Each plan below has recorded coverage in Massachusetts. The lines of business shown are the ones that plan operates in this state — a carrier can run commercial business in one state and Medicaid managed care in the next, and each line is a separate contract.
Coverage data as of July 28, 2026. Payer footprints change with contract cycles; we verify against current payer requirements at the start of any engagement.
Marketplace plans are not listed for Massachusetts. Massachusetts runs its own health insurance exchange rather than using healthcare.gov, and the federal dataset behind this page covers only healthcare.gov states. Carriers selling on the Massachusettsexchange are therefore absent from the marketplace column — that is a gap in our source data, not an indication that none exist.
National carriers
National carriers credential centrally, so one application generally covers every state you practice in. Network participation and fee schedules are still contracted separately by state and by line of business.
| Payer | Parent company | Lines of business in Massachusetts | Credentialing guide |
|---|---|---|---|
| Aetna | CVS Health | CommercialMedicare Advantage | Full guide |
| Cigna Healthcare | The Cigna Group | Commercial | Full guide |
| GEHA | Independent | Commercial | — |
| Humana | Independent | Medicare Advantage | Full guide |
| Molina Healthcare | Independent | Medicare AdvantageMedicaid | Full guide |
| UnitedHealthcare | UnitedHealth Group | CommercialMedicare AdvantageMedicaid | Full guide |
Blue Cross Blue Shield plans
Blue Cross Blue Shield is a federation of independent licensees. Each plan credentials on its own — being in-network with one Blue plan does not make you in-network with another.
| Payer | Parent company | Lines of business in Massachusetts | Credentialing guide |
|---|---|---|---|
| Blue Cross Blue Shield Association | Independent | Commercial | Full guide |
| Blue Cross Blue Shield of Massachusetts | Independent | CommercialMedicare Advantage | Full guide |
Medicaid managed care
Medicaid managed-care organizations contract under a state Medicaid agency. Most require an active state Medicaid provider ID before they will begin credentialing, so the state enrollment has to finish first.
| Payer | Parent company | Lines of business in Massachusetts | Credentialing guide |
|---|---|---|---|
| BeHealthy Partnership Plan | Health New England | Medicaid | — |
| Berkshire Fallon Health Collaborative | Fallon Health | Medicaid | — |
| East Boston Neighborhood Health WellSense Alliance | WellSense Health Plan | Medicaid | — |
| Massachusetts Behavioral Health Partnership | Carelon Behavioral Health | Medicaid | — |
| Navicare HMO | Fallon Health | Medicaid | — |
Regional & local plans
Regional plans operate in a limited footprint and more often credential in-house rather than through a delegated CVO. Turnaround varies more than it does with national carriers.
| Payer | Parent company | Lines of business in Massachusetts | Credentialing guide |
|---|---|---|---|
| Commonwealth Care Alliance | CareSource | Medicare AdvantageMedicaid | — |
| eternalHealth | Eternal Health of Delaware | Medicare Advantage | — |
| Fallon Health | Independent | CommercialMedicare AdvantageMedicaid | — |
| Harvard Pilgrim Health Care | Point32Health | Commercial | — |
| Health New England | Baystate Health | CommercialMedicare Advantage | — |
| Mass Advantage | Central Mass Health Holding | Medicare Advantage | — |
| Mass General Brigham Health Plan | Mass General Brigham | CommercialMedicare AdvantageMedicaid | — |
| Point32Health | Independent | CommercialMedicare AdvantageMedicaid | — |
| Senior Whole Health by Molina Healthcare | Molina Healthcare | Medicaid | — |
| Tufts Health Plan | Point32Health | CommercialMedicare AdvantageMedicaid | — |
| WellSense Health Plan | Boston Medical Center Health System | CommercialMedicaid | — |
Networks & IPAs
Networks, IPAs, and rental networks aggregate provider panels. Joining one can reach several payers at once, but the contracting party is the network — not the payer whose members you end up seeing.
| Payer | Parent company | Lines of business in Massachusetts | Credentialing guide |
|---|---|---|---|
| ChoiceCare Network | Humana | Commercial | — |
| Evernorth Behavioral Health | Cigna Healthcare | Commercial | — |
| First Health Network | Aetna | Commercial | — |
| Galaxy Health Network | Independent | Commercial | — |
| HealthSmart | Independent | Commercial | — |
| MultiPlan (Claritev) | Claritev Corporation | Commercial | — |
| PHCS Network | MultiPlan (Claritev) | Commercial | — |
| Prime Health Services | Independent | Commercial | — |
| Three Rivers Provider Network (TRPN) | Independent | Commercial | — |
| UMR | UnitedHealthcare | Commercial | — |
| Zelis Network | Zelis Healthcare | Commercial | — |
Government programs
Government programs enroll providers through their own systems rather than commercial credentialing. Enrollment is usually a prerequisite for participating in the managed-care plans built on top of them.
| Payer | Parent company | Lines of business in Massachusetts | Credentialing guide |
|---|---|---|---|
| Humana Military | Humana | Government program | Full guide |
| Medicare (Original Medicare / Part A & B) | Centers for Medicare & Medicaid Services | Government program | Full guide |
| VA Community Care Network | U.S. Department of Veterans Affairs | Government program | — |
Credentialing in Massachusetts
Read our Massachusetts guide for how Medicare, state Medicaid, the local Blue plan, and the commercial carriers fit together: provider credentialing in Massachusetts.
Get in-network in Massachusetts
We handle the applications, the portals, and the follow-up until you have an effective date in hand.
Book a free consultationBook Online
Share your details and preferred availability.