Medicare Advantage

Reminder: As we announced in the Oct. issue of Network Matters, as of Jan. 1, 2022, Harvard Pilgrim Health Care is no longer offering StrideSM (HMO) Medicare Advantage plans in Massachusetts and Maine. We continue to offer StrideSM in New Hampshire. Massachusetts StrideSM members had the opportunity to enroll in Tufts Medicare Preferred, which has earned 5 out of 5 stars from the Centers for Medicare and Medicaid Services (CMS) for an unprecedented 7th year in a row — and 7 of 10 former Massachusetts StrideSM members chose a Tufts Medicare Preferred plan for coverage this year. You can access coverage information for these members via the Tufts Health Plan provider portal.


 

Quick Reference Guide

Our Medicare Advantage StrideSM Quick Reference Guide is a handy reference on verifying eligibility, requesting authorizations, submitting claims and requesting claims appeals, and more

Download guide

Referral/Auth. Quick Reference Guide

Resource tool for Medicare Advantage products, indicating which services may require referral or authorization.

View Tool

Medicare Advantage Provider Service Center:
Phone: 888-609-0692
Oct. 1 – March 31:
8 a.m. to 5 p.m. (ET), 7 days a week
April 1 – Sept. 30:
8 a.m. to 5 p.m. (ET), Monday – Friday

To mail Medicare Advantage claims:
Harvard Pilgrim Health Care, Inc.
c/o Stride Claims Processing
P.O. Box 93430
Lubbock, TX 79493

Claims appeals:
Fax#: 617-509-4225
Or mail to:
Medicare Advantage Provider Appeals
P.O. Box 690546
Quincy, MA 02169