Harvard provides optional medical and dental coverage to eligible retirees, their spouses/domestic partners (at the time of retirement) and their eligible dependents.
Your eligibility and cost for retiree health coverage depends on several factors, including when you began working at the University, your employee group, the length of your University service and date of retirement. For details, please review our Retiree Health Coverage overview.
For an estimated date when you may meet eligibility for retiree health benefits, please click on our post-retirement health eligibility calculator.
Important Notice: Health Plan Resources for COVID-19; Certain Copayments Waived
Over-the-counter COVID test coverage:
If you are enrolled in a Harvard-sponsored retiree medical plan, you and your enrolled dependents can be reimbursed for, and purchase or order – at no charge to you – up to eight at-home COVID test kits each per 30-day period through Express Scripts (ESI). Here’s how it works:
Purchase: Buy tests at any ESI network pharmacy, show your ESI ID card when you check out at the pharmacy counter (not the regular checkout lane), and the tests should ring up at no cost to you. To find a local ESI pharmacy, visit express-scripts.com and click “Find a Pharmacy.”
Be reimbursed: If you purchase at a non-ESI pharmacy or pay via the regular checkout lane, you can submit your receipts for reimbursement - up to $12 per test ($24 per two-pack). You can be reimbursed for test kits purchased on or after January 15, 2022.
Note: For those enrolled in a HUGHP or BCBS (other than Medex) plan, requests submitted to BCBS for eligible home test kits purchased January 15 through February 4, 2022 will be processed by BCBS. Tests purchased after February 4 must be submitted to Express Scripts. You cannot be reimbursed for the same kits through both BCBS and ESI.
As the University continues to work to address issues related to coronavirus and the illness it causes, COVID-19, Harvard in conjunction with its health plans will waive certain copayments.
HPHC Medicare Enhanced
For retirees and covered dependents enrolled in HPHC Medicare Enhanced, there will be not member cost-sharing on the following COVID-19 services until further notice:
- COVID-19 diagnostic testing
- COVID-19 treatment
- Telemedicine services for the treatment of COVID-19. Telemedicine services are covered when medically necessary and clinically appropriate.
Cost-sharing and copayments waived as follows:
- For medically-necessary testing, counseling (vaccines, when available) and treatment provided at doctors' offices, emergency rooms and urgent care centers, and acute inpatient care consistent with the guidance issued by the Massachusetts Division of Insurance. Any medical treatment for COVID-19 is covered under a member's health plan within the U.S. and internationally.
- For telephonic and telehealth visits when covered by Medicare, and with a Medicare participating provider, for COVID-19 services.
Tufts Health Plan Medicare Preferred
This plan works with Medicare to cover related needs, as follows:
- Medicare covers the lab tests for COVID-19. Members pay no out-of-pocket costs.
- Medicare covers all medically necessary hospitalizations. This includes if you're diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an in-patient stay, but need to stay in the hospital under quarantine.
- Cost-sharing is waived for COVID-19 lab tests.
- Cost-sharing is waived for telehealth for COVID-19 related care.
- Learn more.
Express Scripts, provider of pharmacy benefits for all Harvard medical plans, offers home delivery for medications. Also note that early refill requirements will be removed for 60 days starting Monday, March 16.
Medial plans continue to evaluate the situation; be sure to check back for updates (posted 3/16/2020).
Plans for Retirees/Dependents Age 65 and Over
Retirees and eligible spouses/domestic partners (and eligible dependents if any) age 65 and over may choose from one of the following plans that supplement Medicare:
- Blue Cross Blue Shield (BCBS) of Massachusetts Medex (no residential restrictions) (Medex Summary of Benefits)
- Harvard Pilgrim Health Care Medicare Enhance, (must live in the U.S.)
- Tufts Health Plan Medicare Preferred HMO (must live in the Tufts HMO service area)
- Kaiser Permanente – available only to retirees of Dumbarton Oaks and the Center for Hellenic Studies living in Washington, D.C., Maryland, and Virginia.
View plan feature comparison charts and rates here.
These plans supplement Medicare and you must also enroll in that coverage 2-3 months prior to turning age 65. You can get additional information at www.Medicare.gov. Also please review this Glossary of Medicare Terms and FAQs.
Prescription Coverage for Retirees in Senior Medical Plans: Participants in Harvard’s medical plans for those over age 65 (except Kaiser Permanente) receive prescription drug benefits included as part of their medical coverage. There is no need to sign up for a separate Medicare Part D plan. Express Scripts Medicare® is the administrator for the prescription benefit in all Harvard-sponsored medical plans. Retirees with questions may call Express Scripts at 877-787-8684 with questions and visit express-scripts.com for more information and to set up an online account.
Plans for Retirees/Dependents Under Age 65
Retirees and eligible spouses/domestic partners (and eligible dependents if any) under age 65 may choose from the same plans offered to active employees.
- Retiree faculty and nonunion staff under age 65 are covered under the active plans for faculty and nonunion staff
- Retirees under age 65 who were members of ATC, HUPA, HUSPMGU, Local 26, and SEIU and retired prior to 9/4/2014 are covered under the active plans for faculty and nonunion staff; those who retired on or after 9/4/2014 are covered by the plan for their union
- Retirees under age 65 who were members of HUCTW and retired prior to 7/5/2011 are covered under the active plans for faculty and nonunion staff; those who retired on or after 7/5/2011 are covered by the plan for their union
Retirees and covered dependents may be eligible to use SmartShopper, a free service that helps you compare costs for certain medical procedures and tests, find lower cost providers and receive a financial incentive up to $250 for using a preferred provider. Learn more.
Retirees and covered dependents under age 65 are eligible for program through PillarRx Consulting that finds copay assistance programs from drug manufacturers for certain specialty medications. If you are prescribed an eligible medication, you will be contacted by PillarRx with details. Learn more.
View plan feature comparison charts and rates here.
Notice: Transparency in Coverage Rule
In 2020, the Federal Government finalized “Transparency in Coverage” Rule, which requires health insurers and group health plans and sponsors to provide cost-sharing data to consumers via machine-readable files and consumer transparency tools.
Dental Plan for Retirees
If you meet the eligibility requirements for retiree health, then you and your spouse (and eligible dependents if any) may participate in the retiree Delta Dental Plan, which has a network of more than 5,000 dentists, including those at the University Health Services Dental Clinic.
You will have two opportunities to enroll in retiree dental coverage:
- At the time of retirement; or
- When you enroll in retiree medical coverage for the first time, if after your initial retirement date