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Looking for a provider?
Use one of the search tools below and look through the most updated listing of participating primary care providers, specialists, hospitals, pharmacies, eyewear providers and more. You will be able to choose from more than 5,500 primary care physicians and specialists who serve Western Massachusetts, Worcester County and parts of Connecticut.
HMO Network - Fully Funded
PPO Network - Fully Funded
HMO Network - Self-Funded
PPO Network - Self-Funded
Connector (HMO Fully Funded)
PHCS/Multiplan National Network
GIC Network - Effective 7/1/2020
Medicare Advantage - 2021
Health New England supports you and your baby by covering breastfeeding support services through participating providers at no cost to you. View a list of participating lactation counseling providers in our network.
Search our network for participating acupuncture providers.
Health New England updates its paper plan provider directory each month. Our website provider directory is updated as required by federal guidelines. Providers are free to join or leave the network at any time. Health New England cannot guarantee that any provider or group of providers will continue to be In-Plan Providers. Some In-Plan Providers may have left or joined the Health New England network since the last directory was printed. For the most up-to-date list of In-Plan Providers, go to healthnewengland.org, or you can call Member Services. A Member Services representative will respond to your question within one business day. If you choose a provider based on information from Health New England that is shown to be inaccurate, you will only have to pay In-Plan Cost Sharing. If you believe your choice of provider was based on inaccurate information, you can file a complaint with the Massachusetts Division of Insurance (DOI). You can submit a complaint at this website: https://www.mass.gov/how-to/filing-an-insurance-complaint or you may call (617) 521-7794.
(Does not apply to Medicare or Medicaid.)
On Your ID Card: Look at your ID Card. If the Group # starts with any number except "5" (see GIC) you are covered under a Fully-Funded plan. You can find the type of plan (HMO, POS, PPO, HDHP) on the right hand side of your card. Description: Most of the plans we offer through employer groups are Fully-Funded plans. This means that the premium paid to Health New England is used to pay for medical care and pharmacy services.
On Your ID Card: Look at your ID Card. If the Group # starts with the letter "S" you are covered under a Self-Funded plan.Description: Some larger employer groups choose Self-Funded or ASO plans. ASO stands for "Administrative Services Only." Under these plans, the group pays a fee to Health New England. Health New England processes claims and performs other activities needed to manage the plan. The employer group pays for medical care and pharmacy services.
On Your ID Card: Look for the GIC logo on your ID Card. Description: GIC stands for Group Insurance Commission. The GIC plan covers people who work for the Commonwealth of Massachusetts and certain municipalities (cities or towns). The GIC plan has a tiered provider network. That means that providers are assigned different copay levels (or tiers) based on access, quality and performance. The GIC provider search can be found here: healthnewengland.org/gic-provider-search
On Your ID Card: Look for the words "Health New England Medicare Advantage" at the bottom of your ID card. Description: Health New England’s Medicare Advantage (MA) Plans cover those who are eligible for Medicare Parts A and B. Health New England MA Plans are available to residents of Hampden, Hampshire, Franklin, and Berkshire Counties. The Medicare Advantage provider search can be found here: healthnewengland.org/medicare/provider-lookup
On Your ID Card: Look for the Health New England BeHealthy Partnership logo on your ID card. Description: Health New England's BeHealthy Partnership plan covers those who are eligible for coverage under the state MassHealth program. Health New England BeHealthy Partnership is available to residents of Hampden, Hampshire, Franklin, and Berkshire Counties.
Please be aware that certain providers may not participate in all networks. Wondering how we choose our provider and hospital networks? Learn More >If you have questions about the Health New England network in which you currently are enrolled, please contact Member Services at (413) 787-4004 or toll-free at (800) 310-2835.
You can also get information about a provider from the Massachusetts Board of Registration in Medicine by phone at (781) 876-8230 or toll-free (in Massachusetts only) at (800) 377-0550.
Massachusetts Health Quality Partners also provides information about provider quality at http://www.healthcarecompassma.org/.
Remember: More care is not always better care. Visit choosingwiselyma.org to learn more about how patients and providers in Massachusetts can think and talk about tests and procedures and when they may or may not be helpful.