Notice of Data Security Incident. Read here.
Data Security Incident
Notice of Data Security Incident. Read here.
When you have questions about your benefits and coverage with Harvard Pilgrim, we’re here for you!
Adults with Harvard Pilgrim plans can get a flu shot at no charge at:
Children coverd on Harvard Pilgrim plans can get a flu shot at no charge at:
Always call ahead to confirm schedules and availability, and make sure the provider or clinic accepts Harvard Pilgrim insurance and will submit a claim. Always bring your ID card with you.
Yes. A colonoscopy is an ACA preventive service. It’s covered at no cost to members when received from a provider who is part of your Harvard Pilgrim network.
As part of Federal Health Care Reform (FHCR) Women’s Preventative Coverage, the following breast pumps and related supplies are covered with no cost sharing.
Your insurance plan also covers comprehensive lactation support, counseling and the costs of renting breastfeeding equipment. The following items are not covered: nursing pads, gel pads, nipple cream and milk storage bags.
Find out by calling your doctor or search our online directory.
Under the Affordable Care Act, also known as the ACA or the PPACA, there are designated services that are considered preventive and must be covered with no cost to members. You receive preventive services whether you are well or sick. They are benchmarks to assess your health, and they determine if you need more specialized care.
See a list of covered preventive services (www.healthcare.gov)
As a Harvard Pilgrim member, you are covered for urgent care at retail clinics, urgent care clinics and other convenient options.
If we receive a claim for a service that indicates a member received care after an accident, we send the member a questionnaire. The completed questionnaire helps us determine if another insurance company should pay because a third party (a person or business) was responsible for the accident. We can then process claims correctly. The questionnaire should be submitted within 60 days of receipt.
A secure online account helps you manage your health plan through a wide variety of resources. You can review claims and authorizations, track your deductible if you have one, use fitness and wellness tools, and more.
Members age 18 and older must create their own individual accounts even if they are on their parent’s plan.
Check your Schedule of Benefits in My Plan Documents in your secure online account. This document is specific to your plan and tells you what is covered and what you pay for services.
Every plan is different. Log into your secure online account to find out if your plan offers a reimbursement.
Learn details about how the fitness reimbursement works
It depends on the type of plan you have. If you have an HMO or POS plan, you must choose a PCP. PPO members are not required to choose a PCP, but it’s typically recommended.
You can change your PCP by logging into your secure online account, or calling Member Services at (888) 333-4742.
Feel free to contact us directly! You can send us a secure message or contact us by phone.
You’ll need to login to send us a secure message. We’ll promptly reply to your message as soon as we can (usually within 1-2 business days).
Contact our Member Services department at (888) 333-4742.
Business hours (Eastern time)
Standard plans:
Monday, Tuesday & Thursday: 8 a.m. to 6 p.m.
Wednesday: 10 a.m. to 6 p.m.
Friday: 8 a.m. to 5:30 p.m.
Access America plans:
Monday, Tuesday, Thursday & Friday: 8 a.m. to 8 p.m.
Wednesday: 10 a.m. to 8 p.m.
Call Now
You’ll need to login to send us a secure message. We’ll promptly reply to your message as soon as we can (usually within 1-2 business days).
Contact our Member Services department at (888) 333-4742.
Business hours (Eastern time)
Standard plans:
Monday, Tuesday & Thursday: 8 a.m. to 6 p.m.
Wednesday: 10 a.m. to 6 p.m.
Friday: 8 a.m. to 5:30 p.m.
Access America plans:
Monday, Tuesday, Thursday & Friday: 8 a.m. to 8 p.m.
Wednesday: 10 a.m. to 8 p.m.
Call Now
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