Blue Cross Blue Shield of Massachusetts 2026 Non-Renewal Q&A

Despite months of good faith negotiations, UMass Memorial and BCBSMA have yet to reach agreement on a new contract. Although we continue to negotiate, we are preparing for the possibility of termination.

Our current agreement with BCBSMA for their commercial products expires on December 31, 2025. This means that the following UMass Memorial entities and provider groups will be out of network for patients with BCBSMA commercial products effective January 1, 2026, including:

• UMass Memorial Medical Group Primary Care Providers
• UMass Memorial Medical Group Specialists
• UMass Memorial Medical Center
• UMass Memorial Health – Harrington
• UMass Memorial Health – HealthAlliance-Clinton Hospital
• UMass Memorial Health – Marlborough Hospital
• UMass Memorial – Milford Regional Physician Group
• UMass Memorial Health – Community Healthlink
• Private physicians who are part of the UMass Memorial Health Managed Care Network 
   

Yes, Milford Regional Medical Center has a separate contract with BCBSMA for their commercial products that runs through September 30, 2026. This means that you can continue to receive diagnostic and laboratory services at Milford Regional Medical Center. However, all providers at Milford Regional are included in the UMass Memorial Health contract and will be out of network for BCBSMA commercially insured patients after December 31, 2025.

Effective January 1, 2026, all primary care and specialty care services UMass Memorial Managed Care Network physicians, including UMass Memorial Medical Group, and UMass Memorial Hospitals, including UMass Memorial Health Alliance – Clinton Hospitals, UMass Memorial Harrington Hospital, UMass Memorial Marlborough Hospital and UMass Memorial Medical Center may no longer participate with BCBSMA commercial plans.

Yes, BCBSMA commercial patients can use any available out-of-network benefits for care at UMass Memorial but may have higher cost-share amounts.

Patients enrolled in a BCBSMA commercial plan on or after January 1, 2026, will be required to use any available out-of-network benefits to receive care from their UMass Memorial primary care physician (PCP).

Patients without out-of-network benefits will be required by BCBSMA to select a PCP that participates in their BCBSMA commercial plan. Patients changing PCPs should inform their UMass Memorial PCP practice of their new provider and the office will work to ensure the patients’ medical records are transferred as appropriate.

If you choose to be seen, you will need to sign a waiver of financial responsibility prior to your visit. We can bill your insurance, but ultimately, you will be responsible for payment and will need to seek reimbursement from your plan for non-covered services.

Patients enrolled in a BCBSMA commercial plan on or after January 1, 2026, will be required to use any available out-of-network benefits to receive care from their UMass Memorial specialty care physician.

Patients without out-of-network benefits will be required by BCBSMA to select a specialty care physician that participates in their BCBSMA commercial plan.

If you choose to be seen, you will need to sign a waiver of financial responsibility prior to your visit. We can bill your insurance, but ultimately, you will be responsible for payment and will need to seek reimbursement from your plan for non-covered services.

As always, UMass Memorial physicians and hospitals will continue to provide urgent/emergent services as required by law.

Yes, scheduling should be based on your primary insurance.

If you are currently undergoing a course of treatment and your providers don’t believe you can be safely transitioned to another provider at this time, you may meet the criteria for continuity of care. Your provider, in partnership with BCBSMA, will determine if you qualify for continuity of care. Additionally, patients covered by BCBSMA products with out-of-network benefits can access UMass Memorial with higher out-of-pocket costs.

Yes, as long as you are an established patient, and UMass Memorial is participating with your new health plan, that plan will allow the PCP selection. The health plan may contact the physician to confirm that you are an established patient.

If you choose to be seen, you will need to sign a waiver of financial responsibility prior to your visit. We can bill your insurance, but ultimately, you will be responsible for payment and will need to seek reimbursement from your plan for non-covered services.

UMass Memorial continues to negotiate with BCBSMA in good faith in the hopes of coming to an agreement before our contract expires. In the event we do not come to an agreement by December 31, 2025, you may choose to cancel your visit as it may not be covered by insurance, with the exception of those patients who have out-of-network benefits or qualify for continuity of care.

If you choose to be seen, you will need to sign a waiver of financial responsibility prior to your visit. We can bill your insurance, but ultimately, you will be responsible for payment and will need to seek reimbursement from your plan for non-covered services.

Preventative Visits – You will be required to use any available out-of-network benefits in order to access care at UMass Memorial. If you do not have out-of-network benefits or are unable to use them, you will be directed to contact BCBSMA for assistance in finding a physician that participates in your plan.