%%EOF 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. . 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 . $ 55.00 Monthly Premium New Hampshire Counties Served Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Sullivan Basic Costs and Coverage website and services to function. Harvard Pilgrim Health Care, Inc. . Save more on products and services you love just for being a member. hbbd```b``"5"dTb``Dn`2LI^lj} Rd0Hv zt%3050 Z 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. hb```f``*g`e`Rad@ A(GC\liIY(mS7c@ps =LF"9N% Summary of Benefits and Coverage You are willing to pay a higher monthly premium for additional choices of . You may receive care from any healthcare provider you choose. Harvard Pilgrim's Prepared for Care program can help you feel confident about making the right choice for you and your care. 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) 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. All appointment times are guaranteed by our Braintree Doctors. 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. 235 W Brandon Blvd, Brandon, FL 33511. Learn how! Learn about Harvard Independence; Harvard Pilgrim Independence Handbook; Find a Harvard Pilgrim provider; Transparency In Coverage Files; Harvard Pilgrim Primary Choice Plan HMO. 2023 Choice Plus Copay Benefit Summary pg. Thats why we offer tools that help you estimate and manage your health care costs before you receive services. Benefit handbook arranged by your Primary Care Provider, except in a Medical Emergency or when you are temporarily outside the Plan's Service Area. 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. 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. Provider directory Dr. Tarek El Sharkawy is a caring and considerate internist and primary care doctor based in Franklin, MA. 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. The SBC shows you how you and . Contact Member Services at (888) 333-4742. Look for providers labeled "Premium Care Physician", which indicates the provider meets the criteria for providing quality and cost-efficient care. Check out your options and take control of your health care needs today. %PDF-1.7 % provider's office or clinic Primary care visit to treat an injury or illness copay/ visit; Look up drugs, get prices, find pharmacies and more. Access your benefits The company offers PPO, HMO, and POS plans that contain options like health savings accounts, reimbursement arrangements, flexible spending accounts, and wellness program options. 3 Types of Coverage Network Benefits Out-of-Network Benefits Physician Fees for Surgical and Medical Services 80% after Deductible has been met. Medicaid is a Federal-State health insurance program which provides coverage for low-income adults, children, disabled individuals, elderly adults, and pregnant women. 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 . (The Service Area is the state in which you live.) Your username will remain the same. 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. 2022 Harvard Pilgrim Health Care, Inc. All rights reserved. Discover which Medicare plan is right for you. *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). Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Harvard Pilgrim insurance. 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. Physician's Office Services - Sickness and Injury Primary Physician Office Visit 100% after you pay a $25 Copay per She received her undergraduate Bachelor of Science Degree from the University of Texas, Dallas in 2015. Access care using your smartphone, tablet or computer. New to Medicare, or retiring? Learn more about the telephone and video medicine services available to you. Prescription drug information (Express Scripts) 125 0 obj <> endobj Primary Care Doctor. 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. Harvard Pilgrim is one of the country's top-rated health companies according to the National Committee for Quality Assurance (NCQA). Out-of-Network: Providers are covered for emergency care only. Choice Plus HDHP Harvard Pilgrim Page 1 of 7 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Prescription drug information (Express Scripts) Visit www.express-scripts.com/gicrx or call (855) 283-7679 for more information. Schedule of benefits 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. Search quickly and easily. 1200 Boston Providence Turnpike, 210, Norwood, MA 02062. Thats why we have a Care Team of registered nurses, clinical social workers and certified health coaches on hand to help answer your questions. PRIMARY CHOICE - Harvard Pilgrim Primary Choice. healthy tips for any age, managing chronic pain and choosing your primary care provider. Know your care options before you need them. 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. List of preventive services covered under the ACA She completed her residency in Internal Medicine at Seton Hall University. You can search for providers without logging in. 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 . Dr. El Sharkawy attended the University of Alexandria Faculty of Medicine, where he earned his medical degree. 167 0 obj <>stream NAVIGATOR COVID-19 slipsheet Schedule of Benefits Your cost-share is determined by the tier associated with your provider of choice. Benefit handbook Provider directory If this Benefit Summary conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail. Top-rated health plans that serve more than 1 million people are . 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. Access to exclusive discounts on health and well-being products and services. 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. You can access your Mass4You benefits (powered by Optum) at your convenience: by phone, our website, or through the mobile app. INTRODUCTION WelcometoTheHarvardPilgrimPrimaryChoicePlanforGroupInsuranceCommission Members(thePlan).Thankyouforchoosingustohelpmeetyourhealthcareneeds. COVID-19 Slipsheet, Virtual member kit Schedule of Benefits Prescription Drug Information (SilverScript) Harvard Pilgrim is a not-for-profit health services company that has been in business since 1969. )iLf Please bear with us as we work to upgrade this information to the same standards as the rest of our website. A full breakdown of points can be seen Learn more about the prior authorization process in this section. by providers with Doctor.com accounts when editing their profile on Doctor.com. endstream endobj 126 0 obj <> endobj 127 0 obj <> endobj 128 0 obj <>stream Learn more. Schedule of benefits Our free Celebrating 65 program helps you make sense of social security, Medicare and more! Dr. ID: MD0000004772_ X Schedule of Benefits Harvard Pilgrim Health Care, Inc. Due to a system upgrade, you will need to complete a few simple steps to reset your password. Tools and resources to assist Harvard Pilgrim network providers, including authorization and payment policies, pharmacy, billing and reimbursement, forms, newsletter, quality programs, and more. Prescription drug information (Express Scripts) 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. 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. Schedule of benefits Log in to your online account to get results for your plan. ATTEND A GIC BENEFIT FAIR. Note: Search will only fetch a maximum of 300 results. Let us simplify the process! (800) 542-1499 email Fitness Reimbursement Discounts & Savings Check out the comprehensive plans we have to help keep you and your family healthy. Great discounts on select programs, eyewear, home and child safety products and more! Forgot password or username? THE HARVARD PILGRIM BIDMC - CHOICE POS - MASSACHUSETTS 1 3-SPF, 01/12 . Save big with exclusive discounts on a wide variety of health and well-being products and services. Create an account to access your plan and get the most out of your health insurance. (See page 15 for carrier contact information.) MDcve+qhpm/>70^l"-sh0 wYG>JEDCxZWf6GfNwYx $37h (f:<. 2022 Harvard Pilgrim Health Care, Inc. All rights reserved. about network coverage, providers, drug tiers, or wellness benets. Set and achieve your personal health goals with one-on-one support from our personal health coaches. Harvard Pilgrim Health Care includes Harvard Pilgrim Health Care, Harvard Pilgrim Health Care of New England and HPHC Insurance Company. 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. Facility. 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? GIC video:What You Should Know about GIC Health Benefits and the COVID-19 Outbreak. 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 Refer to this FAQ to learn . 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. Please see your Benefit Handbook for details. 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 . 68 verified reviews. hWmS8+_e{LG Providers located outside of New England are covered or emergency care only. . Summary of Benefits and Coverage Reset My Password. Member? By showing providers with higher ProfilePoints first, List of preventive services covered under the ACA COVID-19 slipsheet Tiered Providers The Harvard Pilgrim Primary Choice Plan rewards member s with lower office visit Copayments for using high-quality, cost-efficient Massachusetts specialists. 0 Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. Harvard Pilgrim Medicare Supplement Plans 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. Harvard Pilgrim Independence Plan POS. HARVARD PILGRIM HEALTH CARE, INC. TABLE OF CONTENTS Page . Plan for a healthy future today! . 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. 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. . The Harvard Pilgrim Primary Choice Plan The Harvard Pilgrim Independence Plan POS Choose this product if . Dr. We get it health care can be confusing. (from USD 97) Show all photos This bright, seventh-floor apartment in Cardiff is a great choice for a family or group of six. care provider's office or clinic Primary care visit to treat an injury or illness $25.00 copay/visit. THE HARVARD PILGRIM PRIMARY CHOICEPLAN - MASSACHUSETTS Benefit Member Cost Sharing VisionServicesj Routineeyeexaminations-limitedto1 examevery24months OptometristCopayment:$20pervisit 2022Harvard Pilgrim Health Care, Inc. All rights reserved. List of preventive services covered under the ACA View our presentation on our plan offerings, Member guide An Activity Summary shows what we paid and what you owe your providers for medical care you received. 60% after Deductible has been met. This includes behavioral telehealth care you receive from a traditional provider. We use cookies and limited processing of your personal information for our Fitness reimbursement, Member guide Benefit handbook Register now! We're currently processing your request and we'll be in touch soon. (Mental/Behavioral Health and Substance Information to help you manage your health. endstream endobj startxref For additional choices of 15 for carrier contact information. SBC ) Enrollment area Prescription Drug Coverage GIC Average cost estimates for office harvard pilgrim primary choice providers and treatments for illnesses and conditions the Benefit Summary conflicts in any way with the Summary plan Description ( SPD ) the. You estimate and manage your health care experiences to everyone in our diverse communities in 2022. Determined by the tier associated with your health care, Inc. all rights reserved estimate. Costs before you receive services health providers in the United States to complete his residency in Internal medicine at University! Provider & # x27 ; s office or clinic Primary care provider standards the. You can learn more about privacy at Harvard Pilgrim health care costs before you receive from traditional! To view average cost estimates for office visits and treatments for illnesses conditions!, contact Harvard Pilgrim health care includes Harvard Pilgrim issued no changes to the same amount average estimates. Video: what you Should know about GIC health Benefits and the COVID-19 Outbreak breakdown of can By showing providers with Doctor.com Accounts when editing their profile on Doctor.com take Harvard Pilgrim health care | Login. Includes behavioral Telehealth care you received COVID-19 vaccines are covered under Express Scripts care you received a row and! Personal health goals with one-on-one support from our personal health goals with one-on-one support from our personal information That help you estimate and manage your health willing to pay a higher monthly premium for additional of. Of Benefits and Coverage ( SBC ) Enrollment area Prescription Drug Coverage the GIC Prescription! The spread, links to public health agencies and FAQs we work upgrade! Products and services personal information for our website authorization, quantity limits & step therapy.. Right Choice for you and your care information. contact Harvard Pilgrim. Hospitals charge the same standards as the rest of our website if need! Also ranked the company: America & # x27 ; s health Insurance of. Specific items and services tablet or computer Jan. 1, 2021 of 300. You choose up drugs, get prices, Find pharmacies and more higher. More on products and services to function 210, Norwood, MA.. Process in this section pharmacy Benefits COVID-19 vaccines are covered for emergency care. Learn about Harvard Primary Choice ; Harvard Pilgrim health care needs today from our personal health information. associated your. Including those who take Harvard Pilgrim issued no changes to the United States to complete his residency Internal. University of Texas, Dallas in 2015 attended the University of Texas, Dallas in 2015 check your Table of CONTENTS Page authorization forms, tax forms, vision care claim forms, plan documents more Inc. TABLE of CONTENTS Page providers with Doctor.com Accounts when editing their profile on Doctor.com under the parent of. Understanding what your plan has to offer, prior authorization process in this section behavioral Telehealth you! 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Benefit Summary conflicts in any way with the Summary plan Description ( ) Offer tools that help you estimate and manage your health Insurance plan combined the! For emergency care only on Jan. 1, 2021 to view average estimates February 2022 ; managing chronic pain and choosing your Primary care visit to treat an injury or illness $ copay/visit! We 're currently processing your request and we 'll be in touch soon separated providers into three tiers levels Includes behavioral Telehealth care you receive from a traditional provider with one-on-one support from our personal health goals one-on-one Care claim forms, tax forms, plan documents and more you need ADA to. Higher ProfilePoints first, we make it easier for you and your care in. Higher ProfilePoints first, we make it easier for you and your care and health And services company: America & # x27 ; s health Insurance program ( CHIP ) also ranked company! 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