About Our StrideSM (HMO/HMO-POS) Medicare Advantage Plans

We’re pleased to provide an overview of the StrideSM (HMO/HMO-POS) Medicare Advantage plans we’re offering in New Hampshire for 2023 to support our valued providers in serving our member population.

Service Area and Plan Options

In 2023, Harvard Pilgrim StrideSM (HMO)/(HMO-POS) Medicare Advantage plans will be available throughout the state of New Hampshire. Depending on the county in which they reside, Medicare beneficiaries can choose from the following Harvard Pilgrim plan options in New Hampshire (Note that Value Rx Plus is the only plan we offer in Strafford County):

  • Basic Rx – Our fastest growing plan ($0 premium)
  • Value Rx – Our most popular plan ($57 premium)
  • Choice Rx – Our only plan with an out-of-network benefit ($68 premium)
  • Value Rx Plus – Our longest-tenured plan with a statewide service area
  • ($146 premium in Strafford County; $141 premium in all other counties)

The StrideSM Basic Rx (HMO) plan has a $0 monthly premium; other StrideSM (HMO) plans offer competitive premiums. All StrideSM (HMO) plans offer $0 PCP copays and comprehensive benefits including Part D prescription drug coverage, inpatient hospital coverage, routine care and wellness visits, and annual vision and hearing exams.

2023 Benefits for New Hampshire’s StrideSM (HMO)/(HMO-POS) Members

For 2023, benefits include (among others):

  • Aligned copays for services provided in outpatient hospital facilities, including outpatient surgery, outpatient observation, and advanced diagnostic radiology
  • No member cost share for telemedicine virtual check-ins and e-visits
  • $0 copay per one-way trip for non-emergency medical transportation other than by ambulance (prior authorization is required)
  • Full coverage for vaccines covered by Medicare under Part D; no cost to members for most vaccines, including shingles or the COVID-19 vaccine, unless they are in the Catastrophic Coverage stage of their Part D benefit
  • No member cost share for therapeutic continuous glucose monitoring systems (prior authorization is required)
  • $35 copay for a one-month (30-day) supply of each insulin product covered by the plan, no matter what cost-sharing tier it’s on, even if member has not paid their deductible
  • Access to both preferred and standard retail pharmacies in the plan’s network. Network retail pharmacies can be found in the 2023 Provider and Pharmacy Directory (www.harvardpilgrim.org/strideproviders).

Self-Referral Option

Stride℠ (HMO) members may self-refer for specialized care and do not need approval from their PCP to see a network specialist or other provider. Although members have direct access to specialized care, we encourage them to consult with their PCPs first. This self-referral option includes the Choice Rx (HMO-POS) plans, which offer the option for members to seek care outside the Stride℠ (HMO) provider network for Medicare-covered outpatient items and services.

Supplemental Benefits

Harvard Pilgrim StrideSM (HMO) Medicare Advantage plans also offer the following at no additional premium cost:

  • An annual Wallet Benefit to help cover qualified health and wellness expenses such as a fitness tracker, fitness membership and classes, prescription eyewear, bathroom safety devices and installation, equipment for exercising, bodywork, or mind-body therapies at home, subscription to an app or online program for exercising, bodywork, or mind-body therapies at home, acupuncture visits, massage therapy, routine chiropractic visits, and more*
  • A yearly allowance for eligible over-the-counter (OTC) products, including incontinence supplies, toothbrushes, water flossers, and a digital scale*
  • Annual reimbursement for the cost of routine dental coverage such as preventive services, periodontal maintenance, and fillings*
  • Yearly exams to screen for vision and hearing changes
  • Coverage for hearing aids and batteries
  • Non-emergency medical transportation (does not include ambulance transportation)

*Benefits vary by plan