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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

October 2014

New Medicare Advantage Products in 2015

The Medicare Advantage annual open enrollment period runs from Oct. 15 through Dec. 7, and Harvard Pilgrim is offering some new choices in the marketplace for 2015. We’ve enhanced our Medicare Advantage StrideSM (HMO) plan offerings and are introducing new benefit and premium designs. For the coming year, we’re continuing to offer our Medicare Advantage Stride products in Massachusetts (Bristol, Norfolk, Suffolk, and Worcester), Maine (Cumberland and York), and New Hampshire (Hillsborough, Merrimack, and Rockingham), and anticipate expanding our service area in 2016.

For 2015, we’ll be offering the Stride (HMO) Value Rx and Stride (HMO) Value Rx Plus plans. The Value Rx plans are our lowest monthly premium plans ($0 per month in New Hampshire and Maine), while the Value Rx Plus plans offer enhanced benefits, including lower out-of-pocket copayments for doctors visits and inpatient stays, coverage for Tier 1 and Tier 2 medications in the Part D “coverage gap,” and a $25 monthly over-the-counter medication benefit.

Also new for 2015 is our closed formulary for all Stride (HMO) products and Part D benefit designs, which now includes coverage for some medications not typically covered by Medicare, such as erectile dysfunction drugs, select vitamins, and cough and cold medications (limits apply).

You can recognize Stride (HMO) Value Rx and Value Rx Plus members from their ID cards, which include the appropriate plan name (see sample below). 

By Dec. 15, 2014, a description of the Stride (HMO) products will be available in the “Products and Product Administration” section of the Provider Manual. If you are part of Harvard Pilgrim’s Medicare Advantage Stride (HMO) network, please visit our Stride website for important resources, including a quick reference guide (with information on submitting claims, requesting authorizations, and verifying eligibility), our Medicare Advantage Provider Manual, and our Medicare Advantage provider portal for conducting electronic transactions. If you are interested in joining our Medicare Advantage Stride (HMO) network, please contact your Harvard Pilgrim contract manager.

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Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,

Kristin Edmonston,
Production Coordinator