Reduce My Costs

Effective January 1, 2020, the Reduce My Costs program will be included for all fully insured commercial plans in Massachusetts, New Hampshire, Maine and Connecticut, regardless of anniversary date. There is no cost employers or members. This change does not affect the program offered at no cost to Maine small group HSA eligible plans.

Reduce My Costs is a voluntary program that makes it easy for members to save money by finding care at a lower-cost facility for elective, outpatient medical procedures and diagnostic tests.

Reduce My Costs helps lower health care costs by increasing awareness of medical cost differences without reducing benefits or cost shifting.

How Reduce My Costs works

1. A Harvard Pilgrim member calls 855-772-8366 whenever his or her doctor recommends an outpatient test or procedure such as:
   1. Radiology (e.g., MRI and CT scan)
   2. Bone density study
   3. Lab work
   4. Colonoscopy
   5. Mammogram
   6. Ultrasound
   7. Other non-emergency outptient tests and procedures
2. The member speaks with an experienced nurse who will:
   1. Compare provider costs and inform the member of the lower-cost providers in his or her area
   2. Assist with scheduling or rescheduling the member’s appointment and help with any paperwork
3. If the member is already seeing a lower-cost provider, he or she will receive a reward just for calling.¹
4. If the member decide to receive care from a lower-cost provider, he or she will earn a reward, depending on the service and the associated cost savings.

Reduce My Costs reward structure

Here’s what your Harvard Pilgrim members and their dependents will receive when using Reduce My Costs:

$10 Minimum Reward²
For Harvard Pilgrim members who call and are already scheduled at a low-cost provider

$25 Reward²
For Harvard Pilgrim members switching to a low-cost provider for:

• Bone Density Study
• Lab Work
• Mammogram
• Ultrasound

$50 Reward³
For Harvard Pilgrim members switching to a low-cost provider for:

• MRI
• CT Scan
• PET Scan

$75 Reward⁴
For Harvard Pilgrim members  switching to a low-cost provider for:

• Colonoscopy
• Other
• Other outpatient surgeries

Program eligibility

Effective January 1, 2020:

• Reduce My Costs will be included for all fully insured commercial plans at no cost to employers or members. This does not affect the program offered at no cost to Maine small group HSA eligible plans.
• The program will be available in all markets, including Massachusetts, New Hampshire, Maine and Connecticut.
• Members of Connecticut employer plans cannot earn cash rewards due to state regulations but are eligible for gift card rewards.
• It is available as a buy-up for self-insured business at preferred pricing. For self-insured large group accounts with 51+ FTE employees, there is a $2.50 per employee/per month fee and the employer funds the incentives.

Learn more

Contact Harvard Pilgrim at 800-848-9995.

Reward payments are considered taxable income. Massachusetts members may receive a maximum of five Reduce My Costs rewards per calendar year.