Harvard Pilgrim Health Care Insurance Review

Harvard Pilgrim Health Care offers a range of insurance plans to suit different needs and budgets.

Their network covers over 90% of primary care physicians in Massachusetts, making it easy to find a doctor near you.

With Harvard Pilgrim, you can choose from various plan options, including HMO, PPO, and POS plans, each with its own set of benefits and features.

Their plans often include preventive care services, such as annual physicals and screenings, at no additional cost to you.

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Harvard Pilgrim Health Care has a strong reputation for healthcare quality, with an overall rating of 5.6/10 from HealthCare Insider.

Their HMO, PPO, and POS plans, as well as Medigap options, are highly rated.

Harvard Pilgrim Health Care has high NCQA ratings, indicating a commitment to quality and patient-centered care.

Their robust telehealth services allow for convenient access to medical care from the comfort of your own home.

While they have a low NAIC complaint index, some members have mixed reviews about billing and claims issues.

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Harvard Pilgrim Health Care has a strong mix of HMO, PPO, and POS plans, as well as Medigap options, but no STM or Medicaid plans.

Their high NCQA ratings indicate a high level of quality care. They also offer robust telehealth and strong wellness programs.

Harvard Pilgrim has a low NAIC complaint index, but some members have mixed reviews on billing and claims issues.

If you're considering Harvard Pilgrim for Medicare Supplement plans, you can choose from Plans A, F, G, M, and N in Maine and New Hampshire. In Massachusetts, you can buy a Core Plan, a Supplement 1 Plan, or a Supplement 1A Plan.

In Maine and New Hampshire, Harvard Pilgrim's Plan F and Plan G might be good choices, respectively. In Massachusetts, all of Harvard Pilgrim's plans have average rates, but you may be able to find a cheaper plan with another company.

Harvard Pilgrim only sells Medicare Advantage plans in New Hampshire, with four plans ranging from $0 to $132 per month. All plans offer enhanced drug coverage, as well as additional benefits like acupuncture, chiropractic care, and virtual doctor appointments.

Here's a breakdown of the benefits included in Harvard Pilgrim's Medicare Advantage plans in New Hampshire:

Harvard Pilgrim Health Care offers a range of medical coverage options, including routine preventive care and maternity care services, which are covered at no out-of-pocket cost.

All SchoolCare/Harvard Pilgrim plans include routine preventive care and maternity care services covered at no out-of-pocket cost.

Harvard Pilgrim covers in vitro fertilization (IVF), one of the most common fertility treatments, on some of its plans, which can be a deciding factor for those considering IVF due to its high average cost of $12,400.

Harvard Pilgrim Health Care ranked second in J.D. Power's 2022 Massachusetts customer satisfaction survey for group plan health insurance.

You can buy an individual and family health insurance plan from Harvard Pilgrim in Maine, Massachusetts, and New Hampshire between November 1st and January 15th each year, which is called open enrollment.

To buy a plan in New Hampshire, you should go to HealthCare.gov, while both Maine and Massachusetts use their own state-run marketplaces, CoverME and Massachusetts Health Connector, respectively.

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Harvard Pilgrim Health Care has a strong regional presence, mainly serving Massachusetts, Maine, and New Hampshire through its ACA and Medicare plans, with national reach through Access America and Medicare Enhance.

The health care provider has received high NCQA ratings, indicating good quality in its services. This is a testament to its commitment to delivering high-quality care to its members.

Harvard Pilgrim's wellness programs and telehealth services are also notable strengths, allowing members to access care remotely and prioritize their well-being. Global emergency coverage is available on select plans, providing added peace of mind for members traveling abroad.

However, there are some drawbacks to consider. Premiums are rising, which may impact members' budgets and financial planning. Additionally, plan options are limited outside of New England, which may require members to seek alternative coverage if they move or travel to other areas.

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Harvard Pilgrim Health Care has its strengths and weaknesses. Here are some key points to consider:

They offer good reproductive health coverage, which is a plus for those who value comprehensive care. Their plans also have high NCQA quality ratings, indicating a strong focus on quality healthcare.

One area where they shine is in their regional strength in New England, particularly for ACA and employer plans. They also offer national and global coverage through Access America and Medicare Enhance.

However, their limited plan availability outside of core New England states is a drawback, as is the fact that no ACA plans are available outside of these states. Additionally, they've experienced premium increases in some markets, such as a 8.8% hike in Massachusetts.

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Harvard Pilgrim Health Care offers some great benefits. They have regional strength in New England for ACA and employer plans.

Their global coverage is quite impressive, with options like Access America and Medicare Enhance. This means you can get medical care while traveling abroad, which is a big plus for frequent flyers.

You can also expect high NCQA quality ratings, which is a testament to their commitment to providing excellent care. Plus, their robust wellness and telehealth programs can help you stay healthy and connected.

They offer a wide range of provider choices, including tiered and POS options. This flexibility is great for people with different needs and preferences.

If you're considering health insurance options, it's essential to weigh the pros and cons of each plan. Unfortunately, there are some downsides to certain health insurance plans.

One major con is that they may not be available in all areas. For example, ACA plans are not offered outside of the core New England states.

Premium increases are another issue, with some markets experiencing significant hikes. In Massachusetts, for instance, premiums rose by 8.8% in some areas.

Customer complaints have also been filed regarding billing issues and out-of-network claims. It's frustrating to deal with these types of problems, especially when you're already worried about your health.

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Additionally, you won't find short-term or student health plans available through these insurance providers. If you're in a situation where you need temporary coverage, you'll need to look elsewhere.

Limited plan variety is another con, particularly outside of employer and retiree markets. This can make it harder to find a plan that fits your needs and budget.

Harvard Pilgrim Health Care has a robust provider network across New England with national access through employer products.

The tiered HMO/POS plans offer varying cost levels based on provider choice.

All SchoolCare/Harvard Pilgrim plans include routine preventive care and maternity care services covered at no out-of-pocket cost.

Additional services may be fully covered or covered with a deductible and/or a co-pay.

You can review a one-page summary of your specific coverage by clicking the button below and selecting your employer from the dropdown menu.

Harvard Pilgrim covers in vitro fertilization (IVF) on some of its plans, which can be a deciding factor if you're considering this fertility treatment.

The average cost of an IVF treatment is $12,400, according to the American Society for Reproductive Medicine.

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Harvard Pilgrim Health Care offers a range of plans with varying costs. The company's rates are generally higher than the state average, but there are some exceptions.

The average monthly cost of a Silver health insurance plan from Harvard Pilgrim is $563 per month.

If you live in Maine, Harvard Pilgrim's rates are closer to the state average, making it a good option to consider.

Harvard Pilgrim's rates vary by plan tier, with Bronze plans costing $500 per month, Silver plans costing $593 per month, and Gold plans costing $680 per month.

Here's a breakdown of Harvard Pilgrim's rates compared to the state average for a 40-year-old:

Harvard Pilgrim also offers Medicare Advantage plans, which cost an average of $63 per month in New Hampshire.

The company's Medicare Supplement plans are available in Maine, Massachusetts, and New Hampshire, with rates varying by state and plan type.

In Maine and New Hampshire, Harvard Pilgrim's rates for Plan F and Plan G are competitive, but in Massachusetts, its rates are closer to the state average.

Here's a breakdown of Harvard Pilgrim's rates for Medicare Supplement plans in Maine, Massachusetts, and New Hampshire:

Overall, Harvard Pilgrim's rates are worth considering, especially in Maine and New Hampshire where they offer competitive options.

Harvard Pilgrim offers some really great benefits and perks on its plans. These extras can help you take care of your overall health and well-being.

One of the perks is access to Doctor On Demand, which lets you speak to a licensed medical professional through a smartphone app or web portal at any time. This service is perfect for less serious illnesses and injuries, such as colds, allergies, and migraines.

You can also use Doctor On Demand for mental health support, which is really important for your emotional well-being. Many people struggle with mental health issues, and having access to support can make a big difference.

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Some Harvard Pilgrim plans help pay for therapy, which is a great way to get the support you need. Coverage varies, so it's a good idea to check your plan's details or talk with a company representative to see if mental health coverage is included for you.

If you're considering using Doctor On Demand, keep in mind that it's not for serious issues like broken bones or chest pain. It's best for when you need advice on how to manage a minor health issue.

Harvard Pilgrim has built a strong reputation for customer service and satisfaction.

Their customer reviews and feedback have consistently shown high levels of satisfaction, but a data breach in 2023 put millions of plan holders at risk for identity fraud.

Harvard Pilgrim Health Care has a strong mix of HMO, PPO, and POS plans, as well as Medigap options, but it doesn't offer short-term medical insurance or Medicaid.

The company has high ratings from the National Committee for Quality Assurance (NCQA) and offers robust telehealth services and wellness programs.

Harvard Pilgrim has a low complaint index with the National Association of Insurance Commissioners (NAIC), but some members have mixed reviews about billing and claims issues.

Overall, Harvard Pilgrim has earned high ratings from customer surveys and third-party organizations, indicating good coverage and perks, but it's usually more expensive than other health insurance companies.

Harvard Pilgrim has consistently earned high ratings from customer surveys and from third-party organizations like the National Committee for Quality Assurance (NCQA).

The company sells several kinds of health insurance with good coverage and perks, including a strong mix of HMO, PPO, and POS options, as well as Medigap options.

However, Harvard Pilgrim is usually more expensive than other health insurance companies.

Harvard Pilgrim's high NCQA ratings and robust telehealth services make it a good choice for those looking for quality healthcare.

Mixed member reviews on billing and claims issues are a drawback, but Harvard Pilgrim's low NAIC complaint index suggests that it handles complaints efficiently.

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Harvard Pilgrim has a 4.5/5 star rating from the National Committee for Quality Assurance (NCQA), reflecting an overall high level of care and service.

The company's patient experience and treatment categories earned 3.5/5 stars, signaling slightly above-average quality levels.

Harvard Pilgrim has 60% fewer complaints about its health insurance plans than expected for a company its size, according to the National Association of Insurance Commissioners (NAIC).

The company has taken steps to combat problems stemming from a 2023 cyberattack, but identity theft is still an ongoing concern for victims of the attack.

Harvard Pilgrim offers a strong HMO/PPO/POS mix and Medigap options, as well as robust telehealth and wellness programs.

However, the company has a low NAIC complaint index but mixed member reviews on billing and claims issues.

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We used publicly available data from the Centers for Medicare & Medicaid Services (CMS) to create average 2024 monthly rates for Harvard Pilgrim Health Care and state averages.

Rates are for a 40-year-old with a Silver plan, unless otherwise noted. The national average cost for a Harvard Pilgrim health plan was calculated by averaging the average rates for a Silver plan in the three states where plans are sold.

Plans and providers for which county-level data was included in the CMS Crosswalk file were used in our analysis; those excluded from this data set may not appear.

Medicare Advantage rates are from CMS, and we only considered 2024 plans that include prescription drug coverage.

We excluded employer-sponsored plans, Medicare-Medicaid plans, Medicare savings account (MSA) plans, sanctioned plans, Special Needs Plans (SNPs), Program of All-Inclusive Care for the Elderly (PACE) plans, and prepayment plans (HCPPs).

Medigap rates are based on actuarial data from private health insurance companies and represent the cost at initial enrollment for a 65-year-old woman who doesn't smoke.

We sourced average complaint rates from the National Association of Insurance Commissioners (NAIC) by averaging overall complaint indexes for Harvard Pilgrim Health Care of New England and Harvard Pilgrim Health Care Incorporated.

Ratings are from the 2022 and 2023 J.D. Power US Commercial Member Health Plan Study.

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To get an accurate picture of Harvard Pilgrim Health Care's rates and services, ValuePenguin used publicly available data from the Centers for Medicare & Medicaid Services (CMS). This data was used to create average 2024 monthly rates for Harvard Pilgrim Health Care and state averages.

For health insurance rates, the analysis focused on a 40-year-old with a Silver plan, unless otherwise noted. This is an important consideration, as different plan types and ages can have significant impacts on insurance costs.

The national average cost for a Harvard Pilgrim health plan was calculated by averaging the average rates for a Silver plan in the three states where plans are sold. This provides a comprehensive view of the company's rates across different regions.

Medicare Advantage rates are also from CMS, and are for 2024 Medicare Advantage plans that include prescription drug coverage. This analysis excludes certain types of plans, such as employer-sponsored plans and Special Needs Plans (SNPs).

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Medigap rates are based on actuarial data from private health insurance companies, and represent the cost at initial enrollment for a 65-year-old woman who doesn't smoke. This is a key consideration for individuals who are just becoming eligible for Medicare.

The rankings and survey data used in this analysis are from the National Committee for Quality Assurance (NCQA) and the National Association of Insurance Commissioners (NAIC). Average complaint rates from the NAIC were sourced by averaging overall complaint indexes for Harvard Pilgrim Health Care of New England and Harvard Pilgrim Health Care Incorporated.

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