The $270.00 annual deductible only applies to drugs on certain tiers. 0000004575 00000 n Call our recommended rep over at Harvard Pilgrim below. View Locations. Find an Express Scripts provider. 0000003931 00000 n Z'"ni(BFfg3^a#7o&f#`g. 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. Tufts Health Plan today reported an adjusted net income of $28.9 million for the nine months ended September 30, 2020. 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. Average Overall User Rating for providers who take Harvard Pilgrim: Free Quotes Call us 24/7 at (800) 695-5748 Harvard Pilgrim is a not-for-profit health services company that has been in business since 1969. =""6|SBQF1=/8l1dsY/Y9]zNn. 0000040294 00000 n Castle Connolly Top Doctor Since: 2022. Call 855-485-2020 and request the Harvard Pilgrim discounted price. 0000075980 00000 n Member information. 0000006181 00000 n October 1 - March 31 8 a.m. - 8 p.m. 7 days a week Need help with your account? 0000016203 00000 n 0000002344 00000 n The following hearing services are covered from in-network providers. Harvard Pilgrim Stride Choice Rx (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by Harvard Pilgrim Health Care, Inc.. Plan ID: H6750-014. is a Medicare Advantage (Part C) Plan by Harvard Pilgrim Health Care of New England Inc.. 0000060507 00000 n Insurance plans; Health & wellness programs; Resources; 0000008761 00000 n 0000032012 00000 n This page features plan details for 2023 Harvard Pilgrim Stride Choice Rx (HMO-POS) Ni!lu6?6QUj2zn`]oi{ 0000014470 00000 n 0000005675 00000 n Coverage & Cost. 0000058737 00000 n 0000097649 00000 n Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. 0000012287 00000 n MD0000002668 . $ 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. 0000006697 00000 n Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLC and National Insurance Markets, Inc 0000113658 00000 n 0000022194 00000 n Learn about Express Scripts. Schedule of Benefits . 0000005435 00000 n Get the Facts on Medicare . 0000001851 00000 n Harvard Pilgrim Health Care, Inc. Once you reach that amount, you will enter the next coverage phase. Enroll on the phone or online! Get 2021 Medicare Advantage information on Harvard Pilgrim Stride Choice Rx (HMO-POS) from Harvard Pilgrim. In this plan, Members pay different levels of Copayments depending on the tier of the provider delivering a covered service or supply. All Medicare Advantage and Part D Plans Facts . 0000014164 00000 n 0000050960 00000 n Vision hardware for special conditions . 0000012739 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. Medicare Advantage plan information for Harvard Pilgrim Stride Choice Rx (HMO-POS) by Harvard Pilgrim Health Care of New England, Inc.. Plans . Ready to sign up for Harvard Pilgrim Stride Choice Rx (HMO-POS) 0000044903 00000 n 0000004903 00000 n 0000008875 00000 n 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. 0000060993 00000 n THE HARVARD PILGRIM TIERED COPAYMENT HMO MASSACHUSETTS This Schedule of Benefitssummarizes your Benefitsunder The Harvard Pilgrim Tiered Copayment HMO (the Plan) and states the Member Cost Sharing amounts that you must pay for Covered Benefits.However, it is only a summary of your benefits.Please see your BenefitHandbook and The new company serves 2.4 million members in Massachusetts, Maine . All rights reserved | About | Contact | Legal and Privacy, Harvard Pilgrim Stride Choice Rx (HMO-POS). 0000040933 00000 n 0000045822 00000 n This network includes a tiered provider network. 0000044452 00000 n 0000023990 00000 n 0000039825 00000 n Contact Member Services at (888) 333-4742. 0000103461 00000 n 0000169027 00000 n 0000007869 00000 n 0000042741 00000 n "In network" refers to these service providers. ? 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. Please check the plans formulary for specific drugs covered. 0000041239 00000 n 0000059481 00000 n 0000076529 00000 n Login - Harvard Pilgrim Login Please enter your email address and password so we can identify you. 0000020782 00000 n h1 04 vdtyC. 0000008049 00000 n 0000057465 00000 n Enroll . 0000031523 00000 n The dollar or percentage amounts next to "Rx" on your card will tell you how many tiers your plan has. After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00. (800) 836-7536 or (215) 728-2273. 0000040679 00000 n Insurance. For in-network coverage, your PCP must provide or arrange for your care (except in emergencies). 0000010605 00000 n Harvard Pilgrim Health Care, Inc. 0000030256 00000 n Under our parent company, Harvard Pilgrim, we independently administer many PPO plans as well as some EPO, POS and HMO plans. trailer <<3020AE584B4F4F4A887EF33B25F55572>]/Prev 393215/XRefStm 2344>> startxref 0 %%EOF 510 0 obj <>stream Visit MedicareAdvantage.com to compare multiple Medicare Advantage plans, side by side. Chemotherapy drugs. For California residents, CA-Do Not Sell My Personal Info, Click here. This Schedule of Benefits summarizes your benefits under the Harvard Pilgrim BIDMC - CHOICE Tiered Copayment POS (the Plan). hb```a``c`c`kab@ !V da0Wa*ND}RG AAI,vn_L'020x3x)3`LceMbhbgece(z:\9E103\gfab4f fctf0btem%pwX^[V"4O9\e3f . While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. H\n PMh(R=@ Together, we're delivering ever-better health care experiences to everyone in our diverse communities. %PDF-1.4 % trailer <<33B2CFE53F9749EBA750948D9EC1FD3A>]/Prev 311670/XRefStm 1851>> startxref 0 %%EOF 217 0 obj <>stream 0000018050 00000 n 0000012418 00000 n 0000059083 00000 n Harvard Pilgrim Health Care is a non-profit health services company based in Canton, Massachusetts serving the New England region of the United States.. On August 14, 2019, the boards of Harvard Pilgrim Health Care and Tufts Health Plan announced plans for the two insurers to merge their organizations into a new company. 0000006923 00000 n 0000017286 00000 n 0000019146 00000 n 0000029434 00000 n Prescription Drug Benefits - Express Scripts. See the Part D Premium Reduction section below for more details. Your Part B premium may differ based on factors including late enrollment, income, and disability status. 0000059172 00000 n 0000046562 00000 n November 13, 2020. Havard Pilgrim offers both HMO and PPO plans. We do not feature every plan available in your area. 2021 Medicare Advantage Plan Benefits explained in plain text. 1- (888) 660-7179 Or you can visit Harvard Pilgrim's website. 0000009374 00000 n 0000040377 00000 n offers the following coverage and cost-sharing. All insurance agents and enrollment platforms linked to this site have their own terms and conditions. The Tiered POS Plan The Tiered POS Plan is a flexible option for your health care needs. Hospital. To get your discount, be sure request the Harvard Pilgrim discounted price. 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) 0000027309 00000 n 0000012238 00000 n 0000009458 00000 n Stride (HMO) Medicare Advantage Plan Member? 0000076233 00000 n 0000016193 00000 n 0000176095 00000 n Learn more MyConnect Call your dedicated Member Advocate team at (888) 333-4742. Part B Drugs. 0000018353 00000 n q Your plan has in-network coverage and out-of-network coverage, which gives you flexibility hb```f`8 Bl@QIK0'F_'aQO 0000113619 00000 n is offered in the following locations. 31: 8am - 8pm, 7 days a week Apr. H6750 014 0 available in Most of New Hampshire. 431 80 THE HARVARD PILGRIM - NORTHEAST HMO MASSACHUSETTS . 0000007300 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. Live help. H\@w+zQ. 0000042090 00000 n 0000188098 00000 n 0000005588 00000 n 156 62 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. Medicare has neither approved nor endorsed any information on this site. Overview. 0000115837 00000 n 0000018231 00000 n 0000020237 00000 n Are you the PPO plan for Harvard Pilgrim? 0000039434 00000 n 0000011765 00000 n 0000011383 00000 n . 0000006722 00000 n 0000011929 00000 n For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.. 0000002028 00000 n It is the nation's first medical school appointing department based in a health plan. The company offers PPO, HMO, and POS plans that contain options like health savings accounts, reimbursement arrangements, flexible spending accounts, and wellness program options. Got Questions? Password Forgot password? You may also qualify for Extra Help on drug costs. 0000006610 00000 n 0000060756 00000 n 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. 0000006012 00000 n 0000060054 00000 n Medicare Insurance Plans. If you do not, Harvard Pilgrim will assign one to you. 0000003327 00000 n 0000009377 00000 n 0000005092 00000 n q It includes three tiers of in-network providers and hospitals, plus access to out-of-network providers and hospitals if you need it. Plain text explanation available for any plan in any state. 0000060143 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. You also may call Harvard Pilgrim to request a paper copy of the provider directory be mailed to you at no charge. 0000017744 00000 n 0000004168 00000 n ID:MD0000005613_ X ScheduleofBenefits HarvardPilgrimHealthCare,Inc. Harvard Pilgrim Stride Choice Rx (HMO-POS) Members will pay no more than $35 for a 30-day supply of covered insulin in all coverage . Create a secure account to see your personal health information. Log in to Harvard Pilgrim Username Password Log in Member? Harvard Pilgrim Stride Choice Rx (HMO-POS) Medicare Advantage with Part D plan details and help for Harvard Pilgrim Stride Choice Rx (HMO-POS) offered by Harvard Pilgrim Health Care of New England, Inc.. Health Plan Radar. 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). 2022 Medicare Advantage Plan Benefits explained in plain text. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLC and National Insurance Markets, Inc
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