Harvard Pilgrim Health Care provides health care benefit plans, programs, and services in Massachusetts, New Hampshire, and Maine. It was formed in 1994 from the Harvard Community Health Plan merger, founded in 1969. As one of the leading not-for-profit health services providers, Harvard Pilgrim provides services to more than 3 million customers. They have an expansive network of doctors and hospitals that focus on patient-centered care by maintaining clinical quality.
TUFTS Health Plan is a non-profit organization founded in 1979. It is nationally recognized for providing innovative and outstanding quality health care services. TUFTS offers a wide range of health management programs for its members at an affordable price point. They are dedicated to improving the health and wellness of the vast community with high-quality health care services.
Harvard Pilgrim Health Care
Harvard Pilgrim offers extensive health care programs and services in Massachusetts, New Hampshire, and Maine. They provide plans for individuals, family members, and medicare programs for older adults.
Individual and Family Plans
Harvard Pilgrim offers the following plans for each of the three states:
Massachusetts
Harvard Pilgrim Health Care offers HMO, HMO, and HMO HSA, PPO, and PPO and PPO HSA plans for individuals and family members. Here is a list of some of the healthcare plans offered in Massachusetts:
HMO
- HMO 25-Flex
- HMO 1000-Flex
- HMO 2000-Flex
- HMO 2000 with Coinsurance-Flex
HMO and HMO HSA
- HMO 1750 Core-Flex
- HMO HSA 2000-Flex
- HMO HSA 3400-Flex
Focus HMO Plans
- Focus HMO 25
- Focus HMO HSA 3400
PPO
- PPO 25-Flex
- PPO 1000-Flex
PPO and PPO HSA
- PPO 2000-Flex
- PPO 3000-Flex
- PPO HSA 3400-Flex
Connector Plans
- Standard Platinum-Flex
- HMO 2000 Low-Flex
- Standard Low Silver HAS-Flex
New Hampshire
Harvard Pilgrim offers the following off-exchange and on-exchange health care plans for individuals and family members:
ElevateHealth HMO
- ElevateHealth HMO Gold 1500
- ElevateHealth HMO Silver 4000
- ElevateHealth HMO Bronze 6000
- ElevateHealth HMO Catastrophic
ElevateHealth HMOS HSA
- ElevateHealth HMO HSA Silver 3750
- ElevateHealth HMO HAS Bronze 625
ElevateHealth Options HMO
- ElevateHealth Options HMO Gold 500
- ElevateHealth Options HMO Silver 3000
Besides these, the on-exchange health care plans also contain –
- ElevateHealth CSR (Cost Sharing Reduction)
- ElevateHealth Options CSR (Cost Sharing Reduction)
Maine
Harvard Pilgrim offers the following off-exchange and on-exchange health care plans for individuals and family members in Maine:
HMO and HMO HSA
- HMO Gold 1500
- HMO Silver 3000
- HMO HSA Bronze 6000
Maine’s Choice PlusSM HMO
- Maine’s Choice PlusSM HMO Gold 1200
- Maine’s Choice PlusSM HMO Silver 4800
Maine’s Choice PlusSM HMO HSA and HMO Catastrophic
- Maine’s Choice PlusSM HMO Silver 6500
- HMO Catastrophic
Silver CSR Plans
- HMO Silver 3000 CSR73
- HMO Silver 3000 CSR94
- Maine’s Choice PlusSM HMO Silver 2700 CSR73
Medicare Plans
Harvard Pilgrim Health Care provides support to those above 65 years age. They offer Medicare parts A and B, Medicare Advantage, and Medical Supplement plans to customers who depend on others for their survival. These are the Medicare plans offered by Harvard Pilgrim:
- StrideSM (HMO) Medicare Advantage Plan – MA
- StrideSM (HMO) Medicare Advantage Plan – NH
- StrideSM (HMO) Medicare Advantage Plan – ME
TUFTS
Like Harvard Pilgrim, TUFTS also offers a wide range of health care plans and services for its customers. The programs are directed towards employers, individuals, and families, medicare, etc.
Employer, Individual, and Family Plans
Each of our needs is unique and different from one another. TUFTS offers fourth-quarter deductible carryover so that customers can get the same money in case of emergency. The following plans are available at TUFTS for employers, individuals, and families:
- HMO Plans
- PPO Plans
- Advantage HMO and PPO
- Advantage Saver HMO and PPO
- Tiered Plans
- TUFTS Premier
- CareLink
- Cigna Out-of-Area PPO
Medicare Plans
Healthcare providers offer Medicare plans for people of 65 years of age or above that. To opt for a Medicare plan, an individual must meet certain requirements, including mental or physical disabilities or other forms of dependencies. TUFTS offer the following Medicare plans to their customers –
- TUFTS Health Plan Medicare Advantage
- TUFTS Medicare Preferred Supplement
- TUFTS Health Plan Senior Care Options (HMO-SNP)
TUFTS Health Direct Plans
With TUFTS Health Direct plans, customers can get 24/7 nurse care and support from registered nurses. Besides, these plans also cover preventive care, such as annual check-ups and mandatory health examinations. The following programs are offered under Health Direct plans:
- Direct ConnectorCare I
- Direct ConnectorCare II
- Direct ConnectorCare III
- Direct Catastrophic
- Direct Bronze 2700
- Direct Bronze 3550 with Coinsurance
- Direct Silver 2000
- Direct Silver 2000 HSA
- Direct Silver 2000 II
- Direct Silver 2500 with Coinsurance
- Direct Gold
- Direct Gold 2000
- Direct Platinum
TUFTS Health RITogether
TUFTS Health RITogether is specifically designed for the citizens of Rhode Island. The benefits of this program include –
- Full coverage of doctors and specialists visits
- No prescription copayments
- Full coverage of eye exams
- Gift card for children, teens, and adults if they attend annual check-ups
- Free fitness band for adults
- $25 gift card for diabetic members if they take the annual screening
- Cashback offer of up to $50 on gym fees or fitness activities
TUFTS Health Together Plans
TUFTS offers five MassHealth plans to the residents of Massachusetts. They have four Accountable Care Organization (ACO) plans and one traditional MassHealth plan named Managed Care Organization (MCO) –
- TUFTS Health Together with Atrius Health
- TUFTS Health Together with CHA
- TUFTS Health Together with BIDCO
- TUFTS Health Together with Boston Children’s ACO
- TUFTS Health Together (MCO)
TUFTS Health Unity
With the TUFTS Health Unity program customers can get medical, behavioral health, pharmacy, vision, and dental benefits of MassHealth and Medicare.
What type of insurance is TUFTS Health Plan?
TUFTS Health Plan offers MassHealth and Rhode Island Medicaid plans for its customers. These plans cover all Medicaid benefits and offer benefits such as vision, behavioral health, etc. furthermore.
Does TUFTS Health Plan offer dental services?
TUFTS Health Plan offers dental services in coordination with Delta Dental at an affordable price. Their services include –
- Type I Services: Preventive Care
- Type II Services: Basic Restorative
- Type III Services: Major Restorative
Harvard Pilgrim Health Care and TUFTS offer a wide array of health care programs and services for their customers. They give priority to their customers, and that is why their services are cheap and affordable. To know more about their costings and other benefits, please visit www.harvardpilgrim.org and www.tuftshealthplan.com.
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