Harvard Pilgrim And Taylor Benefits: Private Insurance Options

Harvard Pilgrim Health Care offers a range of health insurance plans for individuals and families in Massachusetts and New Hampshire. They provide comprehensive and innovative healthcare solutions that cater to diverse needs, regardless of age, health, race, identity, or income. Meanwhile, Taylor Benefits Insurance Agency, located in San Jose, California, specializes in providing group health insurance and employee benefit plans for businesses of all sizes. They have been operating since 1987 and pride themselves on offering affordable, quality benefits that help companies attract and retain the best employees.

Comprehensive health plans for individuals and families

Choosing a health insurance plan can be a complicated task, but comprehensive health plans for individuals and families can help keep you and your family healthy. Harvard Pilgrim, for example, offers a wide array of plans for individuals and families, including those with competitive prices and a popular statewide network plan. Their PPO plan gives you the freedom to see doctors anywhere in the country.

Harvard Pilgrim provides a variety of benefit options to over a million members in New Hampshire, Massachusetts, Maine, and Connecticut. Their comprehensive coverage includes no-cost preventive services, such as annual physicals, flu shots, and coverage for office visits, inpatient and outpatient care. They also offer pediatric vision benefits for eye exams and eyeglasses or contacts for members aged 18 and under, as well as chiropractic and acupuncture visits.

Additionally, Harvard Pilgrim covers emergency care, thousands of prescription drugs (including generics and brand-name medications), and provides wellness support through personal health coaching and nurse care managers for those with chronic conditions or serious illnesses.

When choosing a health insurance plan, it's important to consider not only the monthly premiums but also other out-of-pocket costs like deductibles, copayments, and coinsurance. Plans can be categorized into different "metal" levels, such as Bronze, Silver, Gold, and Platinum, which indicate how costs are shared between you and the plan. These categories are not indicative of the quality of care but rather the cost-sharing structure.

It's also worth noting that some plans offer more flexibility in choosing providers, while others may have specific networks of doctors and hospitals that you need to use to receive coverage. Understanding your specific needs and comparing the benefits, coverage, and services offered by different plans will help you make an informed decision about which comprehensive health plan is right for you and your family.

Medicare plans for those over 65

Harvard Pilgrim Health Care is a not-for-profit health services company that provides health insurance plans to over one million members in New Hampshire, Massachusetts, Maine, and Connecticut. They offer a variety of benefit options, including some of the most competitively priced plans in the state and a PPO that allows members to see doctors anywhere in the country.

If you are over 65 and looking for Medicare plans, there are a few options to consider. Firstly, there are Medicare health plans, which provide Part A (Hospital Insurance) and Part B (Medical Insurance) benefits. These plans are typically offered by private companies that contract with Medicare and include Medicare Advantage Plans (Part C), Medicare Cost Plans, Demonstrations/Pilots, and the Program of All-inclusive Care for the Elderly (PACE). Medicare Advantage Plans are a popular choice, as they are often offered by Medicare-approved private companies and include drug coverage (Part D). It is important to note that joining a Medicare Advantage Plan may cause you to lose your employer or union coverage, which could also affect your spouse and dependents.

Another option is to explore the Medicare Supplement plans offered by companies like Harvard Pilgrim. These plans can help simplify your options and allow you to take control of your healthcare needs. Harvard Pilgrim offers a variety of plan options to suit specific needs and provides educational resources to answer any questions you may have.

Additionally, when considering Medicare plans, it is worth looking into Special Enrollment Periods (SEPs). SEPs may be applicable if you have experienced certain life events, such as the loss of your previous coverage. By contacting the insurance company, you can find out if you qualify for a Special Enrollment Period and explore your plan options during this time.

Coverage for inpatient and outpatient care

Harvard Pilgrim is a private, not-for-profit health services company based in Canton, Massachusetts, serving the New England region of the United States. It was formed in 1994 from the merger of the Harvard Community Health Plan (HCHP) and the Pilgrim Health Plan.

Harvard Pilgrim offers a variety of benefit options to more than one million members in New Hampshire, Massachusetts, Maine and Connecticut. Their plans are designed to fit different needs and budgets, including competitively priced plans, a statewide network plan, and a PPO that provides coverage to see doctors anywhere in the country.

Harvard Pilgrim's comprehensive coverage includes no-cost preventive services such as annual physicals and flu shots, as well as coverage for office visits, inpatient and outpatient care. Inpatient care refers to hospitalisation and treatment received during a stay in a healthcare facility, such as a hospital or clinic. This can include emergency room visits, surgeries, and other procedures that require admission to the facility. Outpatient care, on the other hand, refers to medical services provided to patients who do not require hospitalisation. This can include visits to a doctor's office, diagnostic tests, and other treatments that can be safely administered without an overnight stay in a healthcare facility.

In addition to inpatient and outpatient care, Harvard Pilgrim's coverage extends to pediatric vision benefits for members under 18, chiropractic and acupuncture visits, emergency care, and a wide range of prescription drugs, including generic and brand-name options. They also offer member support services such as wellness coaching, nurse care managers for chronic conditions, and online tools to help members find providers and manage their health.

Reimbursements for gym memberships, fitness classes, etc

Harvard Pilgrim Health Care offers reimbursements for gym memberships, fitness classes, and more. This is a flexible program where you can get reimbursed for fees paid toward a fitness facility or other qualified memberships. This includes virtual fitness class subscriptions.

To qualify for reimbursement, you must be eligible through your Harvard Pilgrim plan. The membership must be for a minimum of four months in a calendar year, and the current Harvard Pilgrim membership must coincide with the four months of fitness membership. The fitness facility must be full-service, offering cardiovascular and strength-training equipment, or a facility for exercising and improving physical fitness.

Some examples of qualified memberships include aerobic/group classes, indoor cycling/spinning classes, indoor rock climbing, and personal training taught by a certified instructor.

It is important to note that fees for some group classes or personal training outside of a fitness facility/studio may not be covered. Health club initiation fees, instructional dance studios, country clubs, social clubs, spas, gymnastics facilities, martial arts schools, and pool-only facilities are also not eligible for reimbursement.

The reimbursement amount can be up to $150 or $300, depending on your specific plan. You can submit your reimbursement request online or by mail, and reimbursement typically takes up to eight weeks.

Discounts for local health and wellness services

Harvard Pilgrim Health Care is a non-profit health services company based in Canton, Massachusetts, serving the New England region of the United States. It is a private insurance provider, which means it is not a government insurance provider.

Harvard Pilgrim offers a range of benefits to its members, including discounts for local health and wellness services. These discounts can help members save money on various programs and services designed to promote health and well-being.

The specific discounts offered by Harvard Pilgrim for local health and wellness services may vary, but some possible examples include:

• Discounts on fitness and gym memberships: This could include reduced rates at local gyms or fitness centres, promoting regular exercise and active lifestyles.
• Reduced rates for wellness classes or workshops: Harvard Pilgrim may offer discounts on local wellness classes, such as yoga, meditation, or healthy cooking workshops, helping members improve their overall well-being.
• Savings on health-related products: Members may be able to access discounted prices on health-related products, such as fitness trackers, healthy food options, or natural wellness supplements.
• Discounts on alternative therapies: Harvard Pilgrim may provide savings on alternative therapies like chiropractic care, acupuncture, or massage therapy, offering additional ways to manage health and wellness.
• Local wellness event discounts: There may be reduced ticket prices or exclusive member rates for local wellness events, such as health fairs, 5K runs, or community wellness challenges, encouraging members to actively participate in health-promoting activities.

These discounts on local health and wellness services add value to Harvard Pilgrim membership, empowering individuals to take control of their health and well-being while also saving money. Members can contact Harvard Pilgrim directly or review their member benefits to learn about the specific discounts available to them and take advantage of these valuable offerings.

Frequently asked questions