It's Open Enrollment time at MIT again, and we hope you will continue as a member of one of the MIT Health Plans for 2008. Please note that all renewing Traditional and Flexible Health Plan members will be issued a new Blue Cross Blue Shield of MA (BCBSMA) ID for 2008. It is essential that you begin using your new ID card on January 1, 2008, or as soon as possible thereafter.

We are happy to be able to tell you about several exciting benefit enhancements for the coming year and to offer you some tips for getting the most from your MIT Health Plan membership.

Benefit changes

New mental health and substance abuse network: Effective January 1, 2008, we will move from Value Options to a new mental health benefits provider, BCBSMA Managed Care Behavioral Health Network. We expect this network change to enhance our members' access to mental health care and to simplify the member claim process. With the new network, our members will pay a fixed $20 co-pay per visit instead of being responsible for a 25 percent coinsurance fee. There will be no change in the benefit level for services rendered by non-network providers.

Most Value Options clinicians already participate in the BCBSMA Managed Care Behavioral Health Network program. If you are currently seeing a mental health professional, please speak to your clinician to verify her or his participation in our new network. We do not want to disrupt existing relationships for those already in treatment, so if you have any questions regarding your provider's network participation, please contact Claims & Member Services at 617-253-5979.

Your new BCBS ID card will include the contact information for the Managed Care Behavior Health Network. If you need to contact BCBS prior to receiving your card, call 1-877-566-2583.

MIT Medical's Mental Health Service will continue to provide brief treatment to Health Plan members, including mental health evaluations, urgent care, consultations, and referrals to community clinicians. MIT Medical's mental health clinicians can also answer questions about treatment options and resources. To learn more, call the Mental Health Service at 617-253-2916.

Read more about your 2008 Mental Health benefits

Expanded pharmacy options: We have expanded pharmacy options for our patients who need to fill prescriptions during evening or weekend hours or while traveling. At those times, you may get up to a 30-day supply of prescribed medications at any other retail pharmacy that is part of the Express Scripts network. Most major chains participate in this network. A higher co-pay than at the MIT Pharmacy will apply to prescriptions filled through the Express Scripts network. Refills should be obtained at the MIT Pharmacy where co-pays are lower and where you can obtain a multi-month supply of medication if prescribed by your clinician.

Flexible plan members should note that prescription claims can no longer be used to satisfy the out-of-network deductible.

Read more about your 2008 Pharmacy benefits

Immunizations: Due to an increase in the cost of vaccines and immunizations, we are increasing the co-payment from $20 to $25. This increase will not affect flu shots or most childhood vaccinations, as they are provided free of charge at MIT Medical.

Getting the most from your Health Plan membership

To get the maximum benefit from your MIT Health Plan membership, it is important to keep your personal clinician information up to date and know what to do when you need to receive services out of the area:

Your personal clinician: We require every Traditional and Flexible Health Plan member to select a physician or nurse practitioner as his or her personal clinician, or "PCP." Your PCP serves as your primary provider for clinical services and referrals, allowing us to provide you with well-coordinated and continuous care.

Please take a moment to make sure that your MIT Medical health records, and those of your family members, accurately reflect the name(s) of your chosen PCP(s). You may check these records during your next visit to MIT Medical or by calling the MIT Health Plans Enrollment staff at 617-253-1322.

Out-of-area coverage: Members of the Traditional and Flexible Health Plans typically receive all their primary care services at MIT Medical. MIT Medical also provides many specialty services, and when these services are not available onsite, we refer our members to a network of providers in Massachusetts through our BCBSMA partnership arrangement. (For 2008, Flexible Plan members may continue to self-refer outside the network with the same deductibles and coinsurance payments.)

We realize, however, that emergency and urgent situations needing medical attention will occur when you are out of the area and cannot get to MIT Medical. In these situations, our priority is for you to receive the medical care you need, wherever you are. Afterwards, you must notify your PCP if the care was provided in Massachusetts , or your PCP and BCBSMA (using the number on your ID card) if the care was provided out of state. To ensure coverage, these notifications must be made within 48 hours of receiving care. Follow-up care must be coordinated by your PCP at MIT Medical.

Read more about your 2008 out-of-area benefits

If you have questions about Health Plan benefits, feel free to contact Claims & Member Services staff at 617-253-5979.

We look forward to serving you in 2008!