UniCare Logo
UniCare 30 Years GIC Logo

How to Avoid Balance Billing when You Use Non-Massachusetts Providers

What is balance billing?

Balance billing is when a health care provider bills you for the difference between the providerís charge and the amount paid by UniCare (the allowed amount). For example, if the providerís charge is $100 and the allowed amount is $70, the provider may balance bill you for the remaining $30. The Plan doesnít cover balance bills, and balance bills donít count toward your out-of-pocket maximums.

By law, Massachusetts providers arenít allowed to balance bill UniCare members. However, providers in other states may do so. This means that when members use providers outside Massachusetts, they may be balance billed for these services. This may happen if the amount of the bill is more than UniCareís allowed amount for covered services.

For behavioral health services in any state (for all members)

Use a behavioral health network provider for mental health and substance use disorder services to avoid being balance billed and to get higher benefits.

For medical services outside Massachusetts
(for Basic, PLUS and Community Choice members only)


About UniCare
| Legal | Site Map | Contact Us


For self-funded plans, claims are administered by UniCare Life & Health Insurance Company. © 2018 UniCare