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Check Your Health Plan Coverage Before Your Appointment

Health plan coverage may change, so before scheduling an appointment or seeking treatment, please check with your health insurance provider to confirm full coverage. This will ensure that your physician and hospital are included in your specific health plan.
 

Last updated: January 10, 2025

Health insurance terms and requirements can affect how and when your care is covered — and what you may need to pay. Understanding referrals, copayments, deductibles, coinsurance, and whether your care is in-network can help you avoid unexpected costs and plan ahead for your visit.

Learn what you need to know before scheduling an appointment.

Confirm Your Insurance Coverage 

• Check the UMass Memorial Health insurance plans accepted list and contact your insurance provider to verify coverage.
• Ensure UMass Memorial is considered "in-network" for your specific plan. 

Understand Your Insurance Benefits

• Contact your insurance company to confirm benefit coverage before receiving care.
• Review your plan’s tiered or limited network details, as cost-sharing levels may vary depending on where you receive care.
• Verify if referrals or authorizations are required for specific services, as these may affect your coverage. 

Special Insurance Considerations

Understanding Health Plan Referrals, Networks, and Medicare Coverage

Many health plans require members to obtain a referral from a primary care provider before seeing a specialist.

UMass Memorial Health is participating with Original Medicare, but not contracted for some Medicare Advantage plans. For a list of Medicare Advantage Plans with which we participate, view the list of accepted insurance plans.

Certain companies may also require certain services be provided by specific providers within the provider network in order for those services to be covered in full. Some health plans refer to this...