at a glance
- Harvard Pilgrim sells Medicare supplement (Medigap) plans in Massachusetts, Maine, and New Hampshire.
- All plans may not be available in all areas.
- You must have original Medicare (Part A and Part B) to sign up for Medigap.
Harvard Pilgrim is an insurance company that sells Medicare Advantage plans and Medicare supplement (Medigap) plans. It sells these plans to people who live in Massachusetts, Maine, and New Hampshire.
In Maine and New Hampshire, Harvard Pilgrim sells five different Medigap plan types. In Massachusetts, it sells three plan types.
If you live in these states and are researching Medigap plans, here’s what you should know about Harvard Pilgrim’s offerings.
Private insurance companies like Harvard Pilgrim sell Medigap insurance to reduce your out-of-pocket spending. The plans are standardized and named for letters A through N, though some plans (like Plan H and Plan J) are no longer available.
These are different from the letter-name parts of Medicare, such as Medicare Part A and Medicare Part B.
The parts of Medicare refer to your healthcare coverage, such as hospital insurance (Part A) or medical insurance (Part B) for things like doctor’s visit coverage. Medigap plans help cover your expenses for this coverage.
Examples of expenses Medigap plans can cover include:
- Part A costs. Medigap plans may cover costs associated with Part A, such as the Part A deductible, Part A coinsurance, and Part A hospice and skilled nursing facility care coinsurance or copayments.
- Part B. Medigap plans may cover Part B costs, such as coinsurance or copayments and Part B excess charges.
- Foreign travel emergency treatment. This coverage option helps pay for certain healthcare costs (usually up to about 80 percent) while you’re traveling internationally.
- Blood up to the first three pints. If you require a blood transfusion while in the hospital, these plans will cover up to the first three pints of blood needed, which can be costly to pay for out of pocket.
- Out-of-pocket spending. Plans K and L limit out-of-pocket spending up to a specified amount. If you spend the set amount on healthcare in a given year, your Medigap policy will cover the rest of your out-of-pocket expenses for the remainder of the year.
Each policy differs in terms of coverage. When selecting the best one for you, it’s a good idea to consider your needs and budget.
Harvard Pilgrim Medigap plan extra benefits
Harvard Pilgrim also offers additional benefits to plan subscribers. Examples of these benefits include discounts and savings programs, such as:
- discounted membership in the Universal Dental Plan, which offers a 20 to 50 percent discount on all dental procedures from its network of participating dentists
- savings on hearing aids and eyewear purchases
- savings on alternative therapy treatments, such as massage therapy, acupuncture, and chiropractic care
- reimbursement for membership fees at fitness facilities or classes
These are just a few of savings programs available, which vary based on where you live.
Harvard Pilgrim’s Medigap plan offerings vary by location. Here are the 2021 plans offered by state.
New Hampshire and Maine
Harvard Pilgrim sells Medicare supplement policies A, F, G, M, and N to customers in New Hampshire and Maine.
These Medigap plans are standardized and include the following:
- Medigap Plan A. This plan provides coverage for Part A and Part B coinsurance but not for skilled nursing facility coinsurance, foreign travel exchange, or the Medicare Part A and Part B deductibles.
- Medigap Plan F. Plan F was formerly the most comprehensive Medigap plan until Medicare stopped its availability to people new to Medicare as of January 1, 2020. The plan covers Parts A and Part B coinsurance, copayments, and deductibles as well as blood up to the first three pints and 80 percent of foreign travel health costs.
- Medigap Plan G. Now the most comprehensive Medigap plan available, Plan G covers Medicare Part A and Part B coinsurance and copayments, the Part A deductible, blood up to the first three pints, and 80 percent of foreign travel healthcare costs.
- Medigap Plan M. Medigap Plan M covers Part A coinsurance and hospice care coinsurance, blood up the first three pints, and 50 percent of the Medicare Part A deductible, among other costs.
- Medigap Plan N. Medigap Plan N is similar to Plan M, except it requires a copayment for some office and emergency room visits.
Below is a chart that allows you to compare the Medigap plans that Harvard Pilgrim offers:
| Plan A | Plan F | Plan G | Plan M | Plan N | |
|---|---|---|---|---|---|
| Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up | yes | yes | yes | yes | yes |
| Part B coinsurance or copayments | yes | yes | yes | yes | yes, with some set copayments |
| Blood (first 3 pints) | yes | yes | yes | yes | yes |
| Part A hospice care coinsurance or copayments | yes | yes | yes | yes | yes |
| Skilled nursing facility care coinsurance | no | yes | yes | yes | yes |
| Part A deductible | no | yes | yes | 50% | yes |
| Part B deductible | no | yes | no | no | no |
| Part B excess charges | no | yes | yes | no | no |
| Foreign travel exchange (up to plan limits) | no | 80% | 80% | 80% | 80% |
Available plans in Massachusetts
Massachusetts structures Medigap plans differently than most states. Instead of having plan options A through N, Massachusetts has three plans:
- Core Plan
- Supplement 1 Plan
- Supplement 1A Plan
The following chart compares the coverage offered by each of these plan types:
| Core Plan | Supplement 1 Plan | Supplement 1A Plan | |
|---|---|---|---|
| Basic benefits | yes | yes | yes |
| Part A inpatient hospital deductible | no | yes | yes |
| Skilled nursing facility coinsurance | no | yes | yes |
| Part B deductible | no | yes* | no |
| Foreign travel emergency | no | yes | yes |
| Inpatient days in mental health hospitals | 60 days | 120 days | 120 days |
| State-mandated benefits | yes | yes | yes |
*Note that if you’re new to Medicare after January 1, 2020, you can no longer purchase a Supplement 1 Plan due to changes that prohibit new policies from covering the Part B deductible.
The “basic benefits” referenced in the chart above cover the following costs:
- Part A coinsurance plus coverage for 365 additional days after Medicare coverage ends
- Part B coinsurance
- first three pints of blood
- hospice coinsurance or copayments
The state-mandated benefits cover costs such as Pap tests and mammograms. You can check your plan details for additional coverage required in your state.
Medicare supplement plans can vary based on:
- the plan selected
- the area you live in
- other factors, such as your age and if you smoke
You can search for cost estimates for Medigap plans using Medicare’s plan finder tool.
The following are some examples of monthly Medigap premium ranges in Harvard Pilgrim’s service areas. For these examples, we used data for a 65-year-old woman who doesn’t smoke.
| Plan A | Plan F | Plan G | Plan M | Plan N | |
|---|---|---|---|---|---|
| Bangor, ME | $134–$293 | $220–$378 | $199–$353 | $172–$312 | $155–$225 |
| Portland, ME | $134–$293 | $220–$378 | $199–$353 | $172–$313 | $155–$225 |
| Concord, NH | $98–$198 | $174–$354 | $139–$330 | $156–$211 | $102–$252 |
| Core Plan | Supplement 1 Plan | Supplement 1A Plan | |
|---|---|---|---|
| Boston, MA | $108–$163 | $201–$259 | $156–$251 |
| Cambridge, MA | $108–$163 | $201–$259 | $156–$251 |
These are just cost estimates. Monthly premiums may vary based on your ZIP code, age, and overall health status.
You can contact the company directly for a price quote for your specific situation.
Medigap aims to reduce out-of-pocket spending when you have original Medicare (parts A and B).
These standardized policies are intended to reduce your costs under Medicare, which include:
- copayments
- coinsurance costs
- deductibles
Unlike with many Medicare policies, you can sign up for Medigap at any time. You are first eligible during your initial enrollment period: the 3 months before, the month of, and the 3 months after your 65th birthday.
Medigap plans are location-specific. Not all plans are offered in every state, and Medicare doesn’t require insurance companies to sell every Medigap plan.
If you have Medicare Advantage (Part C), you can’t purchase a Medigap policy.
However, you can have original Medicare with a Part D (prescription drug) policy and a Medigap policy. Medicare requires you to have a Part D policy, but you don’t have to purchase a Medigap plan.
Harvard Pilgrim offers Medigap plans that vary by state. If you select one of these plans, you may also receive additional benefits with your membership, such as discounts for some health services.
To find out specific plan costs or to purchase a Harvard Pilgrim plan, contact a local sales representative. Remember, you are under no obligation to buy a plan if you contact them.