Harvard offers you a choice of several medical plans so that you can compare the options and select a plan that best meets your and your family’s needs and preferences. All plans (except the PPO) are offered through both of our providers: Harvard’s own Harvard University Group Health Plan (HUGHP) and top-rated Harvard Pilgrim Health Care (HPHC). See how the two provider networks compare here.
Health Maintenance Organization (HMO)
With an HMO, you select a primary care physician (PCP) who coordinates your care and can provide you with referrals to in-network specialists. Out-of-network care is not covered, except in certain emergency situations.
Point of Service (POS)
Like an HMO, you designate a PCP. However, you have the flexibility to use out-of-network providers for services.
Also available to Faculty and Nonunion Staff
High-Deductible Health Plan (HDHP) Featuring lower premiums and higher deductibles than a traditional health plan, the HDHP is offered in conjunction with a Health Savings Account (HSA). (External postdocs and stipendees are not eligible for this plan.)
With the same benefits as a traditional POS, the POS Plus plan has higher premiums and a higher out-of-pocket maximum in exchange for no deductible or coinsurance for in-network services.
Also available to SEIU Arboretum
Preferred Provider Organization (PPO)
Available only to employees who live outside Massachusetts. Go to any health care professional you choose inside or outside your network without a PCP referral. Only available through HPHC.
Also available to SEIU members
Combined medical, dental and vision coverage through the SEIU for members and eligible dependents (domestic partners are not eligible). If you enroll in the SEIU plan, you cannot also be enrolled in Harvard’s dental or vision coverage.
Learn more by reviewing our Medical Plan Overview for 2019.
Prescription coverage is included in all Harvard plans and is provided through Express Scripts. Express Scripts offers a number of web- and app-based tools, including drug price comparison, signing up for mail order, downloading a member ID card and more. Learn how to make the most of these tools.
Global benefit program
For eligible employees working abroad. Learn more.
Retiree health programs
Benefits for employees who are in retirement. Learn more.
Compare plan features and rates
To compare plans available to you, including rates and coverage options, please go to the Plan Rates & Features page and choose the information for your employee group.
COBRA, Layoff, Global Plan and Ex-Spouse rates can be found under Forms & Documents > Total Rewards > Health Benefit Rates. Rates for Domestic Partner can be found at Forms & Documents > Total Rewards > Domestic Partner.
Fitness reimbursement benefit
Harvard Pilgrim Health Care and HUGHP provide members with a fitness reimbursement of up $150 annually toward membership at gyms/fitness facilities. Check with your health plan provider for details about eligible facilities and reimbursement instructions.
All faculty and staff enrolled in a Harvard-sponsored medical plan have access to an optional program, SmartShopper, that lets you compare costs for certain medical procedures and receive a financial incentive of up to $250 for using a preferred provider.
Prices for same quality medical services can vary by hundreds to thousands of dollars. When your doctor recommends a procedure or test, visit the SmartShopper portal (see flyer for portal links) or call the Personal Assistant team at 877-281-3722 for HUGHP members; 877-274-0746 for HPHC members to determine whether the procedure is offered at a convenient provider at a lower price. When you select a more cost-effective location, you will recieve a financial incentive. Sample incentives (many other procedures are included):
|Health Care Service||Financial incentives paid to participant (amount depends on provider selection)|
|Bone density scan||$25-$50|
|Knee or shoulder arthroscopy||$50-$250|
Payments are taxable and you will receive a 1099 tax form for reporting purposes from SmartShopper when you receive $600 or more in a year. Employees and dependents are eligible provided they are not also enrolled in Medicare or Medicaid.
University Benefits Committee Fact Sheet
The University Benefits Committee (UBC) has provided a Medical Program Fact Sheet with key statistics on the University’s Medical Program to help deepen the community’s understanding of the plan and its related costs. It provide some key spending, enrollment, and utilization statistics for 2013 through 2016. The fact sheet is available here. Comments or questions can be directed to the UBC at email@example.com.
Harvard is required under the federal Affordable Care Act (ACA) to provide Form 1095-C to active employees eligible for Harvard group health coverage in 2018, indicating that coverage meets the ACA's "Minimum Essential Coverage." The 2018 forms will mailed in mid-February, and, by law, they must be postmarked by 3/2/19. This form should be kept with your tax records (although you are not required to submit the form with your tax return). You can learn more here: