Harvard Pilgrim Insurance: Your Comprehensive Guide

Harvard Pilgrim Health Care (HPHC), is a non-profit health insurance organization based in Massachusetts. It is a health insurance plan that aims to provide affordable health care services to the residents of Connecticut, Maine, New Hampshire and Massachusetts. HPHC is one of the top 10 insurance providers in the country, with over 1.2 million insured members.

History of Harvard Pilgrim Insurance

The organization was founded in 1969 by doctors and hospitals from Harvard Medical School. Originally named Harvard Community Health Plan, it was created to provide affordable health care to the residents of Boston. In 1993, the organization was renamed Harvard Pilgrim Health Care, and it started to branch out to other states. Today, HPHC has offices in all four of the New England states it serves.

Over the years, HPHC has established a reputation for providing excellent customer service and innovative health care solutions. It has received many awards and accolades, including being named one of the top 50 companies for diversity by DiversityInc Magazine for six years in a row.

Types of Insurance Plans Offered by Harvard Pilgrim

Harvard Pilgrim offers a range of insurance plans to its customers. These plans include:

Insurance Plan
Description
HMO Plans
The Health Maintenance Organization (HMO) plans are designed to provide health care services at predetermined rates. HMO plans usually require that you choose a primary care physician (PCP), who will act as your primary point of contact for all medical services.
PPO Plans
The Preferred Provider Organization (PPO) plans offer more flexibility than HMO plans. They allow you to choose any doctor or health care provider within the PPO network, and you do not need to choose a primary care physician.
POS Plans
The Point of Service (POS) plans combine features of both HMO and PPO plans. They allow you to choose a primary care physician, but also offer the flexibility to use doctors and hospitals outside the network.
HSA Plans
The Health Savings Account (HSA) plans allow you to save money on your health care expenses by contributing pre-tax dollars to an HSA account. This money can be used to pay for qualified medical expenses.

The Benefits of Harvard Pilgrim Plans

There are many benefits of choosing a Harvard Pilgrim insurance plan. Some of these benefits include:

Comprehensive Coverage

Harvard Pilgrim offers comprehensive coverage for a wide range of medical services. These services include preventive care, emergency care, hospitalization, surgery, and prescription drugs.

Low Copayments and Deductibles

Harvard Pilgrim plans typically have low copayments and deductibles, making them more affordable for policyholders. This means that you will spend less money out-of-pocket when you receive medical services.

Large Network of Providers

Harvard Pilgrim has a large network of doctors and health care providers. This means that you are more likely to find a provider that accepts your insurance plan, and you have more choices when it comes to choosing a doctor.

Excellent Customer Service

Harvard Pilgrim is known for providing excellent customer service. Its customer service representatives are available to answer your questions and help you navigate the complexities of the health care system.

FAQs About Harvard Pilgrim Insurance

How do I enroll in a Harvard Pilgrim insurance plan?

You can enroll in a Harvard Pilgrim insurance plan by visiting the Harvard Pilgrim website or contacting a representative by phone. You can also enroll during the annual enrollment period in the fall.

How much does Harvard Pilgrim insurance cost?

The cost of a Harvard Pilgrim insurance plan will depend on a number of factors, including your age, location, and the type of plan you choose. You can get a quote by visiting the Harvard Pilgrim website or speaking with a representative.

Does Harvard Pilgrim insurance cover prescription drugs?

Yes, Harvard Pilgrim insurance plans cover prescription drugs. The amount of coverage will depend on the specific plan you choose.

What if I need to see a specialist?

If you need to see a specialist, you will need a referral from your primary care physician. Once you have a referral, you can make an appointment with the specialist.

Does Harvard Pilgrim offer dental and vision coverage?

Yes, Harvard Pilgrim offers dental and vision coverage as part of its insurance plans. These services are typically covered separately from medical services.

Conclusion

Harvard Pilgrim Health Care is a non-profit health insurance organization that provides affordable health care services to the residents of Connecticut, Maine, New Hampshire and Massachusetts. It offers a range of insurance plans to suit the needs of its customers, including HMO, PPO, POS, and HSA plans. Its plans offer comprehensive coverage, low copayments and deductibles, a large network of providers, and excellent customer service. If you are looking for a quality health insurance plan, Harvard Pilgrim is an excellent choice.