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Harvard Pilgrim Medicare Supplement Company Review
Last Updated on
We are all looking for the best possible company for our health care dollars. We’ve found one you may have never heard about–Harvard Pilgrim Medicare Supplements. This is an excellent company with multiple benefits.
Our review of Harvard Pilgrim will cover the company history, products, pricing, and our assessment for customers.
Harvard Pilgrim is a regional health insurance company serving the New England states of Massachusetts, Maine, and New Hampshire. If you live in these states, Harvard Pilgrim is an option you should consider for your Medicare Supplement or Medigap insurance.
Here is a brief history and background of Harvard Pilgrim, along with their product features, pricing, reviews, and our recommendation.
Harvard Pilgrim began in 1969 as the first not-for-profit health care system and HMO in the New England region. A dean of the Harvard Medical School established Harvard Pilgrim, and he still remains connected to the University and Medical School. This University backing allows the company to participate in ongoing innovative research around improving health care systems.
The company also established a Health Care Foundation in 1980. The foundation provides food and healthcare assistance to local New England communities. Since the beginning, they have given more than $140 Million in grant money to regional non-profits.
In 1994, Harvard Community Health Plan and the Pilgrim Health Plan merged. After the merger, the combined name became the Harvard Pilgrim Health Care.
Even though they are a regional company, they rank high among national companies. Harvard Pilgrim is one of the country’s top-rated health companies according to the National Committee for Quality Assurance (NCQA). They named the company: America’s number one private health plan. They also ranked the company first in member satisfaction and care quality 8 times in a row.
Products and Features
Harvard Pilgrim offers two basic Medicare products for seniors. First, they offer the traditional Medicare Supplement Product, often called Medigap. Second, they offer a Medicare Advantage Plan. Let’s review both products
Harvard Pilgrim Medicare Supplement Plans
Harvard Pilgrim offers Medicare Supplement Plans A, F, M, & N.
Medigap Plan A
Plan A is the basic benefit package for Supplement Plans. All other plans will include Plan A benefits
Plan A offers 100% coverage on:
Medigap Plan F
Medicare Supplement Plan F is the most purchased supplement product offered by Harvard Pilgrim because of its comprehensive benefits package. It covers 100% of the approved expenses that Original Medicare does not pay.
Medigap Plan M
Plan M is a good plan designed for Seniors on a budget. Plan M pays 50% of your Medicare Part A deductible. You will pay the Part B deductible and Part B excess charges. If you are a healthy individual with few health expenses, Plan M could be a good choice. If you rarely visit the doctors, the savings on your premium may outweigh your out of pocket costs. Plan M is not offered by many carriers, so comparison pricing will be limited.
Medigap Plan N
Plan N provides the basic coverage benefits of Plan A.
Plan M only pays 50% of your Part A deductible, but Plan N will cover 100% of the Part A deductible. You will be responsible both the Part B deductible and Part B excess charges. There is a $20 co-pay for each visit to the doctor and up to $50 for each emergency room visit.
Medicare Advantage Plan Services for Harvard Pilgrim Stride Value Rx (HMO)
The Stride Value Rx program is Harvard Pilgrim’s brand for its Medicare Advantage plan. Sometimes these plans are called Medicare Part C.
The Stride Value Rx plan includes the following coverages:
- Part C covers Medicare Medical, hospital benefits, and supplemental benefits if offered.
- Medicare Prescription Drug Coverage (Part-D)
- $39.00 Monthly Premiums (NH average rates)
- In-Network Maximum Out of Pocket limit of $5,600.
- Local HMO with in-network providers.
- Referrals to specialists are required by primary care physician
- No deductible
- $20 Copay for Primary Care Visits
The cap on out of pocket expense is especially beneficial. If you get sick unexpectedly or have expensive medical procedures, the most you’d pay would be $5,600.
By signing up with the Stride Value Rx you still retain Original Medicare. The difference is that you get additional Part A and Part B coverage from Harvard Pilgrim and not Original Medicare.
With Medicare Advantage plans you receive all the benefits of Original Medicare through Harvard Pilgrim, except hospice care. Original Medicare will provide any hospice care if needed.
Value Rx Plus
Harvard Pilgrim does offer one other advantage plan – the Value Rx Plus. The major difference between this and the standard Value Rx plan is lower copays. Out of pocket costs will be lower, but premiums will be higher. Consider how often you need medical care before you make a decision on this plan.
Both plans do include dental, vision, and hearing coverage. There is a $150 wallet for over the counter drugs and both plans do include a fitness membership reimbursement.
You may be eligible for premium discounts based on your income level. The Harvard Pilgrim Stride Value Rx program offers a reduction of 75%,50%, and 25% based on need.
Have you heard of the “donut hole’? It is a coverage gap for prescription drugs. Once you and the plan provider have spent $3820 on covered drugs. In 2019 once you and your plan provider have spent $3820 on covered drugs, you are in the gap. At this point, you have to 25% for brand-name drugs and 37% on generics. Harvard Pilgrim doesn’t extend coverage into the gap.
Other Features and Benefits
Beyond Medicare products, Harvard Pilgrim also has other benefits. They created a program called Celebrating 65® that helps individuals as they get ready to retire.
Because researchers have found that mindfulness helps with stress and chronic, Harvard Pilgrim created a program called “Mind the Moment”. They have created several classes and workshops that members can attend to lessen stress in their life.
Harvard Pilgrim offers personal health coaches. Members can call coaches for private consultations for:
- Stress management
- Smoking Cessation
- Lowering cholesterol
- Dealing with back pain
- Blood pressure control
- Weight management
Harvard Pilgrim Medicare Supplement Pricing
Here is a sample of average Medicare Supplement monthly premiums for customers in New Hampshire.
- Plan A: $111.00
- Plan F: $155.00
- Plan M: $116.00
- Plan N: $106.00
For Massachusetts residents, you can choose from a Core Plan or a Supplement Plan 1. The rates below were taken from from zip code 02445 in Brookline, MA. Harvard Pilgrim is also offered in Connecticut and Maine.
- Core Plan: $106.25
- Supplement Plan 1: $187.00
The Stride Value Rx plan has an average monthly premium of $61.00 and the Value Rx Plus runs around $157/month.
Members of Harvard Pilgrim are also eligible for discounts on eyewear, massage therapy, tai chi, yoga, diet programs, dental care, and fitness.
What Makes Harvard Pilgrim Different
After years of placing customers with Harvard Pilgrim, we’ve developed a list of Pros and Cons you should consider.
- Competitive Plan F premium, which is important because of the comprehensive nature of the plan.
- Over 25 years in the Medicare Supplements business.
- A full slate of Benefits that come along with being a customer
- Personal health coaching
- Regional company with local flavors. If you live in New England, you probably already know the doctors and hospitals in the program. 80,000 doctors and 183 hospitals participate.
- Known for Clinical programs, customer service, and health strategies.
- Covers many alternative therapies such as acupuncture, yoga, and Tai Chi
- Does not offer Medicare SELECT plans.
- Does not offer the most popular Medicare Supplement Plan G.
- Regional company and only available in four states, Maine, Massachusetts, and New Hampshire. They do have limited offerings in Connecticut.
If you are in New England, Harvard Pilgrim is an excellent choice for Medicare products. Their pricing on Plan F is excellent considering the broad coverage being offered. Because of their not-for-profit status and size, they do not have an A.M. Best rating. However, this should not be a concern. They have been in business for long enough and are affiliated with Harvard University.
Like all competitors, you should get multiple comparisons before making a decision on your Supplements or Advantage plans. Pricing is a big consideration, but shouldn’t be the only one.
Claims responsiveness and customer service need to be examined as well.
Let Us Help You
Most of us don’t have time to do comparison shopping for most products, especially complicated health insurance products. Use our expertise and a wide range of companies to help decide on the right product for you. Remember, Medicare supplements do not cover prescription drug plans. Otherwise known as Medicare Part D. But, don’t worry, we’ve got you covered on that, too.
We can do an analysis of your needs and then tailor the perfect product for your budget and health needs.
Contact us today!