have heard about the federal No Surprises Act. This new federal requirement is intended to protect members of commercial health plans from surprise billing for certain services from an out-of-network provider. You can learn more about this federal requirement and your rights and protections as a Mass General Brigham Health Plan member here.

 

Medical policies

The Mass General Brigham Health Plan medical policies, or clinical coverage criteria, help us evaluate the safety and effectiveness of a service or technology to determine if it should be covered. You can browse the medical policies to see the coverage criteria for a specific condition. However, the medical policies will not tell you whether a service or technology is covered under your plan.

For more information about our medical policies or about your plan, please call the Customer Service number on the back of your member ID card or email healthplanCustomerService-Members@mgb.org. You can also log in to Member.MassGeneralBrighamHealthPlan.org to find personalized information about your covered benefits.

 

2022 disenrollment rates

Massachusetts law requires Mass General Brigham Health Plan to inform you of the following information: In 2022, 14% of members chose to leave their plan and 0.1% of members were involuntarily terminated by Mass General Brigham Health Plan. 

  • Member rights and reference information

    Please log in to Member.MassGeneralBrighamHealthPlan.org for details about the information described below, or call the Customer Service number on the back of your Mass General Brigham Health Plan member ID card with any questions.
     

    • Member rights and responsibilities
      • Your basic rights and responsibilities as a member.
    • Availability of Member Handbook and Provider Directory
      • A summary of information included in your Member Handbook and details on how to use the Provider Directory.
    • Notice of Privacy Practices
      • Our policy for protecting your health information.
    • Post-mastectomy benefits
      • What you’re entitled to if you have a mastectomy.
    • Appeal and grievance process
      • How to appeal a denial or submit a formal complaint.
    • Preventive care guidelines for children
      • When your child should have preventive care and what’s covered.
    • Preventive care guidelines for adults
      • When you should have preventive care and what’s covered.
    • Incentives statement
      • AllWays Health Partners does not specifically reward providers or any organization reviewing our coverage decisions.
    • Utilization management
      • How to learn more about coverage requests, approvals, and denials.
    • Do You Have a Health Care Proxy?
      • How to choose a representative to speak for you in case you can’t make your own medical decisions.
    • Care management and disease management services
      • A list of care management programs offered by your plan.

Need help? Contact our Customer Service team

If you have questions or need help with any of the resources on this page, we are here to help. Please call us at 866-414-5533, or at the number on the back of your member ID card.
 
You can also email us at healthplanCustomerService-Members@mgb.org or go to Member.MassGeneralBrighamHealthPlan.org to start a live chat with a Customer Service Professional. We are available Monday through Friday, 8:00 AM to 6:00 PM and 8:00 AM to 8:00 PM on Thursdays.