About Our Stride (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 2022 to support our valued providers in serving our member population.

Service Area and Plan Options

In 2022, Harvard Pilgrim StrideSM (HMO) 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 our only plan in Strafford County):

  • Basic Rx – Our fastest growing plan ($0 premium)
  • Value Rx – Our most popular plan ($49 premium)
  • Choice Rx – Our only plan with an out-of-network benefit ($55 premium)
  • Value Rx Plus – Our longest-tenured plan with service area statewide
  • ($138 premium in Strafford County; $128 premium in all other counties)

All StrideSM Basic Rx (HMO) plans have a $0 monthly premium. All other StrideSM (HMO) plans offer competitive member premiums, no 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.

2022 Benefits for New Hampshire’s StrideSM (HMO) Members

For 2022, benefits include (among others):

  • Aligned copayments 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 copayment per one-way trip for non-emergency medical transportation other than 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 sharing for therapeutic continuous glucose monitoring systems (prior authorization is required)
    $35 copayment for a 30-day supply of Formulary insulins, including insulin pens, from participating retail pharmacies or $70 for a 90-day supply from participating mail order pharmacies

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’s 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