Four Simple Steps to Get Started
We make it easy to get the care you need. Follow these four steps to see a doctor and fill prescriptions.
- Choose a doctor to be your primary care physician (PCP) if you haven’t already. You can get services from any doctor that is in our network and accepting new members. Your PCP will keep your health records and adjust your care as they get to know your health needs.
- See what medications are covered by our plan. If you don't see a prescription that you take, please call our Member Services department.
- Keep your WellSense member ID card on you at all times. You will need it when you go to your doctor's office and to fill prescriptions at the pharmacy. Note: You should not use your MassHealth ID card but keep it in a safe place in case you need it later.
- Tell us if you move or change your contact information. It is important that we are able to contact you to help coordinate your care.
To make sure that you get the right care at the right time, and that your care remains free, there are some rules for getting care that you must follow.
- You must use doctors that we have relationships with - Typically, you must get care from doctors and hospitals that are in our network, which means that we have an agreement with these providers to offer you care. See a list of available doctors and hospitals.
- You may need approval before getting certain care - Some services such as procedures, medications, or visits to doctors outside our network require approval from us before you can get them. This is sometimes called “prior authorization”. Covered services that require prior authorization are marked in your 2022 Summary of Benefits document. You can also view some of the policies* we use when making these decisions, or you can call us with any questions.