We don’t just talk about change

World-class care. Convenience. Ease-of-use. Lower costs. It all comes together with Allies^SM.   
 
For employers and employees who are located and live within a 20-mile radius of Newton-Wellesley Hospital, there is Allies HMO. Allies offers a health experience that’s nearby, easier. Provides access to world-class hospitals. And saves time and money.
 
Here are the innovations that make Allies unique:
 

• Costs as much as 20% less than our full network plans
• Care provided by Newton-Wellesley Hospital, the highest-ranking community hospital in Massachusetts by U.S. News and World Report, 2020-2021
• Easy access to NWH’s PCPs and specialists—with special areas of expertise including cardiology, oncology, maternity services and women’s health, orthopedics, sports medicine, and more
• For highly specialized complex care, members have access to Mass General Brigham’s world-renowned academic medical centers and specialty hospitals, and without tiering
• Allies Health Navigators are at the ready to deliver an easier health experience. They serve as a bridge between members and the benefits, services, providers, resources, and care they might need
• Leading-edge patient convenience is included: $0 cost sharing for telemedicine visits for PCPs, specialist, behavioral health, and 24/7 urgent care
• A virtual primary care group option for members who choose it. Members can see a provider within one business day, pay $0 copays, and get care where and when they want it, when appropriate

All Allies plans are available on a fully insured basis side-by-side with our standard full network plans.
 
 

IMPORTANT NOTICE This plan provides access to a network that is smaller than AllWays Health Partners’ full commercial HMO provider network. In this plan, members have access to network benefits only from the providers in the Newton-Wellesley Hospital Community Plus network. Please visit the Newton Wellesley Hospital Community Plus provider directory  to determine which providers are included in the Newton-Wellesley Hospital Community Plus Network.

Three no-cost pediatric sick and behavioral health visits
This parent/wallet-friendly benefit covers the first 3 sick PCP visits and 3 behavioral health visits for members age 18 and younger at no member cost sharing, per benefit period.

Removing the cost barriers to care options
Built on the understanding that there’s more than one way to solve a problem, Care Complement gives members the flexibility to try alternatives to opioid painkillers and new treatments for managing chronic conditions.

$0 cost for:

• The first 6 visits to a chiropractor
• The first 6 acupuncture visits (20 visit limit)
• Pain-management therapies
• The first 6 for visits for physical or occupational therapy
• Cardiac rehabilitation therapy
• Services that decrease diabetes complications including an annual routine eye exam, diabetic education, and nutritional counseling
• Medication-assisted therapy office visits and prescriptions to treat substance use
• Recovery coaching
• 11 common prescription medications to treat depression, heart conditions, and high blood pressure

Cash back for making smart choices about care
Members can save money — and earn rewards of up to $500 — with the DoctorSmart Rewards program.

Different providers may charge very different prices for the same procedure, even when they’re delivering the same level of care.

DoctorSmart Rewards makes it easy to find these high-value providers, so members can save on their out-of-pocket costs.

But there’s more. DoctorSmart Rewards also gives members a cash incentive for making smart choices about where to get their care. Eligible services include common procedures like colonoscopy, CT scan, mammogram, MRI, and upper GI endoscopy.

To participate, members simply shop the full list of DoctorSmart Rewards on our secure member portal. Once they select and have a procedure, we’ll process the claim and send them a check in the mail.

Exclusive access to On Demand* for virtual urgent care* care right from a tablet, smartphone, or computer. And it’s staffed by leading Partners HealthCare providers, including providers from Massachusetts General Hospital, Brigham and Women's Hospital, and Partners Community Physicians Organization.**

Members access the Partners On Demand website or app via our secure member portal. During their interactive video visit, they see and talk to a provider who can diagnose, offer treatment, and even send a prescription to an in-network pharmacy, if necessary.

Members age three and older can use On Demand to get care for common urgent care issues like colds and coughs, sinus symptoms, allergies, and rashes.

*Partners On Demand will become Mass General Brigham On Demand on or before 1/1/21. 
*** Board certified physicians from Teladoc will deliver services to patients located outside of Massachusetts.
On Demand is NOT for medical emergencies. For medical emergencies, call 911.

State-of-the-art care management
iHeart Champion helps members reduce their bad cholesterol, blood pressure, and risk of heart attacks. The program is a collaboration with Brigham and Women’s Hospital Remote Cardiovascular Health Program. Eligible members find it easy to engage with navigators and digital tools to return impressive results — all without the need for office visits or additional member costs. Among study participants, average results are:
 

• 40% reduction in bad cholesterol in 12 weeks
• Blood pressure values decreased by an average of 30/10

These reductions would reduce the risk of heart attacks and strokes.

Our LiteSwitch program takes the burden of switching plans off your shoulders.

Account Executive
Your Account Executive provides ongoing support after implementation and through the renewal.

Dedicated online transition center
New members have access to our online transition center, designed to answer common questions about changing plans. There, they can also find and fill out a Transition of Care Form to privately communicate their care needs.

Broker and Account Services and Support (BASS)
After enrollment, the experienced representatives on our BASS team are available to handle account eligibility inquiries, member-specific add/term requests, account and broker collateral requests, and administrative-related questions.

Prescription drug support
​We offer auto auth-placement for drugs that require PA and Step Therapy if a transition fill occurs in the first 120 days of a plan.* Non-covered drugs will be covered for the first 6 months based on the transition fill. We'll work with members to make a switch to a covered drug.**

Live customer service and online chat
Members can speak with one of our expert customer service professionals in English or Spanish by calling 866-414-5533, or use our convenient live online chat. We also offer translation services in more than 200 languages.

On-site enrollment health fairs
AllWays Health Partners representatives help provide clients and employees with information about the plan’s benefits, features, the provider network, and more.
 
Welcome calls and emails
A welcome message greets the new member within 24 hours and connects them with resources that explain their benefits and other important information and services.

* Approval length will vary based on the clinical indication for the drug.
** For excluded drugs (such as cosmetic, OTC not on the OTC list, drugs not FDA approved), the program does not apply.

World class service — guaranteed
AllWays Health Partners is the only health plan in the U.S. to offer personalized performance guarantees ranging from $20,000 to $50,000 for new business accounts with at least 100 eligible FTEs.*

Performance guarantee metrics include customer service call response time, first call resolution rate, and claims processing turnaround times.

*To qualify, the new account must have at least 80 enrolled on the AllWays Health Partners plan and be in good standing. Performance guarantee values vary depending on actual size of new employer customer: up to $20,000 for employers with at least 80 subscribers and up to $50,000 for employers with 500+ employees and 350 enrolled subscribers. Performance guarantees apply only to an employer’s first year with AllWays Health Partners. Upon renewal, other arrangements may mutually be agreed upon. Performance failures attributable to a force majeure event or an event beyond AllWays Health Partners control excluded from measurement.