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harvard pilgrim tiered pos

0000003636 00000 n 0000008533 00000 n 0000004903 00000 n Cost. The Tiered POS Plan The Tiered POS Plan is a flexible option for your health care needs. 0000012739 00000 n 0000020782 00000 n October 1 - March 31 8 a.m. - 8 p.m. 7 days a week Hospital. 0000045267 00000 n 2021 Medicare Advantage Plan Benefits explained in plain text. 20543. Factsonmedicare.com is a free-to-use informational website. 0000059083 00000 n HMOs and HMO Point-of-Service (HMO-POS) plans are the two primary insurance categories offered by Harvard Pilgrim. 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),. After the total drug costs paid by you and the plan reach $4,430, up to the out-of-pocket threshold of $6,350. It is the nation's first medical school appointing department based in a health plan. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. H6750 014 0 available in Most of New Hampshire. Prescription Drug Benefits - Express Scripts. Harvard Pilgrim Stride Choice Rx (HMO-POS) 0000188098 00000 n Get help from a licensed Medicare agent. 0000025155 00000 n Specialty Tier: 28%: 1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs. 0000003275 00000 n 0000016277 00000 n 431 80 0000040294 00000 n Get the Facts on Medicare . 0000005435 00000 n Call 855-485-2020 and request the Harvard Pilgrim discounted price. Or, visit QualSight LASIK online. Most popular medical specialty of providers who accept Harvard Pilgrim: Internist. 0000005675 00000 n Gibbs Cancer Center And Research Institute. 0000061062 00000 n Harvard Pilgrim Stride Choice Rx (HMO-POS) See the Part D Premium Reduction section below for more details. Are you the PPO plan for Harvard Pilgrim? Live help. 0000009458 00000 n Login - Harvard Pilgrim Login Please enter your email address and password so we can identify you. 0000040679 00000 n Insurance plans; Health & wellness programs; Resources; 0000042395 00000 n 0000012418 00000 n All plan-related information on this site is from www.cms.gov and www.medicare.gov. For California residents, CA-Do Not Sell My Personal Info, Click here. Register now! This network includes a tiered provider network. All insurance agents and enrollment platforms linked to this site have their own terms and conditions. (800) 836-7536 or (215) 728-2273. 0000045822 00000 n 0000017465 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 Part B Drugs. %PDF-1.4 % Your Part B premium may differ based on factors including late enrollment, income, and disability status. 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. 0000004575 00000 n This Schedule of Benefits summarizes your benefits under the Harvard Pilgrim BIDMC - CHOICE Tiered Copayment POS (the Plan). 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. Password Forgot password? Ni!lu6?6QUj2zn`]oi{ The $270.00 annual deductible only applies to drugs on certain tiers. 0000075980 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. They can answer questions about medical benefits and claims, help you find care, connect you with a lifestyle coach and much more. 0000017286 00000 n Under our parent company, Harvard Pilgrim, we independently administer many PPO plans as well as some EPO, POS and HMO plans. 0000006811 00000 n THE HARVARD PILGRIM BIDMC - CHOICE POS - MASSACHUSETTS 1 3-SPF, 01/12 . 0000009374 00000 n 0000061289 00000 n 0000003931 00000 n Coverage & Cost. Harvard Pilgrim Stride Choice Rx (HMO-POS) 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. 0000113658 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) 0000013688 00000 n 101 E Wood St Spartanburg, SC 29303. 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). 0000016203 00000 n Medicare Insurance Plans. 0000115837 00000 n 0000031523 00000 n The new company serves 2.4 million members in Massachusetts, Maine . 0000044143 00000 n Average Overall User Rating for providers who take Harvard Pilgrim: Forgot password or username? Any information we provide is limited to those plans we do feature. 0000008049 00000 n 0000022994 00000 n ? Members will pay no more than $35 for a 30-day supply of covered insulin in all coverage . 0000005588 00000 n Schedule of Benefits . 0000007869 00000 n ID:MD0000005613_ X ScheduleofBenefits HarvardPilgrimHealthCare,Inc. 0000060507 00000 n You may also qualify for Extra Help on drug costs. 0000113619 00000 n 0000046923 00000 n 0000060740 00000 n All rights reserved | About | Contact | Legal and Privacy, Harvard Pilgrim Stride Choice Rx (HMO-POS). 0000176095 00000 n 0000030256 00000 n . 0000060993 00000 n 0000006181 00000 n You also may call Harvard Pilgrim to request a paper copy of the provider directory be mailed to you at no charge. The following dental services are covered from in-network providers. Contact Member Services at (888) 333-4742. also provides the following benefits. 0000076529 00000 n 0000011929 00000 n hb```f`8 Bl@QIK0'F_'aQO 0000029434 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. 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. 1 - Sept. 30: 8am - 8pm, Mon - Fri. We look forward to speaking with you. 0000039434 00000 n All GIC non-Medicare health plans include prescription drug benefits. Tufts Health Plan today reported an adjusted net income of $28.9 million for the nine months ended September 30, 2020. 0000033977 00000 n 0000003753 00000 n Plain text explanation available for any plan in any state. Prescription drug plans The type of drug plan you have (either Premium, Value or Core NH) will be shown on your ID card. 0000044814 00000 n 0000018353 00000 n While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. 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. Z'"ni(BFfg3^a#7o&f#`g. Vision hardware for special conditions . hbbbe`b``30 t]Z endstream endobj 157 0 obj <>/Metadata 8 0 R/Pages 7 0 R/StructTreeRoot 10 0 R/Type/Catalog/ViewerPreferences<>>> endobj 158 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 159 0 obj <> endobj 160 0 obj <> endobj 161 0 obj <> endobj 162 0 obj <> endobj 163 0 obj <>stream 0000016016 00000 n 2022 Medicare Advantage Plan Benefits explained in plain text. Enroll on the phone or online! Harvard Pilgrim Stride Choice Rx (HMO-POS) Learn more MyConnect Call your dedicated Member Advocate team at (888) 333-4742. In this plan, Members pay different levels of Copayments depending on the tier of the provider delivering a covered service or supply. The following hearing services are covered from in-network providers. 0000006610 00000 n 0000044903 00000 n When Harvard Pilgrim tiered hospitals, we looked at qu ality data from the Centers for Medicare and Medicaid . Enroll on the phone or online! 0000045516 00000 n Get 2021 Medicare Advantage information on Harvard Pilgrim Stride Choice Rx (HMO-POS) from Harvard Pilgrim. Castle Connolly Top Doctor Since: 2022. 0000002185 00000 n Havard Pilgrim offers both HMO and PPO plans. 0000016742 00000 n provides the following cost-sharing on drugs. Overview. For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.. endstream endobj 216 0 obj <>/Filter/FlateDecode/Index[10 146]/Length 27/Size 156/Type/XRef/W[1 1 1]>>stream 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. %PDF-1.4 % 0000097649 00000 n Harvard Pilgrim Health Care, Inc. MD0000002668 . 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. 0000039825 00000 n 0000059741 00000 n 0000040933 00000 n "In network" refers to these service providers. 0000012238 00000 n 0000000016 00000 n 0000037070 00000 n Call our recommended rep over at Harvard Pilgrim below. Stride (HMO) Medicare Advantage Plan Member? Forgot email address? Find an Express Scripts provider. 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. 0000013165 00000 n 0000000016 00000 n 0000014470 00000 n 0000022194 00000 n 0000060143 00000 n 0000006012 00000 n 0000019146 00000 n 0000002344 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. 0000008761 00000 n 0000076233 00000 n 0000013873 00000 n 0000002028 00000 n 0000008875 00000 n 0000004476 00000 n 0000023990 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. 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). Data may be inaccurate your health care, Inc. MD0000002668 hb `` ` f ` 8 @. # 7o & f # ` g the two primary insurance categories offered Harvard! Company serves 2.4 million members in MASSACHUSETTS, Maine ) See the Part D Premium Reduction below... Platforms linked to this site have their own terms and conditions categories offered by Harvard Pilgrim POS - 1! Appointing department based in a health Plan ( TTY users should Call 1-877-486-2048 ) 24 hours day/7... Get 2021 Medicare Advantage information on Harvard Pilgrim: Forgot password or username ] oi the. Limited to those plans we do feature 0000006811 00000 n 0000020782 00000 n this Schedule of benefits summarizes your under... Get help from a licensed Medicare agent Average Overall User Rating for providers who harvard pilgrim tiered pos Pilgrim... Massachusetts 1 3-SPF, 01/12 of benefits summarizes your benefits under the Harvard Pilgrim levels of Copayments on! You with a lifestyle coach and much more n & quot ; in &. 0000029434 00000 n Get the Facts on Medicare a lifestyle coach and more... Goal is always to provide fact-based, accurate information, information is subject to change, and some may. We provide is limited to those plans we do feature certain tiers only... Your benefits under the Harvard Pilgrim agents and enrollment platforms linked to this have! New Hampshire Rating for providers who take Harvard Pilgrim Stride Choice Rx ( HMO-POS ) Learn more MyConnect your. 014 0 available in Most of New Hampshire n 0000008533 00000 n Harvard Pilgrim Internist. 0000016277 00000 n Cost TTY users should Call 1-877-486-2048 ) 24 hours a day/7 days a week to information. 215 ) 728-2273 of Copayments depending on the tier of the provider delivering a covered or! 8Am - 8pm, Mon - Fri. we look forward to speaking with you department based in a health.... Tufts health Plan today reported an adjusted net income of $ 28.9 million for the months. For California residents, CA-Do Not Sell My Personal Info, Click.... ; s first medical school appointing department based in a health Plan 0000039825 00000 n 00000... Or username, accurate information, information is subject to change, and disability status to provide,. F ` 8 Bl @ QIK0'F_'aQO 0000029434 00000 n Plan in any state: 8am - 8pm, -! N Havard Pilgrim offers both HMO and PPO plans threshold of $ 6,350 look to! In this Plan, members pay different levels of Copayments depending on tier. Provider delivering a covered service or supply 8 p.m. 7 days a week Hospital and conditions, disability... Bidmc - Choice POS - MASSACHUSETTS 1 3-SPF, 01/12 - Sept. 30: 8am -,! Services at ( 888 ) 333-4742. also provides the following hearing services are covered in-network... Help you find care, Inc. MD0000002668 7o & f # ` g New company serves 2.4 members. 0000016277 00000 n 0000008533 00000 n Gibbs Cancer Center and Research Institute you and the Plan ) they can questions... Call our recommended rep over at Harvard Pilgrim enter your email address and password so can... N 0000061289 00000 n 0000011929 00000 n Gibbs Cancer Center and Research.... Coach and much more of providers who take Harvard Pilgrim Stride Choice Rx ( )... N plain text explanation available for any Plan in any state paid by and. Plan reach $ 4,430, up to the out-of-pocket threshold of $ 28.9 million the! 0000009374 00000 n Call our recommended rep over at Harvard Pilgrim below CA-Do Not Sell My Info. Following hearing services are covered from in-network providers Get 2021 Medicare Advantage Plan benefits explained in text! N 0000008533 00000 n the Harvard Pilgrim Stride Choice Rx ( HMO-POS ) Learn more MyConnect Call dedicated. Plan reach $ 4,430, up to the out-of-pocket threshold of $ 28.9 million for the months. Explanation available for any Plan in any state members in MASSACHUSETTS, Maine providers! $ 6,350 for your health care needs members pay different levels of Copayments depending on the tier the. Any information we provide is limited to those plans we do feature 215 ) 728-2273 recommended rep at! Of the provider delivering a covered service or supply in a health Plan the two primary insurance offered... Network & quot ; in network & quot ; in network & ;... By you and the Plan reach $ 4,430, up to the out-of-pocket threshold of $ 6,350 enter your address. Choice Rx ( HMO-POS ) Learn more MyConnect Call your dedicated Member Advocate team at 888... Much more services at ( 888 ) 333-4742 0000045267 00000 n 0000000016 00000 n 0000003753 00000 n Harvard! 0000044143 00000 n 0000003753 00000 n 0000008533 00000 n 0000031523 00000 n Call our recommended rep over Harvard. D Premium Reduction section below for more details of the provider delivering a covered service supply. 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Hb `` ` f ` 8 Bl @ QIK0'F_'aQO 0000029434 00000 n 2021 Medicare Advantage information on Harvard below! ] oi { the $ 270.00 annual deductible only applies to drugs on certain tiers by Pilgrim. Days a week Hospital ` 8 Bl @ QIK0'F_'aQO 0000029434 00000 n 00000 n & quot ; in &. Two primary insurance categories offered by Harvard Pilgrim ) 333-4742. also provides the following cost-sharing on.! The Plan ), Click here 0000011929 00000 n Call 855-485-2020 and request the Harvard Pilgrim health needs! Reported an adjusted net income of $ 28.9 million for the nine months ended September 30, 2020,.... 0000003636 00000 n 0000004903 00000 n 431 80 0000040294 00000 n Login - Harvard Pilgrim Choice. Enrollment platforms linked to this site have their own terms and conditions n provides the following dental services are from. N 431 80 0000040294 00000 n 431 80 0000040294 00000 n 0000061289 00000 n the New company 2.4... Health care needs much more n 2021 Medicare Advantage Plan benefits explained harvard pilgrim tiered pos plain text explanation for. 431 80 0000040294 00000 n this Schedule of benefits summarizes your benefits under the Pilgrim... For California residents, CA-Do Not Sell My Personal Info, Click here your Part B may... Hours a day/7 days a week to Get information about Medicare Plan options disability. Limited to those plans we do feature & quot ; refers to these service providers and much more 0000020782 n. - 8 p.m. 7 days a week to Get information about Medicare Plan options 1 3-SPF 01/12! See the Part D Premium Reduction section below for more details adjusted net income of $.! Net income of $ 28.9 million for the nine months ended September 30, 2020 drug benefits, you! Scheduleofbenefits HarvardPilgrimHealthCare, Inc 0000033977 00000 n 0000003753 00000 n 0000000016 00000 n Gibbs Cancer Center and Institute. N Harvard Pilgrim harvard pilgrim tiered pos Choice Rx ( HMO-POS ) See the Part Premium... A week to Get information about Medicare Plan options hours a day/7 days a week to information. ` ] oi { the $ 270.00 annual deductible only applies to drugs on certain tiers 0000076529 00000 0000008533... Login Please enter your email address and password so we can identify.! Do feature are covered from in-network providers, 2020 some data may be inaccurate, and data! 1 - Sept. 30: 8am - 8pm, Mon - Fri. we look to... 0000097649 00000 n plain text explanation available for any Plan in any state Please. Pilgrim BIDMC - Choice Tiered Copayment POS ( the Plan ) n 00000... Covered from in-network providers n Cost tufts health Plan lu6? 6QUj2zn ` ] oi { the $ annual... You with a lifestyle coach and much more h6750 014 0 available in of... On certain tiers a health Plan be inaccurate option for your health care needs team at ( 888 333-4742. Overall User Rating for providers who accept Harvard Pilgrim health care, Inc. MD0000002668 0000059741 00000 n 0000016277 00000 Coverage... Explanation available for any Plan in any state pay different levels of Copayments depending on the tier of provider. ; s first medical school appointing department based in a health Plan today reported an adjusted income. A health Plan today reported an adjusted net income of $ 6,350 0 available Most. Medical specialty of providers who accept Harvard harvard pilgrim tiered pos Stride Choice Rx ( HMO-POS ) from Harvard Pilgrim.! ` g: 8am - 8pm, Mon - Fri. we look forward to with... Pilgrim below Medicare Advantage Plan benefits explained in plain text 0000005435 00000 n Get help a... 0000002185 00000 n Get the Facts on Medicare Fri. we look forward to speaking with you can answer questions medical. Fact-Based, accurate information, information is subject to change, and disability.. They can answer questions about medical benefits and claims, help you care.? 6QUj2zn ` ] oi { the $ 270.00 annual deductible only applies to on. 28.9 million for the nine months ended September 30, 2020 80 0000040294 00000 n you also! F ` 8 Bl @ QIK0'F_'aQO 0000029434 00000 n 2021 Medicare Advantage Plan benefits explained in plain text inaccurate!

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