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Neighborhood Health Plan to waive some copays

Neighborhood Health Plan is offering new insurance options that waive members’ out-of-pocket costs for a slate of common treatments and prescription drugs, an unusual step aimed at drawing new customers.

Typically, members of commercial health plans must pay copayments and other costs to see a doctor or obtain a prescription. But Neighborhood said it will start waiving those costs for services including nutritional counseling for diabetics, rehabilitation for heart patients, and acupuncture and physical therapy for patients suffering from pain.

Neighborhood is the first insurer in the country to waive out-of-pocket costs for members who choose certain treatments other than opioids for managing pain, executives said.


The nonprofit insurer is also planning to waive costs for 11 common drugs, including those used to treat high cholesterol, high blood pressure, heart disease, and depression.

Dr. Anton B. Dodek, chief medical officer at Neighborhood, said the Somerville-based insurer wants to encourage members to use drugs and medical services that help them manage their chronic diseases and prevent complications and hospital stays, which are ultimately more expensive than pills and regular visits to the doctor.

“What we really want to do is encourage people to get this necessary care by taking the cost-share out of the equation,” he said. “With patients being more compliant, we’re going to get higher satisfaction and [better] patient outcomes.”

Neighborhood is offering the new plans to large employers with hundreds or thousands of employees.

The nonprofit insurer, which is owned by Partners HealthCare, has struggled with financial losses over the past several years. Most of its business is in managing care for low-income patients on the state Medicaid program, called MassHealth.

But beginning next year, the company plans to significantly pare back its MassHealth business and focus predominantly on selling insurance to employers and their workers.

Neighborhood is among the smaller commercial health insurers in Massachusetts, with about 124,000 premium-paying members.


Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.