Medical

Medical Plans

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. Plans are offered through two providers: Harvard's own Harvard University Group Health Plan (HUGHP) and Blue Cross Blue Shield of Massachusetts (BCBSMA). 

While both networks offer access to the same specialists, if you enroll in HUGHP, you will need to choose a primary care physician within the Harvard University Health Services or Atrius Health provider network. See how the two provider networks compare.

Plan options

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, with higher out-of-pocket costs.

Preferred Provider Organization (PPO)
Available only to employees who reside outside New England through BCBSMA. Go to any health care professional you choose inside or outside your network without a PCP referral. You will have higher out-of-pocket costs for out-of-network care.

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.)

POS Plus
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. 

PPO Plus
Available only to employees who reside outside New England through BCBSMA. Same benefits as the PPO, but with higher premiums and a higher out-of-pocket maximum in exchange for no deductible or coinsurance for in-network services. 

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 2020.

Prescription coverage
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.

Additional  plans

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/weight-loss reimbursement benefit

HUGHP and BCBSMA provide members with a reimbursement of up $150 per year toward membership at gyms/fitness facility or eligible weight-loss program. Check with your health plan provider for details about eligible facilities and reimbursement instructions. Español - Solicitud de reembolso por acondicionamiento físico.

Note: If you were covered by Harvard Pilgrim Health Care (HPHC) during 2019, you have until March 31, 2020 to file for a 2019 fitness reimbursement through HPHC.

SmartShopper

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 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 receive a financial incentive.

Note: If you were in an HPHC plan in 2019 and had a SmartShopper referral or appointment for services for 2020, you will need to call SmartShopper Personal Assistant team at 877-281-3722 to get a new referral. 

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
Bunionectomy $50-$150
Cataract removal $50-$125
Colonoscopy $50-$250
CT scan $50-$75
Knee or shoulder arthroscopy $50-$250
Mammogram $25-$50
MRI $50-$100
Ultrasound (non-maternity) $50-$150

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.

Form 1095-C

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 2019, indicating that coverage meets the ACA's "Minimum Essential Coverage." The 2019 forms will mailed in mid-February, and, by law, they must be postmarked by 3/2/20. 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: