JANUARY 2004 - A dilemma continues to exist among some of our non-Medicare members who are insured by the Group Insurance Commission (GIC) and now live out-of-state.

UNICARE, the administrator for the GIC's Commonwealth Indemnity Plan, has established a preferred network of hospitals in many states that will accept the Plan's allowed amount.

While most GIC Indemnity Plan members who live out-of-state have access to UNICARE's network of providers, unfortunately, some do not. If a non-Medicare member is treated by a provider that is not on UNICARE's preferred list, that member may be balance billed. This would also pertain to services provided by a lab that is not on the preferred list. (State law prohibits Massachusetts' providers from balance billing.)

Remember, even though a hospital may be on UNICARE's preferred list, a patient may be treated by a doctor who is not on the preferred list, and subsequently the patient can be balanced billed.
If you move out of state, even for as little as four consecutive weeks, and need medical care, notify UNICARE by phone or e-mail. They will provide information on how to avoid being balance billed by non-Massachusetts providers.

If you use a non-network provider and receive a direct bill from this provider, call customer service at UNICARE (1-800-442-9300) and inform the customer service that you are being billed for out-of-state services.

Our Association will continue to work with UNICARE in seeking to expand UNICARE's out-of-state provider network so that non-Medicare members will not be balance billed.