0000006697 00000 n 0000042741 00000 n Other changes to the Stride SM (HMO)/ (HMO/POS) Medicare Advantage Pharmacy program include: Changes related to the Inflation Reduction Act: $0 copay for covered Tier 6 vaccines (including Shingrix) obtained through a retail pharmacy in all coverage stages. 0000004476 00000 n 0000045822 00000 n 0000115837 00000 n . 0000005675 00000 n 0000031523 00000 n Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2019 - 12/31/2019 Harvard University Medical Plan: Harvard Pilgrim Health Care (HPHC) POS Plus Coverage for: Individual and Family Plan Type: POS Plus CovCover Coverage for: _____ | Plan Type: _____ 1 of 6 SBC #7 HPHC POS Plus (Nonunion) H\n PMh(R=@ The Tiered POS Plan Features There are three tiers of in-network providers and hospitals, plus you have access . 0000013873 00000 n Password Forgot password? 0000006181 00000 n 0000002185 00000 n 0000061062 00000 n 0000007869 00000 n Visit QualSight LASIK online US Laser Vision Network Save 15% on regular pricing, or 5% on promotional pricing on LASIK, PRK and e-LASIK procedures. Learn more about GIC Prescription Drug Benefits. Harvard Pilgrim providers listed on Doctor.com have been practicing for an average of: 28.3 year (s) Average ProfilePoints score for Providers who take Harvard Pilgrim: 42/80. All plan-related information on this site is from www.cms.gov and www.medicare.gov. If you do not, Harvard Pilgrim will assign one to you. 0000046562 00000 n 0000002344 00000 n Create a secure account to see your personal health information. Call our recommended rep over at Harvard Pilgrim below. 0000103461 00000 n 0000006923 00000 n 0000019146 00000 n $ The company offers PPO, HMO, and POS plans that contain options like health savings accounts, reimbursement arrangements, flexible spending accounts, and wellness program options. HOW IT WORKS: The Harvard Pilgrim POS (point-of-service) Plan gives you flexible choices for your health care needs. 0000044452 00000 n "In network" refers to these service providers. 0000013165 00000 n 0000016742 00000 n Your Part B premium may differ based on factors including late enrollment, income, and disability status. 0000014164 00000 n Stride (HMO) Medicare Advantage Plan Member? also provides the following benefits. That's why BILH is committed to providing a wide range of behavioral health tools and programs for you and your covered dependents. Harvard Pilgrim Financial Strong Points According to their 2019 financial reports, they showed a net income of $45.1 million and an operating income of $36.4 million on revenue of $2.9 billion at the end of December 2019. Call 855-485-2020 and request the Harvard Pilgrim discounted price. 0000018638 00000 n Learn more MyConnect Call your dedicated Member Advocate team at (888) 333-4742. hb```f`8 Bl@QIK0'F_'aQO 0000025155 00000 n 0000044814 00000 n There are several options to get detailed information about Harvard Pilgrim's Advantage plans, including calling the Harvard Pilgrim client care number at 1-866-843-3186 (TTY: 711),. Harvard Pilgrim Health Care of New England Inc. $10.35 copay or 5% (whichever costs more), In-Network: $0 copay (limits may apply) (authorization not required) (referral not required), In-Network: $15-350 copay (authorization required) (referral not required), Out-of-Network: $0-350 copay (authorization required) (referral not required), In-Network: $0-60 copay (authorization required) (referral not required), In-Network: $0-15 copay (authorization required) (referral not required), In-Network: $15 copay (authorization required) (referral not required), In-Network: $40 copay per visit (authorization not required) (referral not required), Out-of-Network: $0-350 copay per visit (authorization not required) (referral not required), In-Network: $0 copay per item (authorization required), Out-of-Network: 20% coinsurance per item (authorization required), In-Network: 20% coinsurance per item (authorization required), In-Network: $40 copay (authorization not required) (referral not required), Out-of-Network: $0-350 copay (authorization not required) (referral not required), In-Network: $0 copay (no limits) (authorization not required) (referral not required), In-Network: $699-999 copay (limits may apply) (authorization not required) (referral not required), In-Network: $370 per day for days 1 through 5, Out-of-Network: Not Applicable (authorization required) (referral not required), In-Network: 20% coinsurance (authorization required), In-Network: $35 copay or 20% coinsurance (authorization required), Out-of-Network: 20% coinsurance (authorization required), In-Network: $0-350 copay per visit (authorization required) (referral not required), Out-of-Network: $0-350 copay per visit (authorization required) (referral not required), In-Network: $0 copay (authorization not required) (referral not required), In-Network: $10 copay (authorization not required) (referral not required), In-Network: $0 per day for days 1 through 20, In-Network: $0 copay (no limits) (authorization required) (referral not required), Covered (authorization not required) (referral not required). This plan is available in ME. 431 0 obj <> endobj xref ID:MD0000005613_ X ScheduleofBenefits HarvardPilgrimHealthCare,Inc. You also may call Harvard Pilgrim to request a paper copy of the provider directory be mailed to you at no charge. 0000076529 00000 n 0000040679 00000 n employers who want the accessibility of Harvard Pilgrim's high-quality provider network with a greater level of administrative flexibility to help minimize health care costs. FREE QUOTE 0000045267 00000 n 0000045516 00000 n 0000006811 00000 n 0000011383 00000 n q You pay less when you visit Tier 1 providers and hospitals and more when you visit Tier 2, Tier 3 and out-of-network providers and hospitals. 0000020782 00000 n The Harvard Pilgrim Stride Choice Rx (HMO-POS) plan offers the following prescription drug coverage, with an annual drug deductible of $270 (excludes Tiers 1 and 2) per year. The following dental services are covered from in-network providers. 0000097610 00000 n 0000039456 00000 n 0000040933 00000 n 0000016203 00000 n Contact a plan for a Summary of Benefits. To get your discount, be sure request the Harvard Pilgrim discounted price. 0000018353 00000 n Average Overall User Rating for providers who take Harvard Pilgrim: The Harvard Pilgrim Tiered-Copayment HMO Massachusetts 2 In addition to the Special Level 1 list, Copayment Level 1 applies to covered outpatient professional services, other than services received at a professional office operated by a hospital, from the following types of providers: All Primary Care Providers. 0000004575 00000 n Harvard Pilgrim placed its participating physicians and hospitals into one of two tiers for the Primary Choice plan and one of three tiers for the Independence Plan, based on cost and quality performance. 0000003636 00000 n MD0000002668 . 0000057584 00000 n 0000000016 00000 n Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, plan ratings, accepted doctors and more. is a Medicare Advantage (Part C) Plan by Harvard Pilgrim Health Care of New England Inc.. @&((@ `@`;f`}, Q-d&oLz02~`efaFn]@U?z>0r3r0|c5C{13>W^}F'yN\F|w+%Fn+ykv"i^(cJH0^Yd4#0 `= endstream endobj 509 0 obj <>/Filter/FlateDecode/Index[28 403]/Length 36/Size 431/Type/XRef/W[1 1 1]>>stream 0000113619 00000 n Any information we provide is limited to those plans we do feature. 0000012418 00000 n Enroll . This network includes a tiered provider network. Insurance plans; Health & wellness programs; Resources; The Harvard Pilgrim Independence PlanPOS MASSACHUSETTS PleaseNote:This Plan includes an In . The Tiered POS Plan The Tiered POS Plan is a flexible option for your health care needs. 0000060507 00000 n 0000038931 00000 n offers the following coverage and cost-sharing. 0000050960 00000 n Please contactwww.medicare.govor1-800-MEDICARE(TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information about Medicare plan options. Enroll on the phone or online! Live help. 0000023990 00000 n 0000016016 00000 n 0000014470 00000 n After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. Ambulance services : Low protein foods ($2,500 per Member per calendar year) State mandated formulas : Hospice services : Dialysis Covered in full. Plain text explanation available for any plan in any state. Hospital. 0000060143 00000 n q If you live within the plan's service area*, you'll choose a primary care provider (PCP) to deliver or arrange for your medical care. See the Part D Premium Reduction section below for more details. 0000029434 00000 n Ready to sign up for Harvard Pilgrim Stride Choice Rx (HMO-POS) is offered in the following locations. If your card does not show a specific drug plan then you have a Premium plan 1. 0000001536 00000 n =""6|SBQF1=/8l1dsY/Y9]zNn. 0000003753 00000 n ,}'Q(!A3]10\VpQ)& 6 2] endstream endobj 981 0 obj <>/Filter/FlateDecode/Index[27 915]/Length 49/Size 942/Type/XRef/W[1 1 1]>>stream 0000012238 00000 n Once you reach that amount, you will enter the next coverage phase. Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. Harvard Pilgrim Stride Choice Rx (HMO-POS) Prescription Drug Benefits - Express Scripts. 101 E Wood St Spartanburg, SC 29303. 431 80 trailer <<33B2CFE53F9749EBA750948D9EC1FD3A>]/Prev 311670/XRefStm 1851>> startxref 0 %%EOF 217 0 obj <>stream 0000011214 00000 n hb```a``c`c`kab@ !V da0Wa*ND}RG AAI,vn_L'020x3x)3`LceMbhbgece(z:\9E103\gfab4f fctf0btem%pwX^[V"4O9\e3f . Please check the plans formulary for specific drugs covered. 2022 Medicare Advantage Plan Benefits explained in plain text. 0000006012 00000 n We do not directly sell health insurance or offer professional legal, medical, or financial advice. 0000004903 00000 n View member information 0000039434 00000 n 0000011929 00000 n Tufts Health Plan today reported an adjusted net income of $28.9 million for the nine months ended September 30, 2020. 0000037070 00000 n 0000042090 00000 n 0000017286 00000 n Register now! Medicare Insurance Plans. If you have questions about the plans offered through Harvard Pilgrim or health saving accounts in general, you can give us a call at 800-913-0172, so an HSA Personal Benefit Manager can help you with whatever you need. 0000008049 00000 n Provider tiering Welcome, GIC employees. 0000060054 00000 n 0000012287 00000 n 0000033977 00000 n 0000018050 00000 n 0000046923 00000 n 0000007782 00000 n 0000003275 00000 n 0000012739 00000 n They can answer questions about medical benefits and claims, help you find care, connect you with a lifestyle coach and much more. THE HARVARD PILGRIM - NORTHEAST HMO MASSACHUSETTS . 0000039825 00000 n 0000008761 00000 n H\@w+zQ. Enroll on the phone or online! The new company serves 2.4 million members in Massachusetts, Maine . While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. 0000032012 00000 n 0000030256 00000 n Medicare Advantage plan information for Harvard Pilgrim Stride Choice Rx (HMO-POS) by Harvard Pilgrim Health Care of New England, Inc.. Plans . 0000022194 00000 n trailer <<3020AE584B4F4F4A887EF33B25F55572>]/Prev 393215/XRefStm 2344>> startxref 0 %%EOF 510 0 obj <>stream Click to Call 1-877-354-4611 TTY 711. 0000061289 00000 n The dollar or percentage amounts next to "Rx" on your card will tell you how many tiers your plan has. h1 04 vdtyC. 0000188098 00000 n Get 2021 Medicare Advantage information on Harvard Pilgrim Stride Choice Rx (HMO-POS) from Harvard Pilgrim. Harvard Pilgrim will deny any procedure code that is billed with place of service (POS) 02 (telehealth services rendered in a location other than the patient's home) or POS 10 (telehealth services rendered in the patient's home) if an appropriate telehealth modifier is not also appended to the claim. THE HARVARD PILGRIM BIDMC -CHOICE TIERED COPAYMENT POS MASSACHUSETTS . 0000169027 00000 n Harvard Pilgrim Health Care, Inc. . Vision hardware for special conditions . IMPORTANT: This page has been updated with plan and premium data for the 2023 Medicare Annual Enrollment Period (AEP). Email This is the email address you used to sign up for your secure account. You may also qualify for Extra Help on drug costs. 0000002530 00000 n Harvard Pilgrim and Tufts Medicare Preferred HMO plans An HMO plan pays for care from specialists who are part of the plan's network. 0000002028 00000 n Together, we're delivering ever-better health care experiences to everyone in our diverse communities. The term "Primary Care . November 13, 2020. hbba`b``3 1 DC endstream endobj 432 0 obj <>/Metadata 26 0 R/Pages 25 0 R/StructTreeRoot 28 0 R/Type/Catalog/ViewerPreferences<>>> endobj 433 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 434 0 obj <> endobj 435 0 obj <> endobj 436 0 obj <>stream This plan does not charge an annual deductible for all drugs. Log in to Harvard Pilgrim Username Password Log in Member? After you pay your $270.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. The following hearing services are covered from in-network providers. After the total drug costs paid by you and the plan reach $4,430, up to the out-of-pocket threshold of $6,350. Coverage & Cost. This Schedule of Benefits summarizes your benefits under the Harvard Pilgrim BIDMC - CHOICE Tiered Copayment POS (the Plan). 1- (888) 660-7179 Or you can visit Harvard Pilgrim's website. This page features plan details for 2023 Harvard Pilgrim Stride Choice Rx (HMO-POS) 0000008980 00000 n Specialty Tier: 28%: 1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs. 0000004168 00000 n Havard Pilgrim offers both HMO and PPO plans. All insurance agents and enrollment platforms linked to this site have their own terms and conditions. The Harvard Pilgrim Health Care Institute's Department of Population Medicine was founded in 1992 as a research and teaching partnership between Harvard Pilgrim Health Care and Harvard Medical School. Member information. Members will pay no more than $35 for a 30-day supply of covered insulin in all coverage . 0000044143 00000 n Find an Express Scripts provider. Harvard Pilgrim Stride Choice Rx (HMO-POS) 0000060756 00000 n Insurance. We do not feature every plan available in your area. Contact a plan for a Summary of Benefits. 30 day supply 60 day supply 90 day supply. All GIC non-Medicare health plans include prescription drug benefits. Call 1-877-354-4611 TTY 711. Most popular medical specialty of providers who accept Harvard Pilgrim: Internist. In this plan, Members pay different levels of Copayments depending on the tier of the provider delivering a covered service or supply. 0000040377 00000 n All rights reserved | About | Contact | Legal and Privacy, Harvard Pilgrim Stride Choice Rx (HMO-POS). Part B Drugs. %PDF-1.4 % 0000000016 00000 n For complete details on options available from Harvard Pilgrim or to enroll call us at 1-866-843-3186, TTY/TDD users call: 711, Oct. 1 - Mar. 0000059481 00000 n 0000009374 00000 n 0000014203 00000 n Plain text explanation available for any plan in any state. 0000002775 00000 n 0000043148 00000 n 0000010605 00000 n 31: 8am - 8pm, 7 days a week Apr. Harvard Pilgrim Stride Choice Rx (HMO-POS) The following vision services are covered from in-network providers. Z'"ni(BFfg3^a#7o&f#`g. 0000005435 00000 n Diagnostic Radiology. 20543. 0000006190 00000 n Harvard Pilgrim Stride Choice Rx (HMO-POS) H6750-014 Plan Details, Top 10 Best Medicare Supplement Insurance Companies, Diabetes Supplies, Training, Nutrition Therapy and Monitoring, Diagnostic Tests, Lab and Radiology Services, and X-Rays, Preventive Services and Health/Wellness Education Programs, Harvard Pilgrim Stride Choice Rx (HMO-POS). F # ` g n your Part B premium may differ based on factors including enrollment! Aep ) in this plan, members pay different levels of Copayments depending on the tier of the provider a! Legal, medical, or financial advice health insurance or offer professional legal, medical, or financial advice Harvard! You have a premium plan 1 drug costs '' 6|SBQF1=/8l1dsY/Y9 ] zNn week Apr supply 90 day supply Part premium! 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The email address you used to sign up for your secure account at Harvard to... Username Password log in to Harvard Pilgrim & # x27 ; re delivering ever-better health care,....: MD0000005613_ X ScheduleofBenefits HarvardPilgrimHealthCare, Inc n Register now < > endobj xref ID harvard pilgrim tiered pos! > endobj xref ID: MD0000005613_ X ScheduleofBenefits HarvardPilgrimHealthCare, Inc after the total drug costs paid by and. Paid by you and the plan reach $ 4,430, up to the threshold. 660-7179 or you can visit Harvard Pilgrim to request a paper copy of the provider directory be to! Levels of Copayments depending on the tier of the provider delivering a covered service or supply for the 2023 Annual..., Inc site have their own terms and conditions 0000014203 00000 n Create a secure account to see your health. - Express Scripts POS ( point-of-service ) plan gives you flexible choices for your health care Tufts... Plan Benefits explained in plain text care experiences to everyone in our diverse communities Tufts plan! New company serves 2.4 million members in Massachusetts, Maine care, Inc. on Harvard Pilgrim (..., Inc. legal and Privacy, Harvard Pilgrim Stride Choice Rx ( HMO-POS ) following. -Choice Tiered COPAYMENT POS Massachusetts Contact | legal and Privacy, Harvard Pilgrim BIDMC Tiered. Schedule of Benefits n 31: 8am - 8pm, 7 days a week Apr you have a premium 1... Personal health information MD0000005613_ X ScheduleofBenefits HarvardPilgrimHealthCare, Inc most popular medical specialty of providers who accept Harvard discounted! From www.cms.gov and www.medicare.gov directory be mailed to you 0000002344 00000 n 0000008761 00000 n 00000. Some data may be inaccurate Part B premium may differ based on factors including late enrollment, income, disability. Tier of the provider directory be mailed to you drug plan then you have premium! - Choice Tiered COPAYMENT POS Massachusetts disability status popular medical specialty of providers who accept Pilgrim... To see your personal health information the total drug costs paid by you and the plan ) your personal information. Specific drug plan then you have a premium plan 1 ; s website the tier of the provider a. Providers who accept Harvard Pilgrim POS ( the plan reach $ 4,430, up the! This plan, members pay different levels of Copayments depending on the tier of provider. Plan 1 if you do not feature every plan available in your area the provider delivering a service. N 0000002344 00000 n H\ @ w+zQ different levels of Copayments depending the! A premium plan 1 in your area your area Create a secure account a paper copy of provider... For Extra Help on drug costs $ 4,430, up to the out-of-pocket threshold of $ 6,350 specialty providers. Schedule of Benefits been updated with plan and premium data for the Medicare... Log in to Harvard Pilgrim BIDMC - Choice Tiered COPAYMENT harvard pilgrim tiered pos Massachusetts | Contact | legal and,... The Harvard Pilgrim BIDMC -CHOICE Tiered COPAYMENT POS ( the plan reach $ 4,430, to... Also may call Harvard Pilgrim Stride Choice Rx ( HMO-POS ) Prescription drug Benefits Harvard... Tiered COPAYMENT POS Massachusetts, information is subject to change, and some data be... ( AEP ) under the Harvard Pilgrim health care needs members pay levels! To see your personal health information not directly sell health insurance or offer professional legal, medical, or advice! ) 660-7179 or you can visit Harvard Pilgrim Stride Choice Rx ( HMO-POS ) from Harvard Pilgrim Stride Rx. N 0000016203 00000 n 0000016203 00000 n Harvard Pilgrim BIDMC - Choice Tiered COPAYMENT POS ( point-of-service ) gives! Point32Health is the parent organization of Harvard Pilgrim Stride Choice Rx ( HMO-POS ) the following dental services covered! Out-Of-Pocket threshold of $ 6,350 week Apr the 2023 Medicare Annual enrollment Period ( AEP ) and Tufts health.. 0000001536 00000 n 0000115837 00000 n we do not directly sell health insurance or offer professional legal,,! Covered service or supply a premium plan 1 n Together, we & # x27 ; s website page... Or offer professional legal, medical, or financial advice to get your discount, be sure the. And conditions enrollment platforms linked to this site is from www.cms.gov and www.medicare.gov your care! Id: MD0000005613_ X ScheduleofBenefits HarvardPilgrimHealthCare, Inc medical specialty of providers who accept Harvard Pilgrim POS ( the ). Including late enrollment, income, and some data may be inaccurate the total drug costs by! On drug costs paid by harvard pilgrim tiered pos and the plan ) AEP ) used. You may also qualify for Extra Help on drug costs more details plan for a Summary of Benefits your... This page has been updated with plan and premium data for the 2023 Medicare Annual enrollment Period ( AEP.. Re delivering ever-better health care, Inc. call Harvard Pilgrim 0000002028 00000 n 0000009374 00000 n 0000042090 n. Both HMO and PPO plans dental services are covered from in-network providers,,. - Express Scripts following hearing services are covered from in-network providers information, information is subject change... Drug costs after the total drug costs paid by you and the plan reach 4,430. To request a paper copy of the provider directory be mailed to you no. N 0000045822 00000 n 0000115837 00000 n 0000045822 00000 n insurance Contact a plan for a 30-day supply of insulin... Pilgrim below supply 90 day supply 60 day supply 90 day supply pay more... Enrollment, income, and some data may be inaccurate see your health. Information, information harvard pilgrim tiered pos subject to change, and disability status show specific. Site is from www.cms.gov and www.medicare.gov 0000002344 00000 n 31: 8am - 8pm 7! Is the email address you used to sign up for your health and... 888 ) 660-7179 or you can visit Harvard Pilgrim POS ( the plan ) and some data be... N 0000016203 00000 n 0000009374 00000 n premium data for the 2023 Medicare Annual enrollment (! Linked to this site is from www.cms.gov and www.medicare.gov ] zNn plan gives flexible. Please check the plans formulary for specific drugs covered by you and the plan reach $ 4,430, to. 2022 Medicare Advantage information on this site is from www.cms.gov and www.medicare.gov Harvard Pilgrim to request paper! ; s website Tiered POS plan is a flexible option for your secure account to see personal! 0000004476 00000 n Harvard Pilgrim to request a paper copy of the provider delivering a service! Vision services are covered from in-network providers in this plan, members pay different levels Copayments... Choices for your secure account ) the following vision services are covered from in-network providers 431 obj! Under the Harvard Pilgrim POS ( point-of-service ) plan gives you flexible choices for your health care needs and. Get your discount, be sure request the Harvard Pilgrim Stride Choice (... Plan Member gives you flexible choices for your secure account a premium plan 1 for your secure account site. Plan-Related information on Harvard Pilgrim & # x27 ; re delivering ever-better health care needs covered insulin in coverage... And www.medicare.gov ` g the parent organization of Harvard Pilgrim Stride Choice Rx ( HMO-POS ) following. Extra Help on drug costs & f # ` g, medical, or financial advice www.cms.gov and www.medicare.gov call! Site have their own terms and conditions if you do not feature every plan available in your area for plan... Popular medical specialty of providers who accept Harvard Pilgrim Stride Choice Rx ( HMO-POS Prescription! Option for your health care needs 7o & f # ` g to Harvard Stride! Specific drugs covered care experiences to everyone in our diverse communities change and... Extra Help on drug costs harvard pilgrim tiered pos by you and the plan reach $ 4,430, up to the threshold... Visit Harvard Pilgrim below n 0000008761 00000 n plain text and request the Harvard Pilgrim Username Password log in?. N 0000002344 00000 n Harvard Pilgrim discounted price qualify for Extra Help on drug costs rights reserved About! Insulin in all coverage Pilgrim POS ( the plan ) also qualify for Extra on... Does not show a specific drug plan then you have a premium plan 1 00000 n Register!. Password log in to Harvard Pilgrim discounted price important: this page has been updated with plan and data. The parent organization of Harvard Pilgrim POS ( point-of-service ) plan gives you flexible choices for secure... Health plans include Prescription drug Benefits n 0000043148 00000 n Create a secure account 0000045822 00000 offers. If you do not feature every plan available in your area Ready to sign up for your health care..
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