Offerings that enhance our value for members, employers and brokers. Fees may apply to some programs.
Medical, Pharmacy and Health Services
Transparency tools, pharmacy information and other resources for when members need guidance with their care.
Health Services
We’re proud to offer our members a diverse menu of well-being offerings but we also know it’s a lot to unpack. Discover a resource that puts all these services in one place. Our Health Services Cheat Sheet easily differentiates one offering from another and gives you access to the talking points that will speak to your client. Find information on dozens of services now available to fully insured and self-insured members in an easy to digest format that cuts through the noise.
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Emergency Room Cost Sharing
Starting with 2019 renewals, members on our New Hampshire plans will pay higher cost sharing for emergency room (ER) visits that are not considered medical emergencies. We will not deny any claims based on the reason for a member’s ER visit.
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ICD-10 codes
Pharmacy Program
We offer a variety of tiered formulary offerings to meet your clients’ needs.
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Urgent Care Options and ER Alternatives
When their PCPs aren’t available, members who need care right away for minor illnesses and accidents have a variety of cost-effective options.
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Member Savings
Programs for helping members keep more of their money.
Fitness Reimbursement Benefits
We know the value that a healthy workforce brings to your clients. So, to guide and support employee well-being, we offer fitness reimbursements of up to $150-$300 a year for our members.
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Estimate My Cost
This search tool lets members find and compare estimated health care costs before they receive services. It’s available to members in CT, MA, ME and NH.
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Reduce My Costs
Voluntary program that makes it easy for members to save money by finding care at lower-cost facilities for elective, outpatient medical procedures and diagnostic tests. Members can earn rewards for choosing lower-cost providers.
Reduce My Costs
Additional Products & Programs
MyHealthMath
Do you have clients offering high-deductible HSA plans to their employees, or thinking about it? Educating employees about these types of plan options can be difficult and time-consuming, and employees may be hesitant to get on board if they can’t make sense of all the information.
To help employees better understand their options and select the plan that gives them the best value, we offer Decision Doc, a personalized decision-support platform from MyHealthMath.
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Guardian
Harvard Pilgrim and Guardian are partnering to provide a full line of ancillary insurance products – including dental, vision, short- and long-term disability and more – to employers in Maine, Massachusetts and New Hampshire. Learn how your clients can save money and provide more insurance options for their employees.
Guardian Ancillary Products
HSAs and HRAs
HSAs and HRAs can offset the costs of high-deductible health plans and motivate members to make smarter health care decisions. Our preferred vendors can get you and your clients started.
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Population Health
Care Management
As industry leaders in population health, we combine data and analytics with robust care-management outreach. Our “Whole person, In Person” approach to care encourages wellness and contains costs.
Care Management Resources