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Welcome to
AlliesSM Choice HMO

You are now a member of the Allies Choice HMO Newton-Wellesley Hospital Community Plus Tiered plan. Watch the video to learn about your plan, then check out these simple steps to help you get off to a great start.

Step 1: Create an account on the member portal

The best way to get started with your new plan is to create an account on allwaysmember.org, your secure member portal. You'll be able to create an account after your effective date. There you'll find everything you need to manage your plan, like plan documents, claim statuses, a digital ID card, provider search, and more.
You can also download the AllWays Member app to manage your Allies Choice plan on the go.

Step 2: Get to know your plan

  • About the Allies Choice network: Newton-Wellesley Hospital Community Plus Tiered HMO

    Your care starts at Newton-Wellesley Hospital, the highest-ranking community hospital in Massachusetts by U.S. News and World Report, 2020-2021. 

    Within Newton-Wellesley Hospital, you get integrated primary and specialty care, including access to the hospital’s special areas of expertise: cardiology, oncology, maternity services and women’s health, orthopedics, and sports medicine.

    The limited tiered provider network also gives you access to Mass General Brigham’s renowned academic medical centers and specialty hospitals when your provider refers you. 

    This plan divides the limited tiered hospital network into higher and lower cost tiers: Tier 1 (lower cost) and Tier 2 (higher cost). In addition, the tiering is limited to these services:

    • Inpatient medical services
    • Outpatient diagnostic imaging and X-ray (including ultrasound)
    • Outpatient high-tech radiology (CT Scans, MRIs, etc.)
    • Outpatient surgery
    • Outpatient short-term rehabilitation (cardiac, physical, occupational, and speech therapy)
     

    You can search for a Newton-Wellesley Primary Care Provider or specialist in the provider directory. You can also use the directory to find tiering information for a specific service.

  • Your virtual care options

    Your virtual visit options are plentiful. (Money-saving, too.) You get $0 cost sharing for virtual visits with select PCPs, specialists, behavioral health, and 24/7 urgent care.

    You can also choose the Virtual First Primary Care option and see a provider within one business day upon request, schedule visits online, and pay $0 out of pocket for that visit. Of course, some office visits may be required and cost sharing may apply.

  • Your Member ID card

    Waiting for your new member ID card to arrive? No problem. We’ve made it easy for you to get a digital copy while you wait. Just visit allwaysmember.org and look for the “Get your card now” button.

  • Helpful tools and resources

    We’ve put our members most frequently used resources all on one page. See your Member Resource page. You can also log in to allwaysmember.org to access all your plan’s info and online tools.

Step 3: Choose a Newton‐Wellesley Hospital  Primary Care Provider (PCP)

If you already have a Newton-Wellesley Hospital PCP or chose one during open enrollment, you’re all set. But if you still need to select one, watch these videos to get to know several PCPs accepting new patients on the Allies PCPs page, or reach out to the Allies Health Navigator for more help.

You even have an option of choosing virtual primary care from the Virtual First Primary Care practice. Learn more about this digital experience that makes seeing your PCP easy and helps save on costs.

Once you've found the right PCP for you, be sure to schedule an appointment for a physical with your new provider so they can get to know you and your care needs.

Step 4: Transition your current care

  • Share your medical records with your new Primary Care Provider (PCP)

    Medical Records Transfer Request Form authorizes your former PCP or Specialist to share your medical records with your new PCP. Your Allies Health Navigator can help you with any questions you may have. They can be reached via the number on the back of your Member ID card

  • Complete a Transition of Care form

    Let us know as soon as possible if you or a family member have care that needs to continue with your new plan by completing and sending this Transition of Care form to us by email, mail, or fax. If you have any questions or need help, call us at 866‐643‐8392.

    If you or a family member:

    • Have an upcoming treatment, procedure, or surgery planned
    • Are having a baby (Congratulations!)
    • Take prescription drugs that require authorization
    • Plan to see specialists with referrals already in place
    • Rely on durable medical equipment (DME) such as a wheelchair or sleep apnea device (CPAP)
    • Are undergoing care for an illness, chronic condition (like diabetes and asthma), your behavioral health, or special needs
    • Receive infusions at a hospital or home
     

    We are here to make sure you continue to receive care during your transition to Allies – even helping you find an in‐network provider you might need.

Step 5: Get help when you need it from the Allies Health Navigator

Allies Health Navigators are ready to deliver an easier health experience. Simply call the number on the back of your Member ID card and follow the prompts to speak with one.

An Allies Health Navigator can help you:
  • Set up your Patient Gateway account
  • Transfer your medical records from your previous primary care provider (PCP) to your new one using a Medical Records Transfer Request Form
  • Identify providers that are right for you
  • Deliver shortened wait times (within 3 business days of primary care referral) for appointments with select specialists, including cardiology, orthopedics, dermatology, and gastroenterology.
  • Help streamline your care with Mass General Brigham hospitals, if appropriate
  • Provide answers to any coverage question or concern you might have.
IMPORTANT NOTICE: This plan includes a limited tiered provider network called Allies Choice HMO and provides access to a network that is smaller than AllWays Health Partners’ full commercial HMO provider network. Members have access to network benefits only from the providers in the Allies Choice HMO network and pay different levels of copayments, coinsurance, and/or deductibles depending on the tier of the provider delivering a covered service or supply. This plan may make changes to a provider’s benefit tier annually on January 1. Please consult the Allies Choice HMO provider directory or visit the provider search tool at allwayshealthpartners.org to determine which providers are included in the Allies Choice HMO network and the tier of those providers.