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Harvard Pilgrim Health Insurance Company

Harvard Pilgrim Health Insurance Company was founded over 30 years ago with the mission, “to improve the health of the people we serve and the health of society.” Ever since, they have done their best to improve health care for their clients in Maine, New Hampshire, and Massachusetts through disease management, preventive care, and quality emergency care.

Read through this Harvard Pilgrim review, check out the reviews of Harvard Pilgrim Health Insurance left by customers at the bottom of this page, and then be sure and compare quotes from multiple health insurance providers online by using the free tool on the side of the page.

Here is a little more about Harvard Pilgrim. These facts can help you decide if this company can meet your health care needs.

US News & World Report Rating

For four years in a row, Harvard Pilgrim has been rated number one in US News and World Reports America’s Best Health Plans edition. In addition to this, Harvard Pilgrim provides programs for the community and holds teaching programs for those who statistically don’t have the best access to medical care. Teaching topics include medical ethics, asthma control, women’s health issues, and mental health care. Harvard Pilgrim also started a blog that answers questions and updates consumers on changes to the insurance industry.

Harvard Pilgrim Network Growth

Since 1980, Harvard Pilgrim has steadily increased access to physicians and health care facilities. The company has done this by allowing a variety of doctors to participate including large specialty groups, individual practices, and small medical groups. This has resulted in 135 hospitals and over 28,000 physicians being a part of the Harvard Pilgrim medical community.

Member Benefits

Members of Harvard Pilgrim are given many benefits in addition to health care coverage. Benefits include: free eye wear, help with laser vision correction surgery, hearing aids, $150 towards a fitness membership, reimbursement for fitness DVDs, discounts at sports clubs, 25% off acupuncture and chiropractic care, discounts on massage therapy, discounts at Diet.com, Jenny Craig, or Weight Watchers, discounts on comfort bedding, child safety products, senior care assistant, health magazine subscription discounts, and spa discounts.

Harvard Pilgrim HMO Plan

Harvard Pilgrim offers a wide variety of plans to meet the total range of needs of their clients. Their HMO Plan is available through employers and is a comprehensive coverage plan. It includes coverage for well-baby check-ups, emergency care, immunizations, routine office visits, and preventive care. The insured chooses a primary care physician (PCP) who helps guide the overall care of the individual. There are co-pays, but this eliminates bills and reimbursement claims.

Harvard Pilgrim POS Plan

Harvard Pilgrim also offers a POS Plan through an employer. This too is a comprehensive plan which covers a wide variety of services and medical situations. A primary care physician is chosen and service through the PCP, or arranged by this person, are covered in full with just a small co-pay. Under this plan, members can choose to go to doctors, hospitals, and clinics outside of Harvard Pilgrim’s network. However, deductibles and co-insurance applies.

Harvard Pilgrim PPO Plan

The PPO plan offered through Harvard Pilgrim is a comprehensive plan available through employers. Members do not have to choose a Primary Care Physician and can choose to receive care from in network or out of network providers. Outside of the network there are over 360,000 providers and over 3,500 hospitals to choose from nationwide. Again, going outside the network subjects members to deductibles and coinsurance; but, the flexibility allows you to make your own choices.

Harvard Pilgrim Best Buy Plan

Those who need a lower premium, but adequate coverage, can get one of Harvard Pilgrim’s Best Buy Plans. Best Buy Plans combine the best features of HMO’s and PPO’s, but with a lower premium. Premiums are lower because these plans have deductibles and co-pays. If you are a typically healthy person, this type of plan may save you money in the long run.

Harvard Pilgrim First Seniority Freedom Plan

For those 65 and older, Harvard Pilgrim offers the First Seniority Freedom Plan. This is a Medicare supplement plan and offers fee for service coverage. Anyone who qualifies for Medicare can sign up for this plan on January 1st of each year. By doing this, members are committing to staying in the program for a full calendar year. This plan is meant to fill in the gap that is often left with Medicare.

Harvard Pilgrim Pulse Plan

The Pulse Plan is for members aged 18-26 years old. This is an affordable health care plan with monthly premiums as low as $119 a month. Coverage includes three doctor’s visits a year, choice of doctors, prescription drug coverage for $15 per prescription, fitness club reimbursement. This plan is ideal for college students or those who just graduated and are looking for a job.

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Even with all this information, it is still important to shop around to make sure you are getting your best deal. You can use the comparison tool on this page right now to compare rates and quotes from top companies. It’s easy to do. Just type your zip code into the box above, and you’re on your way!

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3 reviews

  • sharon gutwin /
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    • 11111
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    I am a provider and find Harvard Pilgrim one of the worst insurers to do business with.

    The administrative demands are more time consuming and costly than the vast majority and what is paid is often less than my cost of providing the service.

    Customer service is almost useless for resolving real problems. It is unfortunate that Harvard Pilgrim is going opposite to health care reform.

  • Unhappy /
    • 11111
    • 11111
    • 11111
    • 11111

    HP care has gone downhill!

    If you want to spend all your time filling out paperwork and on the phone, then this is the company for you. If you want health care, go somewhere else! I’ve been a customer for over 20 years. They’ve changed and NOT for the better!!

    It now costs $50 to see a specialist in Partners and that adds up. I have two excellent doctors at my local hospital and it now costs $50 to see them instead of the regular co-pay. I can’t afford Physical Therapy because of the $50 co-pay. Going twice a week for a month is $400 dollars!

    I have two kids in college. One needed vaccines for an internship involving travel so he got them at school. HPHC denied them. A customer service rep told me they are routine and covered but because he got them at school and not his PCP they won’t cover them! But if he attended an out-of-state school they would be covered.. Doesn’t matter that he is 90 miles away and doesn’t have a car. But if he went to college in NH which is 10 miles away he’d be covered.

    My other son will be 100 miles away with no transportation. I was told by customer service I have to change his PCP every time he goes to or leaves school in order to use their infirmary. So before and after every semester I have to change doctors. Anyone else see how RIDICULOUS this is?? Our current PCP sure does.

    Then there’s compounded prescriptions… if you need one your PCP has to request coverage in writing from HPHC explaining why you need it. And then you have to wait for approval.

    HPHC has gone off the deep end with their policies and procedures. It’s a bureaucratic NIGHTMARE!!

  • Anthony Diggins /
    • 11111
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    I am a 55-year-old male who suffers from low testosterone.I have been on a testosterone med for over a year and with having to increase my dosages I have started to benefit from it . Went to pick up a refill at the pharmacy and out that Harvard Pilgrim decided that I don’t need to be on that anymore (androgel).

    They decided that my symptoms were not improving on the medicine.I spoke with someone on the phone about this and all they said was that I could do would be to appeal the issue.I asked about another med and they said they would not cover any testosterone medicine for me.

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