We are pleased to participate in the following individual ACA/Exchange plans: Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, and Tufts Health Plan (Premier plans).
Members who used to have coverage with other insurers who have since left the ACA Exchanges and no longer have in-network coverage with One Medical are always able to pay for visits according to our fee schedule.
We participate with exchange plans that provide us with the best opportunity to provide the high level of care and service you expect from One Medical. Our goal is to participate with as many plans as possible, and we expect to continue to expand the list of participating plans over time.
At this time, One Medical is only in-network with ACA plans sold via the Health Insurance Marketplace, and we do not accept Off-Exchange or mirrored plans. For plans purchased privately (outside of an employer) through an insurance company, broker, or small business group, please be aware that if we are not in-network with their Exchange counterparts we may not be in-network with those plans. If you have any questions or concerns, please call us at 617-419-2893.
What is the difference between Exchange and Off-Exchange ACA plans?
An off-exchange plan is just an individual health insurance policy that is purchased directly from the carrier or through an agent or broker, outside of the state health insurance exchange. "On-exchange" refers to when an individual chooses a plan on the ACA's health insurance exchanges (marketplaces). The exchange is where individuals can compare policies, enroll in a plan, and receive a subsidy if they're eligible.
Self-Pay Fee Schedule
Our prices for uninsured members are below. While common services are included, some may not be listed.
|Primary Care — Initial Visit/New Issue
|Primary Care — Follow-up Visit
||Call for rates