You can search for providers without logging in. Look up drugs, get prices, find pharmacies and more. 2022Harvard Pilgrim Health Care, Inc. All rights reserved. Virtual Choice SM gives Connecticut members access to more innovative virtual primary care plans to best fit their family's health care needs. arranged by your Primary Care Provider, except in a Medical Emergency or when you are temporarily outside the Plan's Service Area. Our free Celebrating 65 program helps you make sense of social security, Medicare and more! 2023 Choice Plus HDHP Benefit Summary pg. Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. From preparing for maternity leave to dealing with being a working parent, find resources to support you no matter where you are in the journey of reproductive health, pregnancy and parenthood. ID: MD0000004772_ X Schedule of Benefits Harvard Pilgrim Health Care, Inc. Easily access your information and begin feeling secure with your health. HARVARD PILGRIM HEALTH CARE, INC. Canton, Massachusetts As of December 31, 2020 NAIC GROUP CODE 0595 NAIC COMPANY CODE 96911 EMPLOYER ID NUMBER 04-2452600 . Benefit handbook Harvard Pilgrim issued no changes to the provider tier assignments for the 2022-2023 plan year. 2023 Choice Plus Copay Benefit Summary pg. . @>J]z FYYNp! ; H,tgr'^|hDG`2 G 11 %%EOF If you need ADA accommodation to access our materials, contact Harvard Pilgrim. HNE - Health New England. They named the company: America's number one private health plan. We make staying healthy fun, informative and engaging with a variety of activities on topics like eating healthy, mindfulness, financial wellness, stress management and more! (from USD 97) Show all photos This bright, seventh-floor apartment in Cardiff is a great choice for a family or group of six. The SBC shows you how you and . . Primary Care Doctor. Top-rated health plans that serve more than 1 million people are . P hysicians in the following 13 specialties have been rated and placed into one of three categories or "tiers." Tier 1 C opayments are the lowest and Tier 3 C . Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Harvard Pilgrim insurance. Don't wait, get the best treatment options today! Tips for preventing the spread, links to public health agencies and FAQs. 1 Choice Plus HDHP (HSA Qualified) Harvard Pilgrim This Benefit Summary is intended only to highlight your Benefits and should not be relied upon to fully determine your coverage. Your cost-share is determined by the tier associated with your provider of choice. Create an account to access your plan and get the most out of your health insurance. Find Harvard Pilgrim Health Care Doctors in Braintree, Massachusetts & make an appointment online instantly! Contact Member Services at (888) 333-4742. Discover which Medicare plan is right for you. For a faster response, please call us directly at 888-666-8135. However, not all doctors and hospitals charge the same amount. hWmS8+_e{LG Call Now: (888) 407-2072. Harvard Pilgrim Independence Plan POS. Schedule of Benefits . Summary of Benefits and Coverage (SBC) Enrollment area Prescription Drug Coverage The GIC provides prescription drug coverage through Express Sctipts. %PDF-1.7 % Harvard Pilgrim is a not-for-profit health services company that has been in business since 1969. Register now! ProfilePoints measure the overall completeness of a Total number of Providers on Doctor.com who Accept Harvard Pilgrim: Most popular medical specialty of providers who accept Harvard Pilgrim: Harvard Pilgrim providers listed on Doctor.com have been practicing for an average of: Average ProfilePoints score for Providers who take Harvard Pilgrim: Average Overall User Rating for providers who take Harvard Pilgrim. The Harvard Pilgrim Primary Choice sm Plan Massachusetts 1 Schedule of Benefits The Harvard Pilgrim Primary Choice sm Plan Massachusetts Services listed are covered when medically necessary and provided or arranged by Harvard Pilgrim Health Care Primary Choice Providers. List of preventive services covered under the ACA Log in. Summary of Benefits and Coverage Fitness reimbursement, Virtual member kit Know . 0f`H$881000&0Nc`t`Tddo{ye(`X84-. iM2@v,. In-Network: Cambridge Health Alliance (CHA) and CHA ReferredSearch CHA providers and facilities, Search Harvard Pilgrim Health Care providers and facilities*. The Harvard Pilgrim Primary Choice Plan The Harvard Pilgrim Independence Plan POS Choose this product if . 13353 Bel-Red Rd, #105, Bellevue, WA 98005 4.94 17 verified reviews Dr. Wendy completed her Naturopathic Medical Degree and degree in Acupuncture and East Asian Medicine from Bastyr University in 2021. Summary of Benefits and Coverage The information you are about to access may not meet accessibility standards for people with disabilities, including visual impairment, nor is it optimized for people using tablets or phones. Provider directory Harvard Pilgrim Health Care and Tufts Health Plan combined under the parent organization Point32Health on Jan. 1, 2021. . If youre already enrolled in Tufts Health Plan or Harvard Pilgrim through the GIC, there wont be any changes to your plan as a result of our combination, and theres nothing you need to do differently. You will need to select a plan name to search for participating providers. GIC video:What You Should Know about GIC Health Benefits and the COVID-19 Outbreak. Being a Harvard Pilgrim member is so rewarding! Forgot password or username? Benefit handbook Managing out-of-pocket costs can be confusing. 2022 Harvard Pilgrim Health Care, Inc. All rights reserved. She received her undergraduate Bachelor of Science Degree from the University of Texas, Dallas in 2015. Create a secure account to see your personal health information. Tier 2:Harvard Pilgrim Health Care and UnitedHealthcare Options PPOYou'll pay slightly more cost share when you choose HPHC and United Healthcare providers. The SBC shows you how you and . The Massachusetts Managed Care Reform Law requires disclosure of premium information and information concerning Harvard Pilgrim Health Care's voluntary and . The company offers PPO, HMO, and POS plans that contain options like health savings accounts, reimbursement arrangements, flexible spending accounts, and wellness program options. COVID-19 Slipsheet, Virtual member kit If you're not sure of your plan's network, check your member ID card, log in to your online account, or give us a call at the phone number listed on your card and we can help. Learn more about the telephone and video medicine services available to you. Benefit handbook Practicing mindfulness involves breathing methods, guided imagery and more to help the mind to refocus on the present moment, relax the body and mind, and reduce stress. Log in to your online account to get results for your plan. Primary Choice is a limited-network plan that offers an ideal combination of access and cost. 3 Types of Coverage Network Benefits Out-of-Network Benefits Physician Fees for Surgical and Medical Services 80% after Deductible has been met. PRIMARY CHOICE - Harvard Pilgrim Primary Choice. provider's office or clinic Primary care visit to treat an injury or illness copay/ visit; by providers with Doctor.com accounts when editing their profile on Doctor.com. Tiered Providers The Harvard Pilgrim Primary Choice Plan rewards members with lower office visit Copayments for using high - quality, cost-efficient Massachusetts specialists. The Harvard Pilgrim Primary ChoicePlan MASSACHUSETTS PleaseNote . Note: Search will only fetch a maximum of 300 results. Harvard Pilgrim Health Care includes Harvard Pilgrim Health Care, Harvard Pilgrim Health Care of New England and HPHC Insurance Company. Member? Let us simplify the process! Here you'll find information on a variety of health topics: behavioral health conditions, healthy tips for any age, managing chronic pain and choosing your primary care provider. Fitness reimbursement, Member guide (800) 542-1499 email Fitness Reimbursement Discounts & Savings with a behavioral health professional. *Information contained in this database is either primary-source verified or self-reported by the physician, and is validated every 36 months during recredentialing (with the exception of Medical group affiliation, which is determined by contractual arrangement). THE HARVARD PILGRIM PRIMARY CHOICEPLAN - MASSACHUSETTS Benefit Member Cost Sharing VisionServicesj Routineeyeexaminations-limitedto1 examevery24months OptometristCopayment:$20pervisit NAVIGATOR She completed her residency in Internal Medicine at Seton Hall University. COVID-19 slipsheet website and services to function. PHARMACY BENEFITS COVID-19 vaccines are covered under Express Scripts. Username. insurance, payment options, etc. 235 W Brandon Blvd, Brandon, FL 33511. Due to a system upgrade, you will need to complete a few simple steps to reset your password. From personalized support in dealing with stressful health conditions or life changes to behavioral health tools, we make it easy to talk (or message!) Prescription drug information (Express Scripts) HARTFORD, Conn. (April 28, 2021) - Harvard Pilgrim Health Care and Doctor On Demand today announced the launch of Virtual Choice SM, a unique plan that allows adult family members over the age of 19 to have a choice of how they receive primary care . Great discounts on select programs, eyewear, home and child safety products and more! Primary Care Doctor. *Care received from Harvard Pilgrim Health Care providers and facilities is covered only when referred by a CHA provider. Harvard Pilgrim Stride Choice Rx (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by Harvard Pilgrim Health Care, Inc.. Plan ID: H6750-014. Know your options and select the right care for your specific needs, day or night, virtually or in-person. . Being a Harvard Pilgrim member is so rewarding! Dr. El Sharkawy attended the University of Alexandria Faculty of Medicine, where he earned his medical degree. Whether you need help managing your weight or controlling your blood pressure, a health coach will support, educate and motivate you to achieve your health goals. MDcve+qhpm/>70^l"-sh0 wYG>JEDCxZWf6GfNwYx $37h (f:<. care provider's office or clinic Primary care visit to treat an injury or illness 20% coinsurance (Mental/Behavioral Health and Substance endstream endobj startxref Thats why we offer tools that help you estimate and manage your health care costs before you receive services. Fitness reimbursement, Member guide List of preventive services covered under the ACA )iLf  provider's profile, including items like having a photo, a biography, COVID-19 Information and Resources - Harvard Pilgrim Health (7 days ago) 7.1.22: Removed previously end dated policies related to prior authorization and concurrent review; streamlined existing COVID-19 Treatment information; added information Harvardpilgrim.org . Behavioral health treatments; Healthy tips for any age; Managing chronic pain; Save time and money. He then immigrated to the United States to complete his residency in internal medicine at Hahnemann University Hospital. Check out your options and take control of your health care needs today. Dr. Kilgore is a graduate of the University of South Florida where he majored in zoology and chemistry, and the University of Tennessee with honors in 1975. Check out the comprehensive plans we have to help keep you and your family healthy. Please bear with us as we work to upgrade this information to the same standards as the rest of our website. Search quickly and easily. Save big with exclusive discounts on a wide variety of health and well-being products and services. Plan for a healthy future today! care provider's office or clinic Primary care visit to treat an injury or illness $25.00 copay/visit. Schedule of benefits HARVARD PILGRIM HEALTH CARE - 41 Reviews - 93 Worcester St, Wellesley Hills, MA - Yelp Harvard Pilgrim Health Care 41 reviews Unclaimed Insurance Eagle Trust Insurance Winchester Associates Ralph J Galante Insurance Agency Garrity Insurance Frequently Asked Questions about Harvard Pilgrim Health Care How is Harvard Pilgrim Health Care rated? List of preventive services covered under the ACA, Prescription drug information (Express Scripts), Prescription Drug Information (SilverScript), What You Should Know about GIC Health Benefits and the COVID-19 Outbreak, The video provides important tips and resources to help members with GIC health coverage during the COVID-19 outbreak. Access to exclusive discounts on health and well-being products and services. Harvard Pilgrim's Prepared for Care program can help you feel confident about making the right choice for you and your care. We use cookies and limited processing of your personal information for our From the most commonly asked questions to understanding your plan, our Help section provides everything you need to know to successfully navigate your health care journey. Tiered Providers The Harvard Pilgrim Primary Choice Plan rewards member s with lower office visit Copayments for using high-quality, cost-efficient Massachusetts specialists. The 2022-2023 plan year for Harvard Pilgrim and the Group Insurance Commission's (GIC's) Primary Choice HMO and Independence Plan POS begins on July 1, 2022. All appointment times are guaranteed by our Braintree Doctors. THE HARVARD PILGRIM PRIMARY CHOICEPLAN - MASSACHUSETTS Tiered Provider Specialists . Dr. Anjali Choudhary, MD 3 mi Internist 550 Newark Ave, Suite 406, Jersey City, NJ 07306 4.70 532 verified reviews Dr. Anjali Choudhary attended the School of Graduate Medical Education, at the Jersey City Medical Center. 4.81. An Activity Summary shows what we paid and what you owe your providers for medical care you received. The term "Primary Care Provider" (PCP) includes physicians and nurse practitioners in the following specialties: Internal medicine, Family Top 10 Harvard Pilgrim Provider Specialties in Shrewsbury, MA: Internist (8 providers) Family Doctor (3 providers) Obstetrician / Gynecologist (OBGYN) (3 providers) Ophthalmologist (Eye Doctor) (3 providers) Optometrist (Eye & Vision Specialist) (2 providers) Pediatrician (Kids / Children Specialist) (2 providers) Surgeon (2 providers) Prescription drug information (Express Scripts) Out-of-Network: Providers are covered for emergency care only. Facility. Schedule of benefits Look for providers labeled "Premium Care Physician", which indicates the provider meets the criteria for providing quality and cost-efficient care. Together, we're delivering ever-better health care experiences to everyone in our diverse communities. 1200 Boston Providence Turnpike, 210, Norwood, MA 02062. You can learn more about privacy at Harvard Pilgrim by reading their Privacy Policy. Harvard Pilgrim Health Care, Inc. . Visit www.express-scripts.com/gicrx or call (855) 283-7679 for more information. GIC works with Benefit Strategies to administer Flexible Spending Accounts for active state employees. A full breakdown of points can be seen ALLWAYS COMPLETE - AllWays Health Partners Complete HMO. Top 10 Harvard Pilgrim Provider Specialties: Internist (3718 providers) Pediatrician (Kids / Children Specialist) (2533 providers) Family Doctor (2306 providers) Obstetrician / Gynecologist (OBGYN) (1337 providers) Surgeon (850 providers) Orthopedic Surgeon (757 providers) Cardiologist (Heart Specialist) (725 providers) We get it health care can be confusing. 2022 Harvard Pilgrim Health Care, Inc. All rights reserved. Specific items and services require that either your provider or you obtain approval (prior authorization) from Harvard Pilgrim. - Harvard Pilgrim Independence. Learn more about the prior authorization process in this section. Learn about Harvard Primary Choice; Harvard Pilgrim Primary Choice Handbook; Find a Harvard Pilgrim provider; Transparency In . 146 0 obj <>/Filter/FlateDecode/ID[<229762ED7A849B47AA676C2ABA5A6B11>]/Index[125 43]/Info 124 0 R/Length 102/Prev 191414/Root 126 0 R/Size 168/Type/XRef/W[1 3 1]>>stream healthy tips for any age, managing chronic pain and choosing your primary care provider. Let us guide you toward information on how to apply for Social Security benefits, what types of health care options are available to you under Medicare, and much more. hbbd```b``"5"dTb``Dn`2LI^lj} Rd0Hv zt%3050 Z . If this Benefit Summary conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail. INTRODUCTION WelcometoTheHarvardPilgrimPrimaryChoicePlanforGroupInsuranceCommission Members(thePlan).Thankyouforchoosingustohelpmeetyourhealthcareneeds. Zocdoc helps you find Doctors in Braintree and other locations with verified patient reviews and appointment availability that accept Harvard Pilgrim Health Care and other insurances. Set and achieve your personal health goals with one-on-one support from our personal health coaches. Choice Plus HDHP Harvard Pilgrim Page 1 of 7 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Tier 1:Cambridge Health Alliance (CHA) and Beth Israel Deaconess Medical Center (BIDMC)You'll receive the highest level of benefits and pay the lowest cost share when you choose from providers and facilities of CHA and BIDMC, and the facilities listed below. Your policy remains in place, you can use your current ID card and you can continue to enjoy the great programs and services you do today. Save more on products and services you love just for being a member. Did you know you can get reimbursed for fees paid toward fitness facilities, certain complementary and alternative medicine services, weight management programs and more? (The Service Area is the state in which you live.) MassHealth is comprised of Medicaid and the Children's Health Insurance Program (CHIP). Prescription drug information (Express Scripts) Schedule of benefits By using our site, you agree to our use of cookies and our, Pediatrician (Kids / Children Specialist), Gastroenterologist (Stomach & Bowel Specialist), Otolaryngologist (Ear, Nose & Throat - ENT), Endocrinologist (Diabetes & Hormones Specialist), Physiatrist (Physical Medicine & Rehabilitation), Rheumatologist (Joints & Arthritis Specialist), Plastic, Reconstructive, and Cosmetic Surgeon, Thoracic Surgeon (Cardiothoracic Vascular Surgeon), General Practice Doctor (General Practitioner), Hepatologist (Liver, Gallbladder & Pancreas), Medical Geneticist (Genetic & Hereditary Disease Specialist), Technologists, Technicians & Other Technical Service Providers. Were here to provide education and information about your medicines, including potential side effects, helpful tips on how to take your medications and more. Apr 28, 2021, 12:00 ET HARTFORD, Conn., April 28, 2021 /PRNewswire/ -- Harvard Pilgrim Health Care and Doctor On Demand today announced the launch of Virtual Choice SM, a unique plan that. You may receive care from any healthcare provider you choose. Harvard Pilgrim Medicare Supplement Plans Summary of Benefits and Coverage Prepared for Care information Employee assistance program You can access your Mass4You benefits (powered by Optum) at your convenience: by phone, our website, or through the mobile app. Save big with exclusive discounts on a wide variety of health and well-being products and services. Benefit handbook This includes behavioral telehealth care you receive from a traditional provider. Every doctor and hospital participating in your plans networks meets stringent nationally-accepted quality standards. This provider search tool also shows information about the cost of care. . Medicaid is a Federal-State health insurance program which provides coverage for low-income adults, children, disabled individuals, elderly adults, and pregnant women. THE HARVARD PILGRIM BIDMC - CHOICE POS - MASSACHUSETTS 1 3-SPF, 01/12 . Dr. Effective January 15, 2022, insurance carriers and plan sponsors (such as the GIC) will be required to cover the cost of up to 8 at-home/over-the-counter rapid test kits for COVID-19 each month, in response to the widespread impact of the Omicron variant. OTHER BENEFITS Understanding what your plan has to offer, Prior authorization, quantity limits & step therapy policies. Starting on July 1, 2021, for all non-Medicare health plans, each covered member will be eligible for three no-copay in-network behavioral health telehealth visits per year. When your primary care providers office isnt open and you need medical care for a non-life-threatening injury or illness, you have optionsother than the ERthat can save you time and money. endstream endobj 126 0 obj <> endobj 127 0 obj <> endobj 128 0 obj <>stream Tier 1: Cambridge Health Alliance (CHA) and Beth Israel Deaconess Medical Center (BIDMC) You'll receive the highest level of benefits and pay the lowest cost share when you choose from providers and facilities of CHA and BIDMC, and the facilities listed below. Access care using your smartphone, tablet or computer. Prescription drug information (Express Scripts) Your cost-share is determined by the tier associated with your provider of choice. COVID-19 Slipsheet. Please note, if your CHA or BIDMC provider is also in the Harvard Pilgrim or UnitedHealthcare networks, they are still considered a Tier 1 provider.Harvard Pilgrim Health Care and UnitedHealthcare Options PPO United Behavioral Health Network Tier 3:All other non-network providersYou'll pay the highest cost share when you choose out of network providers. Harvard Pilgrim is one of the country's top-rated health companies according to the National Committee for Quality Assurance (NCQA). Password. 68 verified reviews. You want to save money with a lower monthly premium and you will be sure to use a smaller provider and hospital network (except in medical emergencies). MD0000002668 . about network coverage, providers, drug tiers, or wellness benets. (Have your ID card handy.). View our presentation on our plan offerings, Member guide Providers located outside of New England are covered or emergency care only. Back to Table of Contents 4 Click on a specific provider to view average cost estimates for office visits and treatments for illnesses and conditions . Reset My Password. The Harvard Pilgrim Primary Choice HMO Summary of Benefits and Coverage: Whatthis Plan Covers & You Pay For Covered Services Massachusetts Coverage 07/01/2017Period: 06/30/2018 . Providers received their tier assignment notifications in February 2022. Thats why we have a Care Team of registered nurses, clinical social workers and certified health coaches on hand to help answer your questions. Provider directory Health Plans Inc. is a Harvard Pilgrim company Copyright 2022, Harvard Pilgrim Health Care and UnitedHealthcare Options PPO, Search Harvard Pilgrim Health Care providers and facilities, MetroWest Medical Center Framingham/Natick. We apologize for the inconvenience. Learn more. Tools and resources to assist Harvard Pilgrim network providers, including authorization and payment policies, pharmacy, billing and reimbursement, forms, newsletter, quality programs, and more. His career in medicine has spanned clinical practice, treating patients, and medical research. Provider directory Harvard Pilgrim has tools and resources to help your overall well-being: saving money on well-being products and services, a health assessment to learn about ways to improve your health, or even meet with a health coach. Please see your Benefit Handbook for details. We're currently processing your request and we'll be in touch soon. List of preventive services covered under the ACA We are excited and optimistic about our future, and we believe our new organization will bring more value to you and the communities we serve. Making decisions about your care and treatment can be stressful. So weve separated providers into three tiers (levels). Learn about Harvard Independence; Harvard Pilgrim Independence Handbook; Find a Harvard Pilgrim provider; Transparency In Coverage Files; Harvard Pilgrim Primary Choice Plan HMO. List of preventive services covered under the ACA Physicians in the following 13 specialties have been rated and placed into one of three categories or "tiers." Tier 1 Copayments are the lowest and Tier 3 Copayments . Schedule of Benefits By showing providers with higher ProfilePoints first, Harvard Pilgrims Prepared for Care program can help you feel confident about making the right choice for you and your care. Access your benefits Need help with your account? You are willing to pay a higher monthly premium for additional choices of . Harvard Pilgrim placed its participating physicians and hospitals into one of two tiers for the Primary Choice plan and one of three tiers for the Independence Plan, based on cost and quality performance. 0 Your username will remain the same. Category: Health Detail Health Schedule of Benefits hb```f``*g`e`Rad@ A(GC\liIY(mS7c@ps =LF"9N% Find a provider in your network Select your network name below to start your provider search. Learn how! COVID-19 Slipsheet, Virtual member kit 60% after Deductible has been met. They also ranked the company first in member satisfaction and care quality 8 times in a row. Dr. Tarek El Sharkawy is a caring and considerate internist and primary care doctor based in Franklin, MA. COVID-19 slipsheet Benefit handbook Know your care options before you need them. Prescription Drug Information (SilverScript) $ 55.00 Monthly Premium New Hampshire Counties Served Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Sullivan Basic Costs and Coverage Reimbursement forms, authorization forms, vision care claim forms, tax forms, plan documents and more all in one convenient location. Information to help you manage your health. 125 0 obj <> endobj Dr. Provider directory HARVARD PILGRIM HEALTH CARE, INC. TABLE OF CONTENTS Page . Benefit handbook 167 0 obj <>stream (Mental/Behavioral Health and Substance Refer to this FAQ to learn . Our Tufts Health Together plan provides high-quality MassHealth . Summary of Benefits and Coverage (See page 15 for carrier contact information.) ATTEND A GIC BENEFIT FAIR. COVID-19 slipsheet we make it easier for you to quickly identify the most informative profiles on Doctor.com. Schedule of Benefits Provider tiering Welcome, GIC employees. Choice Plus Copay Harvard Pilgrim Page 1 of 7 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Prescription Drug Information (SilverScript) You can access your Mass4You benefits (powered by Optum) at your convenience: by phone, our website, or through the mobile app. New to Medicare, or retiring? Physician's Office Services - Sickness and Injury Primary Physician Office Visit 100% after you pay a $25 Copay per

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