Find the right doctor and build a good relationship with them. When you trust your doctor you can work together to make important health decisions. Your doctor will be there for you. In illness and injury, you’ll know where to turn.

If you are in need of a new doctor or looking for someone new, Health New England has ways to help narrow down your search.

• Step 1. Before you schedule an appointment, go online to check which doctors are in your network. Visit healthnewengland.org/medicare/provider.
• Step 2. Search by the criteria that are important to you. This could be location, gender, specialty, languages spoken or special interests.
  
  

Next, it’s important to build a strong relationship with your doctor. Your doctor is your partner in your health care. Let them know your expectations. Be an active participant in each appointment. Listen carefully. Ask questions. Tell them if something will be hard for you to follow through with. Here are some more helpful tips:

• Bring your medicines to your appointment including prescribed or over-the-counter medicines, vitamins or herbal remedies. If you cannot bring them, bring a list.
• Ask for instructions to make sure you know what you are supposed to do to take care of yourself.
• Be sure to make and go to all appointments.

Finding the right doctor for you may take time and it’s okay to look for another doctor who may be a better match for you. We’re here to help you along the way. Our Member Services team is available at (413) 787-0010 or toll-free (877) 443-3314 (TTY: 711), Monday – Friday, 8 a.m. - 8 p.m. (Oct. 1 - Mar. 31: 8 a.m. – 8 p.m., seven days a week).

Your plan covers both an annual well-care visit and annual physical exam at no cost to you. Taking advantage of these visits is a great way to help you stay healthy.

If you don’t have one of these scheduled already for this year, we encourage you to call your primary care provider (PCP) today for an appointment. Don’t wait until you get sick to see your PCP; take advantage of your free annual preventive care visits. You can even get rewarded for doing so! Read more about Preventive Care Visits and Rewards here >>  hnetalk.com/member/2025-annual-preventive-care-visit/

Your health plan benefits help cover the cost of medical care, which can include doctor appointments, emergency or urgent care visits, prescription medications and more.  

When you join Health New England, you receive a membership ID card and a booklet with your plan details. You can access all of your coverage documents anytime online in the Member Portal. To view and download your Evidence of Coverage, go to healthnewengland.org/medicare/eoc or call Member Services to have it mailed to you.

By understanding your coverage, you can work with your doctor to decide what’s best for your health and your budget.

If you receive medical services, you will get an Explanation of Benefits that shows how much is covered for your visit and any amount you may owe. If you do owe anything, your provider will send you a bill. You should compare the bill to the Explanation of Benefits to help you understand what is covered.

Extra Benefits & Member Program Highlights

Your plan also includes lots of extras to help you stay as healthy as possible. Here are a few:

Virta—Transform your health with nutritional therapy for weight loss and diabetes reversal.
For eligible members, Virta uses nutrition science to build custom plans to help you lose weight and lower blood sugar. To see if you qualify, visit >> www.virtahealth.com/join/healthnewengland

Signify Health In-Home Visits—Get a comprehensive in-home health evaluation.
Eligible members can get a visit from a medical professional at no extra cost to help you enjoy more healthy days at home. If you qualify, our partner, Signify Health, will contact you.

Over-the-Counter (OTC) Care Items—Medline at Home, our new vendor, has you covered! You get a credit loaded onto your Additional Benefits Mastercard to spend every three months. Learn more at healthnewengland.org/medicare/otc-2025. To place an order, visit athome.medline.com/HNE or call (833) 660-0906 (TTY: 711).

Mom’s Meals—Recently discharged from the hospital or a skilled nursing facility?
We can help you get back on your feet with nutritious meals delivered from Mom’s Meals. If you qualify, please contact Health New England’s Care Management team within 30 days of discharge at (800) 842-4464, ext. 3940, for assistance in requesting Mom’s Meals.

Learn about all of your Additional Benefits

Visit healthnewengland.org/medicare/Additional-Benefits or call Member Services toll-free at (877) 443-3314 (TTY: 711), 8:00 a.m. - 8:00 p.m., Monday - Friday (Oct. 1 - Mar. 31: 8:00 a.m. - 8:00 p.m., seven days a week).

When it comes to overall health, staying active and connecting with our communities benefit our physical and mental health.

Regular exercise makes you strong and flexible. It also reduces stress, boosts energy and helps you control your weight. Exercise can even help you sleep better! Here are some ways to incorporate exercise into your life:

• Walking
• Swimming
• Cycling
• Jogging
• Fitness DVDs or videos
• Gardening
• Stair Climbing
• Dancing
• Lifting weights
• Push ups
• Sit ups
• Stretching
• Yoga

Use your Health New England Additional Benefits Mastercard to join a fitness center, weight management program or to purchase a fitness tracker!

Read more about how to stay healthy in 2025 here >> hnetalk.com/member/new-year-healthy-habits/

Getting involved in your community is another way to lower stress levels and help you build relationships. Are you curious about trying something new? Start by reaching out to family members, friends, or your local recreation or community center. These are a great way to connect with people who have similar interests, for example, book clubs and fitness classes.

Need extra help? Sometimes we also need to turn to community resources for extra help. Health New England members have access to the findhelp search tool, which is a social care network platform that connects you to verified social care providers serving your community. The search is based on your zip code that you enter into the tool. You can find support for financial assistance, food pantries, medical care, and other free or reduced-cost services at healthnewengland.findhelp.com/

Sometimes the right medicine can be the key to getting and staying healthy. And, you want to know your options for ways to save. Here are a few important things to know about your medication coverage:

Covered Drug List (Formulary)

All health plans have a covered drug list, also called a formulary. This is a list of covered drugs and prescription therapies determined to be a necessary part of treatment. Your plan covers both brand name drugs and generic drugs. Each drug is assigned a tier. This tells you the level of any cost sharing. Tier 1 drugs are the lowest cost. Search our Formulary to find a drug.

Preferred Pharmacies

Your costs for some prescription drugs may be less at pharmacies that offer preferred cost sharing. In Health New England’s pharmacy network, these include CVS, Walmart, Big Y, Baystate Health Pharmacies and others. Check our Pharmacy Directory for the complete listing.

Over-the-Counter (OTC) Care Items

Medline at Home, our new vendor, has you covered! You get a credit loaded onto your Additional Benefits Mastercard to spend every three months. Learn more at healthnewengland.org/medicare/otc-2025. To place an order, visit athome.medline.com/HNE or call (833) 660-0906 (TTY: 711).

Mail Order Drug Program

Save time and money by getting your medications at home. Mail order can save you up to 4 copays a year—you can get a 3-month supply and pay only 2 copays on Tier 1, 2 and 3 drugs. Health New England can save you. Fill out the appropriate form located in your member portal or go to healthnewengland.org/medicare/Pharmacy/Mail-Order-Drug-Program.

Medication Therapy Management (MTM)

When you take several drugs to manage your health conditions, our MTM program can help you. The program includes a free discussion and review of all of your medications by a pharmacist or other health professional to help you use them safely. You will get a summary of this discussion to help you get the most benefit from your medications. You can have this summary available when you talk with your doctors or other health care providers. We will contact you directly if you are eligible. For full details, visit healthnewengland.org/medicare/mtm.

New! Part D Out-of-Pocket Maximum Reduced

Health New England has significantly lowered the out-of pocket maximum for prescription drugs to $2,000 per year. And no more donut hole—if you reach the catastrophic coverage stage (over $2000 in drug costs), you pay nothing for your covered Part D drugs for the remainder of the year.

New! Medicare Prescription Payment Plan

Need help managing your out-of pocket drug costs? This new payment option works with your Health New England drug coverage, and it can help you manage your drug costs by spreading them across monthly payments that vary throughout the year. Learn more by visiting healthnewengland.org/medicare/m3p or by calling OptumRx at (800) 393-0395.

Learn More About Your Rx (Plan D) Benefits

Still have questions? Check out our pharmacy information, search prescription drugs, and learn about mail order and other resources at healthnewengland.org/medicare/pharmacy.

Reminder: View and manage your health care and Rx benefits online Log into your Member Portal account at my.healthnewengland.org.

Find other cost savings programs on our Additional Resources page.

*Applicable to members enrolled in a Health New England Medicare Advantage plan with prescription benefits.

There are times when you need to find care quickly. We want you to know what your covered options are in case your primary care provider (PCP) isn’t available.

24-Hour Nurse Advice Line: As a Health New England member, you can call our free Nurse Advice Line if your doctor’s office is closed and you have questions about health concerns or health-related topics. Our team of medical professionals give helpful advice that is easy to follow. The Nurse Advice Line is available to active Health New England members 24 hours a day, 7 days a week at (866) 389-7613. Interpretation services are also available for your call. To learn more, read our Nurse Advice Line flyer.

Urgent Care: Go to an Urgent Care Center when you have an illness or injury that needs immediate attention, but is not life threatening and you can’t get in to see your doctor. They are often less expensive than an emergency room visit and can be convenient because it’s open at hours when your regular doctor might not be available. A list of contracted urgent care facilities is available here.

Telehealth:

• Telehealth, or telemedicine, is a 24-hour service where you can see or talk to a doctor over the phone, computer or other device. With telehealth services, your provider may be able to diagnose and treat illnesses, which includes writing prescriptions. Ask your doctor if your visit can be completed via telehealth.
• Health New England members also have Teladoc®, which gives you access to U.S. board certified physicians 24 hours a day, 365 days a year, to treat non-emergency, non-chronic medical issues via phone, app or video consultation. Call 1-800-835-2362 or go to Teladoc.com/HNE.

Remember: If you or a family member is having a life-threatening condition, immediately call 911 or go to the emergency room.

To learn more about your care options, read our Choosing the Correct Care flyer.

Register for Health New England’s Member Portal to manage your health care benefits online in one convenient location. You get the following helpful features on the portal:

• NEW! Pay your monthly premium, if applicable
• Your plan benefit documents and coverage information
• A dashboard with recent claims, payments, spending summary, and links to your Explanation of Benefits (EOB)
• Your personal Pharmacy benefits*
  • View recently processed pharmacy claims
  • Manage mail order prescriptions
  • Look up drugs and pharmacies
• Access to Teladoc®, EyeMed, the Healthy Directions portal, and the Additional Benefits Card portal
• A directory to locate providers in your plan network
• Links to important forms
• Option to request a new ID card
  

*Pharmacy claims and benefits apply only to members with a Health New England Medicare Advantage plan with prescription drug benefits.

To Register: Go to my.healthnewengland.org and select “Member” in the “Register” drop down menu. Follow the prompts to enter your member information.

Use your health care provider’s Patient Portal too! Your health care provider’s patient portal is another great digital tool to keep your health information organized and at your fingertips. A patient portal is a secure website that gives you access to your health records. You can use it to schedule visits, check test results, request prescription refills, and message your provider. Simply visit your health care provider’s portal, which is usually available on their website, and create your account.

We are here for you every step of the way whether you need help finding a doctor, figuring out a bill, understanding your coverage or dealing with a health condition. The Health New England team prides itself on delivering superior customer service along with comprehensive health care coverage.

Call us when:

• You have questions about your benefits or a bill you received.
• You are having trouble reaching a provider or scheduling an appointment.
  
  

Tips for when you call us:

• Have your member ID number ready. This number is on your member ID card.
• Have a pen and paper nearby if you need to take notes.

Local: (413) 787-0010 
Toll Free: (877) 443-3314 (TTY: 711)
Fax: (413) 233-2655 
Hours: 8 a.m. - 8 p.m. / Mon - Fri (Oct. 1 - Mar. 31: 8 a.m. - 8 p.m. / 7 days a week)

Visit our website: Keep in mind, our website has lots of useful information about benefits, coverage, extras and resources. We have Medicare-specific podcasts too! Visit healthnewengland.org/medicare.

We are here for you!

Contact Us >> healthnewengland.org/medicare/contact