Harvard Pilgrim is proud to be at the forefront meeting the needs of our members and communities who are impacted by the opioid crisis. We are committed to doing our part to fight this epidemic and return our communities to better health.
Our framework for approaching the opioid crisis is: prevent, treat and support. We aim to prevent addiction, treat people facing challenges with chronic pain and with substance misuse, and support people and their communities in finding solutions.
How we Prevent:
We provide coverage for many FDA-approved prescription non-opioid drug products that are effective pain management alternatives and have a lesser potential for misuse than opioid drug products.
Many of our participating retail pharmacies receive an online alert when a Harvard Pilgrim member is prescribed a high dose of opioids, which reminds the pharmacist to counsel on opioid safety and offer NARCAN®. Read about NARCAN®
We work with our physician partners to support their prescribing needs and meet the needs of our members.
A Harvard Pilgrim company TrestleTree, LLC, signed an exclusive agreement for the rights to an Opioid Risk Prediction Tool, to pre-identify individuals that might be susceptible to opioid addiction. Health coaches engage with patients before they receive the prescription of the opioids. Learn more.
Prevention resources for you and your family:
Smart and Safe (Massachusetts Medical Society) offers guidance on how physicians and patients can maximize their interactions and how physicians can follow safe, effective and responsible prescribing practices.
CDC Opioid Overdose (Centers for Disease Control and Prevention) provides helpful materials for individuals living with chronic and acute pain.
The National Institute on Drug Abuse (NIDA) offers downloadable publications on addiction science, medical consequences and drug-related trends and statistics.
Opioid Facts for Teens (NIDA) addresses the most frequently asked questions they have received from teens and offers brief summaries based on research.
How we Treat:
Harvard Pilgrim covers Naloxone (NARCAN® and Evzio) with no cost sharing for members. More than 80% of opioid overdoses occur at home when a friend or caregiver is present, which is why it’s important to keep NARCAN® Nasal Spray within reach in case of an emergency.
For members with substance misuse, we support medication-assisted treatment (MAT), without the need for prior authorization - which uses FDA-approved medications with counseling to prevent opioid overdose, relieve cravings and promote recovery. We have a robust network of primary care providers (PCPs) and behavioral health providers who are certified to provide MAT.
We support a range of evidence-based treatments for pain management as alternatives to opioids including:
- Coverage for acupuncture visits and physical therapy (coverage varies by plan).
We offer our members:
- A Behavioral Health Access Center, (888) 777-HPHC, where members can speak confidentially with a licensed clinician for routine behavioral health inquiries.
- A 24/7 Substance Use Treatment Helpline: (855) 780-5955, that’s free, confidential and staffed by licensed clinicians.
- liveandworkwell.com, which provides access to licensed behavioral health clinicians who provide in-depth assessment and determines the most appropriate type and level of treatment.
How we Support:
Our Mind the Moment mindfulness program, which provides access to online guided meditations and exclusive e-learning resources and discounts for members.
Discounts on complementary and alternative medicine, such as yoga. Visit Discounts & Savings to learn more.
Access to online portals and apps that offer guidance, reminders and immediate help needed to support long-term recovery.
Members have access to certified peer support specialists who have lived the experience of treatment and recovery.
We are supporting our communitites through our Quality Grants Program and the efforts of The Harvard Pilgrim Health Care Foundation.
How we Support our Employer Groups:
We offer voluntary opioid epidemic education and training in the administration of NARCAN® to any employer group that is willing to host a session in the workplace.