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Focus NetworkSM - MA

As a member of Focus Network – MA (Focus Network), you have access to the largest high-performance, defined network in Massachusetts.1 It includes more than 16,500 doctors and 50 hospitals throughout the Commonwealth that were chosen for consistently providing high quality, comprehensive and affordable care for individuals and families.

The medical plans offered with Focus Network give you a full range of benefits, including preventive care, emergency coverage, inpatient care, online wellness programs and much more.

How it works
The plans offered with the Focus Network are HMOs, which means you choose a primary care provider (PCP) for yourself and each family member.

Once you select a PCP, he/she will provide or arrange for your care, including referrals for specialty care.

Providers in the Focus Network are divided into two categories.

  1. Easy Access – These are the providers you can receive coverage from without prior authorization. View hospital list.
    If you require care that an Easy Access provider can not provide, there are a limited number of Authorized Access specialists and hospitals.

  2. Authorized Access – These providers require a referral from your PCP and approval from Harvard Pilgrim Health Care before your visit will be covered.

The good news is that the vast majority of the PCPs in the state are among the thousands of Easy Access providers in the Focus Network. Chances are, you and your family can continue to see the doctors you already know and trust.

How do I find a doctor or hospital in the network?
Use the Focus Network – MA provider directory to find a doctor or other health care provider in the network. This will also let you know if there are additional requirements (such as pre-authorization) for that provider.

We have also worked with several medical groups and hospitals in the network to make it even easier to find a PCP. When you contact any of these providers, they will help you get an appointment and ensure a smooth, timely transition to a new PCP.

How do I check my benefits?
Your healthcare benefits and coverage are all available on HPHConnect, our secure online tool for members. You can also track the status of your authorization requests through HPHConnect.

Who can I call with questions?
Call Member Services (888) 333-4742. For TTY service, call (800) 637-8257. Representatives are available weekdays from 8:00 a.m. to 5:30 p.m., and until 7:30 p.m. on Monday and Wednesday evenings.

*This plan provides access to a limited provider network that is smaller than Harvard Pilgrim’s full provider network. In this plan, members have coverage only from providers in the Focus Network – MA provider network. Please consult the Focus Network – MA provider directory or visit the provider search tool for a list of providers in the Focus Network – MA. You may also call Harvard Pilgrim to request a paper copy of the provider directory.

1 Based on publicly available data as of April 2014.

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How the network works*

Employee brochure*

Focus Network – MA provider directory

Members' Right to Transitional Continuation of Care for Serious Diseases*