Orlando Harmon
Harvard Pilgrim is a not-for-profit health services company that provides health insurance plans to over a million members in the US. Founded in 1969, Harvard Pilgrim offers a variety of benefit options to fit different budgets and needs, including individual and family coverage. The company is consistently ranked among the nation's highest-rated health plans for quality and member satisfaction. Members can access a range of services, including wellness support, personal health coaching, nurse care managers, and online tools to help shop for providers and manage health and wellbeing.
| Characteristics | Values |
|---|---|
| Type | Health insurance |
| Company | Harvard Pilgrim Health Care |
| Year founded | 1969 |
| Area served | New Hampshire, Massachusetts, Maine, Connecticut |
| Number of members | More than one million |
| Plan options | Individual & Family, HMO, PPO, Limited Network plans (Focus NetworkSM, ElevateHealthSM), Tiered Network plans (ChoiceNet, Maine's ChoiceSM), Deductible/CDHP plans (Best Buy) |
| Coverage | In-network services, out-of-network services (higher out-of-pocket cost), annual physicals, flu shots, office visits, inpatient and outpatient care, pediatric vision benefits, chiropractic and acupuncture visits, emergency care, prescription drugs |
| Member support | Wellness support through personal health coaching, nurse care managers for chronic conditions or serious illnesses, online tools for provider selection and information access, member savings program for eyewear, fitness clubs, diet programs, dental care, and fitness reimbursements |
| Plan selection | Plan options depend on individual and family needs and budget; plans may have funding arrangements like HRA or HSA to meet deductibles |
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What You'll Learn
- Harvard Pilgrim Health Care offers a range of individual and family insurance plans
- The company provides a variety of benefit options to over one million members
- Members can choose from different tiers, each with varying costs and provider networks
- Harvard Pilgrim offers deductible/CDHP plans, which can be combined with an HRA or HSA account
- The company provides members with wellness support, personal health coaching, and online tools to manage their health
Harvard Pilgrim Health Care offers a range of individual and family insurance plans
Harvard Pilgrim Health Care is a not-for-profit health services company that provides health insurance plans to over a million members in New Hampshire, Massachusetts, Maine, and Connecticut. The company offers a range of individual and family insurance plans, with benefits and features to meet the needs of its members.
Harvard Pilgrim's individual and family plans provide comprehensive coverage, including preventive services such as annual physicals, flu shots, and coverage for office, inpatient, and outpatient care. The plans also include pediatric vision benefits for eye exams, glasses, or contacts for members under 18, as well as chiropractic and acupuncture visits. In addition, members have access to emergency care and a wide range of prescription drugs, including generic and brand-name options.
Harvard Pilgrim offers several types of plans, including HMO and PPO options. With an HMO plan, members receive care within Harvard Pilgrim's network, select a primary care provider (PCP), and obtain referrals for most of their medical needs. PPO plans, on the other hand, offer more flexibility, allowing members to go out of the network for a higher out-of-pocket cost.
Harvard Pilgrim also provides limited network plans, such as Focus Network and ElevateHealth, which offer lower costs due to a smaller network of providers. Tiered network plans, like ChoiceNet and Maine's Choice, are also available, where members pay different cost-sharing levels depending on the tier of the provider. Additionally, deductible/CDHP plans, such as Best Buy, can be either HMO or PPO, and members must meet a deductible before Harvard Pilgrim pays for the services.
Overall, Harvard Pilgrim Health Care offers a diverse range of individual and family insurance plans designed to fit the unique needs and budgets of its members. With a variety of benefit options, preventive services, and provider networks, Harvard Pilgrim aims to provide high-quality and valuable healthcare solutions.
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The company provides a variety of benefit options to over one million members
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. The company offers a variety of benefit options to meet the diverse needs of its members, with plans available for individuals, families, and employers.
One of the key advantages of Harvard Pilgrim's plans is their flexibility. Members can choose from various plan options, including HMO, PPO, and limited network plans. With an HMO plan, members receive care within Harvard Pilgrim's network, select a primary care provider (PCP), and obtain referrals for most of their medical needs. PPO plans, on the other hand, offer more flexibility, as members are covered for in-network services but can also go out of network for a higher out-of-pocket cost. Limited network plans, such as Focus NetworkSM and ElevateHealthSM, provide access to a smaller network of providers, resulting in lower costs for members.
Harvard Pilgrim also offers Tiered Network plans, where members pay different levels of cost-sharing based on the tier of the provider. This allows members to choose the tier that best suits their needs and budget. Additionally, the company provides Deductible/CDHP plans, which can be structured as HMO or PPO. With these plans, members meet a deductible before Harvard Pilgrim covers the cost of services. To assist with this, some plans may include funding arrangements like an HRA (Health Reimbursement Arrangement) or an HSA (Health Savings Account).
The company's comprehensive coverage includes a range of benefits such as annual physicals, flu shots, inpatient and outpatient care, pediatric vision benefits, chiropractic and acupuncture visits, emergency care, and coverage for thousands of prescription drugs, including generics and brand-name medications. Harvard Pilgrim also prioritizes member support and offers various tools and resources to promote health and well-being. This includes wellness support through personal health coaching, nurse care managers for those with chronic conditions, and online tools like now iKnowSM, which helps members choose providers based on cost and quality.
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Members can choose from different tiers, each with varying costs and provider networks
Harvard Pilgrim Health Care is a not-for-profit health services company that was founded in 1969. It provides health insurance plans to over a million members in New Hampshire, Massachusetts, Maine, and Connecticut.
Harvard Pilgrim offers a variety of health insurance plans to cater to different needs and budgets. Members can choose from different tiers, each with varying costs and provider networks. The provider tiers determine the price members pay for their services.
Tiered Network plans, such as ChoiceNet and Maine's Choice, can be either HMO or PPO plans. In HMO plans, members receive care within Harvard Pilgrim's network, select a primary care provider (PCP), and get referrals for most of their care. PPO plans, on the other hand, offer more flexibility, as members are covered for in-network services but can also go out of the network for a higher out-of-pocket cost.
Harvard Pilgrim's Tiered Network plans provide access to a limited provider network, which is smaller than their full provider network. Members' coverage is specific to the providers in the network of their chosen plan. The benefit tier of a provider within a particular plan's network may change annually on January 1st.
Harvard Pilgrim also offers Deductible/CDHP plans, such as Best Buy, which can also be structured as HMO or PPO plans. With these plans, members must meet a deductible before Harvard Pilgrim pays for their services. In some cases, these plans may include funding arrangements like HRAs (Health Reimbursement Arrangements) or HSAs (Health Savings Accounts) to assist members in reaching their deductibles.
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Harvard Pilgrim offers deductible/CDHP plans, which can be combined with an HRA or HSA account
Harvard Pilgrim Health Care offers a range of health insurance plans to meet the needs of individuals and families. One type of plan offered by Harvard Pilgrim is the deductible or Consumer-Directed Health Plan (CDHP). These plans have a deductible that must be met before Harvard Pilgrim starts paying for services. The deductible amount varies depending on the specific plan chosen.
The CDHP plans can be combined with a Health Reimbursement Arrangement (HRA) or a Health Savings Account (HSA) to help members meet their deductibles. With an HRA, employers decide which out-of-pocket expenses are covered and how unused funds are carried over or forfeited. On the other hand, HSAs are available to those enrolled in a qualified high-deductible health plan, whether through an employer or purchased individually. HSAs are never taxed at the federal income tax level for qualified medical expenses, and most states recognize HSA funds as tax-deductible.
Harvard Pilgrim's CDHP plans include the Best Buy HMO and PPO options, which provide access to a limited provider network that is smaller than their full network. Members are covered only for providers within this specific network. These plans may also include a funding arrangement, such as an HRA or HSA, to assist with meeting deductibles. It's important to note that not all plans are available to all employers and/or individual members.
In addition to CDHP plans, Harvard Pilgrim offers other types of plans such as Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) options. With an HMO plan, members receive care within the Harvard Pilgrim network, select a primary care physician (PCP), and obtain referrals for most of their medical needs. PPO plans offer in-network coverage and the flexibility to go out of the network for a higher out-of-pocket cost, without the need for referrals.
Harvard Pilgrim also provides Tiered Network plans, where members pay different cost-sharing levels depending on the tier of the provider. The benefit tier of a provider can change annually on January 1st, and members can refer to the Harvard Pilgrim provider directory or request a paper copy to determine a provider's tier. Overall, Harvard Pilgrim offers a range of deductible/CDHP plans with HRA or HSA options, ensuring that individuals and families can find a plan that suits their unique healthcare needs and preferences.
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The company provides members with wellness support, personal health coaching, and online tools to manage their health
Harvard Pilgrim Health Care is a health insurance provider that offers its members a range of wellness support services, personal health coaching opportunities, and online tools to help them manage their health effectively.
The company is committed to enhancing the health and wellness of its members and fostering healthier communities. To achieve this, they adopt a holistic approach, considering various aspects of health, such as healthy eating and nutrition, physical activity and fitness, mindfulness, and behavioural health.
Harvard Pilgrim members can access a comprehensive library of health topics covering behavioural health conditions, wellness, prevention, and life stages. This online resource enables members to take ownership of their health by providing valuable information and tools. Additionally, members can benefit from personal health coaching, allowing them to receive tailored guidance and support to achieve their health goals.
One notable offering is the Wellness Account program. This program is available to members who have access to Harvard Pilgrim through their employer or their spouse's employer. While specific details about the program are scarce, it appears to be an initiative that encourages and supports members in their pursuit of improved wellness.
By providing these comprehensive support services, online tools, and personal health coaching opportunities, Harvard Pilgrim empowers its members to take a proactive role in managing and improving their health and well-being. This holistic approach to health insurance contributes to the creation of healthier individuals and communities.
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Frequently asked questions
Harvard Pilgrim is a not-for-profit health services company that provides health insurance plans to over a million members.
Harvard Pilgrim offers individual and family plans, including HMO, PPO, and limited network plans.
Their comprehensive coverage includes preventive services like annual physicals, flu shots, and office visits. It also covers inpatient and outpatient care, pediatric vision and chiropractic benefits, emergency care, and a range of prescription drugs.
Harvard Pilgrim offers a variety of plans to fit different needs and budgets. You can visit their website to explore the full list of individual plan options and choose the tier of service that suits you best.
They offer wellness support through personal health coaching, nurse care managers for those with chronic conditions, and online tools to help members shop for providers and manage their health.
