Blue Cross Blue Shield of Massachusetts

As a health care leader in Massachusetts for more than 80 years, our vision to provide access to high quality, affordable health care is as strong and relevant today as it was in 1937 when our company was founded by a group of business, health care, and community leaders. Back then, Blue Cross of Massachusetts was the first organization of its kind to offer statewide insurance coverage for hospital stays. In 1941 coverage for doctors’ office visits was established through a separate entity known as Blue Shield of Massachusetts. The companies operated separately until 1988, when both organizations merged to become Blue Cross Blue Shield of Massachusetts. Although much has changed in health care through the years, the single-minded commitment to doing what’s best for our members is still at the forefront of everything we do.

We strive to offer our members the latest in proven medical technologies by reviewing current scientific evidence and considering expert physician opinion when we develop our medical policies. We incorporate input from the Massachusetts Medical Society, specialty societies, national technology review organizations and community physicians in the development and review of all policies.

The purpose of our medical policies is to provide guidelines for determining coverage criteria for new and evolving medical and behavioral health technologies, including procedures, equipment, and services.

Medical policy does not override the health insurance contract that defines members’ benefits, nor is it intended to dictate to providers how to practice medicine. Physicians and other health care providers are expected to exercise their medical judgment in providing the most appropriate care. An independent licensee of the Blue Cross Blue Shield Association, we are a not-for-profit company that has a significant impact on our state’s economy and makes considerable tax payments to local, state, and federal governments.