New Cost of Care Estimator Tool Coming Soon
Posted on December 16, 2022
As part of the Transparency in Coverage Final Rule released in 2020, all individual and group health plans, including self-funded group plans, are required to provide a web-based, self-service cost of care tool that must be accessible to its members, enrollees or beneficiaries for plan years beginning on or after January 1, 2023.
Health New England currently provides members access to a cost of care calculator/estimator tool on our member portal at my.healthnewengland.org. Because the new regulations require additional information to be contained within this tool, Health New England will be transitioning to an enhanced cost estimator tool in early 2023.
The enhanced tool will allow you to view the following:
- Your estimated cost-sharing liability
- How much of your deductible and/or out-of-pocket maximum (MOOP) has been met
- Negotiated rates by Provider for the item or service you are researching
- Out-of-Network allowed amounts (when applicable) for the item or service you are researching
- Detailed information on which items or services are included as part of any bundled payments
- Notice of any pre-requisite to coverage, such as prior authorization
- Plain language disclosures
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