Health New England’s enhanced Cost of Care Calculator, powered by HealthSparq, is now live on the Member Portal at my.healthnewengland.org.

The newly enhanced tool allows members to find information related to the following:

• Estimated cost-sharing liability
• Amounts accumulated toward deductible and/or out-of-pocket maximum (MOOP)
• Price estimates that reflect actual negotiated rates for an item or service
• Out-of-network allowed amounts (if applicable)
• Details on what items or services are part of a bundled payment
• Notification of any prerequisite to coverage, such as prior authorization
• Plain language disclosures

The enhancements are part of the Transparency in Coverage (TiC) provision of the Consolidated Appropriations Act 2020 (CAA), which requires all health plans to make specific cost information available for an initial list of 500 shoppable services. The information is to be made available through an online self-service tool and in paper form, if requested. The tool can be used to compare prices and better estimate a member’s potential out-of-pocket costs.

Getting Started

Access this improved cost estimator tool by logging into your Health New England member portal account at my.healthnewengland.org and click on the “Cost of Care Calculator” icon. From there, you can click the “Get Started” button and begin your search (first-time users will need to accept the terms/conditions of the tool).

Click here for instructions on how to use the enhanced Cost of Care Calculator tool.

If you have any questions about the Cost of Care Calculator, our Member Services team is here to assist you. Representatives are available 8:00 a.m. – 6:00 p.m., Monday – Friday, at (413) 787-4004 or toll-free at (800) 310-2835 (TTY: 711).