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The largest health insurers in Massachusetts said they will ease the strain of medical costs for those injured in the Marathon bombing by waiving out-of-pocket fees, while three Boston hospitals promised to hold off mailing bills to those patients.

Donations have poured in to the One Fund launched last week by the city and the state to help those most affected by the April 15 attack, and to funds created by patients’ friends and families to offset treatment costs. But many who were seriously injured, including at least 14 who had limbs amputated, could require expensive medical and rehabilitative care for months to come.


Blue Cross Blue Shield of Massachusetts, the state's largest insurer, created a dedicated team of customer support specialists and caregivers to help members who were affected and to evaluate bills on a case-by-case basis, while Harvard Pilgrim Health Plan pledged to waive all out-of-pocket medical costs for those hurt during the bombing.

For Tufts Health Plan, the dramatic events hit close to home. Its corporate offices in Watertown are about four blocks away from where the police and the two bombing suspects engaged in a shoot-out early Friday morning.

The insurer plans to waive patient costs for both physical and mental health care resulting from the bombing and the manhunt that kept many Boston-area residents indoors for most of Friday.

“We are focused on making sure all our members have access to the care they need during this time,” said Sonya Hagopian, a Tufts spokeswoman. “The physical injuries are easier to determine, but the mental health component is important. Six months down the road, someone may have a hard time dealing with these issues.”

Hagopian said that, in the hours after the bombings, the company reached out to more than 1,200 mental health providers, nearly half of whom agreed to keep appointments open for those who need support.


Blue Cross identified 57 members who have received medical care for injuries caused by the bombings, including 18 who were hospitalized.

“Everything from hearing issues to prosthetics, to behavioral health services — we are committed to making sure that every Blue Cross member affected by this is getting the care that they need,” said spokesman Jay McQuaide.

Instead of waiving patient costs across the board, the company will review each case individually, McQuaide said, ensuring that “financial challenges are not an obstacle or a hurdle to our members.”

Harvard Pilgrim planned to waive copayments, deductibles, and other fees for members’ medical care for an indefinite period of time but hasn’t decided whether to extend the waiver to mental health care.

“The focus is clearly on getting well and getting the treatment they need, and this is a small act of kindness,” said spokeswoman Joan Fallon.

Thirteen people enrolled in Harvard Pilgrim plans were admitted to area hospitals, but Fallon said it has been difficult finding those who were treated in an emergency department and released or who sought care in the days that followed.

Most Massachusetts residents are required by state law to have health insurance. Under many plans, patients pay a percentage of hospital bills or a fee for each visit to a specialist — costs that can add up when a person has extensive medical and mental health needs.

The state has a safety net program that may cover some hospital charges for people who are low income or cannot afford their portion of bills. Less clear is what assistance is available for patients from other states, where state subsidies may be less generous.


People treated at some Boston hospitals may never see a bill.

The 39 patients treated at Massachusetts General Hospital after the bombing have been removed from an automated billing system, chief financial officer Sally Mason Boemer said.

Boemer said the hospital will continue billing insurance companies, but will hold back the patient portion with the hope of covering costs through donations to the hospital or assistance funds.

Brigham and Women’s Hospital and Tufts Medical Center, which combined treated at least 50 patients, planned to follow a similar model, according to spokesmen. Other major trauma centers declined to provide details of how they’re handling patient bills.

Health Care for All, a consumer group, and Health Law Advocates, which provides free legal assistance, have offered their helplines to anyone struggling with medical costs resulting from the bombing. Counselors can be reached at 1-800-272-4232.

Chelsea Conaboy can be reached at cconaboy@boston.com. Follow her on Twitter @cconaboy. Kay Lazar can be reached at klazar@globe.com. Follow her on Twitter @GlobeKayLazar.