Insurer has not charged copays for more than three years

Wellesley, MA (December 20, 2017) -  Harvard Pilgrim Health Care has lead the way in the fight against opioid addiction by choosing not to charge copays for naloxone for more than three years. Naloxone can save lives during an overdose by blocking the effects of opioids.

Harvard Pilgrim began covering naloxone syringe with no copays in 2014. The syringe uses a nasal adaptor to allow nasal administration of the life-saving drug.  Narcan Nasal Spray, a newer product, became available in February of 2016 and Harvard Pilgrim immediately began covering it with no copays.

 The insurer was the first commercial carrier in the region to eliminate copays for naloxone, ahead of others in the industry.

“We made a decision three years ago not to charge copays for naloxone because we believe there should be no barriers between this drug and the individuals who need it,” said Harvard Pilgrim’s Chief Medical Officer Michael Sherman.  “When an individual needs naloxone to save his or her life, it must be available. Restricting access in any way runs counter to efforts to combat our national crisis.

“We made our decision some time ago and hope that other insurers will see the value of this approach, which is intended to support the work of law enforcement and others in the community to make naloxone more widely available,” said Harvard Pilgrim President and CEO Eric H. Schultz. “The Centers for Disease Control (CDC) have said that naloxone distribution through community-based programs providing prevention services for substance users has been demonstrated to be associated with decreased risk for opioid overdose death at the community level.”

Harvard Pilgrim also covers all forms of medication-assisted treatment for substance abuse disorder without the need for prior authorization and supports a range of evidence-based treatments for pain, such as acupuncture. The insurer is also broadening access to non-opioid approaches such as mindfulness and therapeutic yoga for those dealing with pain and/or addiction and is working with providers in these disciplines who have experience in pain management.

About Harvard Pilgrim Health Care
Harvard Pilgrim and its family of companies provide health benefit plans, programs and services to more than 3 million customers in New England and beyond. A leading not-for-profit health services company, we guide our members –  and the communities we serve – to better health.   

Founded by doctors nearly 50 years ago, we’re building on our legacy. In partnership with our expansive network of doctors and hospitals, we’re improving health outcomes and lowering costs through clinical quality and innovative care management.

Our commitment to the communities we serve is driven by the passion of the Harvard Pilgrim Health Care Foundation. Through its work, low- and moderate-income families are gaining greater access to fresh, affordable food — a cornerstone to better health and well-being.


Harvard Pilgrim Health Care
Joan Fallon
(617) 509-7458