Healthy Actions Program by BCBS Massachusetts
This document outlines the Healthy Actions Program offered by Blue Cross Blue Shield of Massachusetts. It provides detailed instructions on how to participate and earn rewards for healthy choices. Discover how you can get started and make positive changes to your health with this guide.
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How do I fill this out?
Filling out this form is straightforward and can be done online. First, register on the Healthy Actions website and complete the health assessment. You may need to involve your doctor for a health review to proceed.

How to fill out the Healthy Actions Program by BCBS Massachusetts?
1
Register online at www.healthy-actions.com.
2
Complete the online health assessment.
3
Have your clinician complete the Health Review form.
4
Submit the form via fax or mail.
5
Receive your reward upon approval.
Who needs the Healthy Actions Program by BCBS Massachusetts?
1
Individuals looking to improve their health and wellness.
2
Employees of companies that offer the Healthy Actions Program.
3
People looking to earn rewards for participating in health activities.
4
Patients who need to submit health-related documents.
5
Doctors who need to provide health review forms for their patients.
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What are the instructions for submitting this form?
To submit this form, you can either fax it to 440-934-9850 or mail it to Healthy Actions at 36711 American Way Suite 2F, Avon, Ohio 44011. Ensure you deliver the form promptly to speed up the approval process for your health rewards. For online submission, head to the Healthy Actions website and follow the guidelines provided.
What are the important dates for this form in 2024 and 2025?
Ensure to complete your submissions before your employer's plan renewal date to qualify for the Healthy Actions rewards in 2024 and beyond.

What is the purpose of this form?
The purpose of this form is to facilitate participation in the Healthy Actions Program designed by Blue Cross Blue Shield. By completing this form, individuals can outline their health status and eligibility for rewards based on their healthy behaviors. It is aimed at promoting wellness and offering financial incentives for making healthy lifestyle choices.

Tell me about this form and its components and fields line-by-line.

- 1. Personal Information: Includes name, address, and contact information.
- 2. Health Assessment: Section for completing a health assessment based on questionnaire.
- 3. Clinician Health Review: Section where the clinician's health review information is documented.
What happens if I fail to submit this form?
Failing to submit this form may result in losing out on valuable health rewards. Additionally, not submitting on time could prevent participation in the Healthy Actions Program for that plan year.
- Lost Rewards: You won't receive any financial incentives.
- Ineligibility for Future Programs: May impact eligibility for future health initiatives or plans.
- Medical Risks: Not undergoing the health review could overlook significant health issues.
How do I know when to use this form?

- 1. Health Improvement Participation: To record information to participate in a health improvement program.
- 2. Reward Eligibility: To ensure eligibility for the available health rewards.
- 3. Routine Check-ups: To provide a summary of recent health check-ups and screenings.
Frequently Asked Questions
How do I start the process?
Begin by registering online at the Healthy Actions website.
What if I don't have a printer?
You can use the online submission options available.
Can I edit the PDF after downloading?
Yes, you can use editing software to make further changes.
How long does it take to receive rewards?
Rewards are typically processed within two to three weeks.
Do I need a doctor's visit?
A health review by your doctor is necessary to participate.
What if my health needs improvement?
You can still receive a $100 reward with a set health goal.
Is preventive care included?
Yes, certain preventive care services are covered at no cost.
What should I do if I'm not eligible?
You can wait until the next plan year to participate.
Can I submit the form online?
Yes, it can be submitted through various online methods.
Are there specific requirements?
All requirements must be met before your plan renews.
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