These are HMO deductible plans that require members to choose a PCP (Primary Care Provider) and receive referrals to specialists for services as needed. Members must access the Harvard Pilgrim network which includes 182 hospitals across New England and thousands of providers.
These plans offer distinctive features: Members can save money when receiving diagnostic lab testing and outpatient surgery procedures from participating LP providers. When members receive lab services from LP providers it’s covered in full. This is ideal for anyone with chronic medical conditions that require routine blood monitoring such as diabetes, thyroid disorders, cholesterol and blood thinners. When day surgeries are performed at participating LP locations, procedures are covered at only a copayment instead of the deductible.
- Schedule of Benefits (SOB) (pdf)
- Summary of Benefits & Coverage (SBC) (pdf)
- Premium 4 Tier Prescription Drug Coverage (pdf)