01.21.2022 — Updated COVID testing section with additional coverage information.
01.19.2022 — Updated COVID at home testing section with further coverage information.
01.12.2022 — Updated COVID testing section with information on at-home tests; updated language throughout to streamline and remove outdated references.
During the COVID-19 public health emergency (PHE), we have adapted our policies and business operations to support our members in receiving the care, and to aid our provider partners in their efforts to provide patients with safe access to the care, they need. As states lift PHE orders, Harvard Pilgrim Health Care is returning to many pre-pandemic operations and policies. Please see the information below for details on Harvard Pilgrim’s COVID-19 related practices.
The PHE-related policies outlined below apply to our fully insured, Medicare Advantage, Medicare Enhance, and Medicare Supplement products, unless otherwise noted. Coverage for self-insured groups may vary. For any product not specifically stated within the PHE-related policies outlined below, the pre-pandemic policy applies.
Harvard Pilgrim understands the urgency of getting vaccines administered swiftly and effectively and is committed to supporting providers in this important work. We are also conducting education and outreach to our members to educate them about the known safety of COVID-19 vaccines and the importance of getting vaccinated.
The federal government has purchased the vaccine and is supplying it to vaccinators. Providers will receive the vaccines from state and/or federal health agencies.
COVID-19 Testing and Treatment
We are covering the cost of up to eight over-the-counter (OTC), at-home COVID-19 tests per member, per month for Commercial members as further described below. We will pay only for tests that are approved by or granted emergency use authorization by the FDA, are intended for individualized diagnosis or treatment of COVID-19 (not for resale) and are not for employment purposes. We continue to work on finding additional solutions to simplify the process for our members. Although not mandated by the federal requirements, we are working with CMS to determine if we can provide coverage for at-home COVID-19 tests for our Medicare members.