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Harvard Pilgrim

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LAST UPDATED: January 24th, 2024

Harvard Pilgrim Health Care (HPHC) is a local health insurance provider focused on Massachusetts, New Hampshire, and Maine. 

Whether you're looking for a group health plan, Medicare, or a plan for you and your family, HPHC has competitive options. The health insurance company also works with its affiliate HPHC insurance agency to refer health plans for international visitors issued by International Medical Group (IMG).

In addition to its local focus, the HPHC stands out because many of its plans include coverage for chiropractic care and acupuncture. You can also find competitive perks like discount and savings programs, health support, and mindfulness.

The company recently merged with Tufts Health Plan and plans to use the efficiency and savings to keep premium costs low for its members.

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The Good

  • Individual and Familiy Health Plans
  • Coverage for Chiropractic Care and Acupuncture
  • Competitive Perks
  • Reduce My Costs Program
  • Range of Group Plans
  • Support for Adults turning 65
  • Assistance with Coverage for International Visitors

Individual and Family Health Plans

You can find the common health insurance options for choosing an individual or family health insurance plan from HPHC. They include CSR, HMO, and PPO plans. CSR plans are Cost Sharing Reduction plans. These plans lower out-of-pocket expenses (e.g. deductible, copays, coinsurance) for eligible plan members.

HMO and PPO plans offer different types of physician networks. HMO (Health Maintenance Organization) plans only cover treatment from an in-network doctor. PPO (Preferred Provider Organization) plans cover in- and out-of-network physicians at different rates.

You can also find plans that are compatible with Health Savings Accounts (HSAs). These accounts allow you to set aside money in a separate account. This money is tax-free and can only be used for qualified medical expenses.

Coverage for Chiropractic Care and Acupuncture

Many of HPHC's plans include coverage for chiropractic care and acupuncture. Coverage for these services is uncommon for the industry, so this offering makes an HPHC plan advantageous.

Competitive Perks

HPHC insurance company is dedicated to helping their members with their health and well-being. Some of these perks may vary based on the kind of plan you have and your area. 

Members of Harvard Pilgrim are eligible for savings on eyewear, diet programs, dental care, massage therapy, tai chi, yoga, and fitness.

Harvard Pilgrim also has a mindfulness program called “Mind the Moment” which offers classes and workshops. Researchers have found that mindfulness helps people with stress and chronic pain. This program is also available to companies in the form of organized education and retreats. This offering makes Harvard Pilgrim unique among health insurers.

HPHC offers personal health coaches who support members over the phone with stress management, smoking cessation, blood pressure control, and more.

These programs and perks are common for the industry, so HPHC's offerings make it competitive.

Reduce My Costs Program

HPHC continues to distinguish itself from competitors with its Reduce My Costs program that helps you save costs for elective outpatient medical procedures and diagnostic tests. You can benefit from savings just by participating in the program.

In addition to Reduce My Costs, you can also get an estimate of out-of-pocket costs. This estimate can help you prepare financially for your health care costs.

Range of Group Plans

Employers and groups can also find competitive plans through Harvard Pilgrim. Although you'll need to work with the insurer directly for details, you can find the following options:

  • HMO
  • PPO
  • Limited network
  • Tiered network
  • Consumer Directed Health Plans (CDHP; compatible with HRAs or HSAs and usually have an HMO or PPO network)
  • Medicare enhance (designed for employees on Medicare)

Support for Adults Turning 65

HPHC has a program called Celebrating 65® that helps individuals as they get ready to retire and become Medicare beneficiaries. Through this educational program you can meet with sales executives and attend seminars to learn more about Social Security, Medicare, and health care during retirement. 

Although similar educational services are offered by other Medicare companies and insurance agencies, Harvard Pilgrim's Celebrating 65® program shows its dedication to helping people transition to Medicare confidently.

Of course, HPHC also offers Medicare plans including a Medicare Advantage plan called Stride and a Medicare Supplement Plan (Medigap). To view Medicare plan options in your area, you'll need to enter your zip code on HPHC's Medicare website.

Assistance with Coverage for International Visitors

If you have family coming to visit from abroad, you can work with Harvard Pilgrim's affiliate HPHC Insurance Agency to get a referral to a plan issued by International Medical Group.

This assistance with finding a health plan for international visitors makes Harvard Pilgrim stand out.

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The Bad

  • Variations by State
  • Limited Customer Insight

Variations by State

Harvard Pilgrim's offerings vary by state, so you may not always see the same types of health plans depending on where you live. However, this variation is common for the insurance industry.

Limited Customer Insight

Harvard Pilgrim Health Care reviews are few on BestCompany.com, so conclusions about member satisfaction are limited. It's also unfortunate that current reviews are mostly negative.


The Bottom Line

Although additional customer insight is necessary for a full recommendation, Harvard Pilgrim Health Care offers a nice selection of health plans and competitive perks. You can find individual and family plans, group plans, and Medicare plans. 

HPHC's affiliate HPHC Insurance Agency works with clients to find health care coverage for international visitors from IMG.

With its health plans, you can find competitive perks like health and wellness discounts, support from a health coach, and a mindfulness program.

Harvard Pilgrim stands out from other insurers for its inclusion of chiropractor and acupuncture coverage, Reduce My Costs program, and out-of-pocket cost estimator. These features make an HPHC health plan worth considering.

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francis marzilli Falmouth, ME

I wish I had learned my lesson during year one, but this is my second year with this company and it has proven to be the absolute worst of any company, insurance or otherwise, that I have dealt with in fifty years of adulthood. For the second year in a row they have taken the wrong amount for my premium, promised return calls and refunds, none of which have arrived after three weeks, and actually had the nerve to take my next premium from my pending refund a week early without my permission. Thankfully there is a robust insurance commission in my state, and they will be receiving full details of the debacle that is Harvard Pilgrim Insurance. To anyone considering purchasing insurance from them, good luck; you're going to need it.

2 months ago

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Heather Wyman West Springfield, MA

As a benefits manager for my office, I would highly advise all prospective employers looking at using HP for their benefits to think twice. Hold times over an hour an a half to reach a representative are normal at any time of the day, and it will take multiple calls and hours of effort doing incorrectly advised actions before you, or your employees actually get the help and care they deserve. STAY AWAY!

3 months ago

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michael Mike Salem, NH

absolutely the WORST the insurance company. They authorize procedures and then dont pay. I was given the green light to get a pet scan done on 12/13/203 and then told by the health provider that insurance company isnt paying. the code to pay was '78816" which is no authorization needed. i have called HP numerous times and they see the code and told someone will get back to. no one ever gets back to me. The absolute worst insurance company ever. I'm 62 yrs old and have had many insurance companies over the years. THE ABSOLUTE WORST.

9 months ago

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Milica Krajisnik Portsmouth, NH

This is the worst insurance! Their representatives don't know what they are doing. They gave you wrong informations and you end up with problems.

4 years ago

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Lynn Hillier

terrible, scripted customer service, high rates, small value

5 years ago