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Reimbursement details for Wallet Benefit and dental services

Harvard Pilgrim Health Care StrideSM (HMO)/(HMO-POS) plans offer services in addition to those covered by Medicare.  These services include the Wallet Benefit and Dental coverage.  Both are reimbursement programs that require members to pay at the time of service and then submit a reimbursement form along with proof of payment.

Members can submit for reimbursement up to an annual total of $400 for the Wallet Benefit and up to $1,000 for the dental benefit depending on the plan they are in.

There are separate forms for Wallet and Dental:

Wallet Benefit reimbursement form

  • This form is used to request reimbursement for fitness facility fee, home fitness equipment, eyewear (frames and lenses), acupuncture, alternative therapies, fitness training devices (like Apple Watch), massage therapy, weight loss programs and more.
  • The Member Reimbursement form is available on this page: Member Reimbursement Form
  • The Wallet Addendum to the EOC provides coverage details and is available on this page: Wallet Addendum to EOC link

Dental benefit reimbursement form

  • This form is used for dental coverage that Medicare does not cover including preventive services, cleaning, x-rays, exam.
  • Comprehensive dental services are also covered such as fillings, inlay/onlay restorations, crowns, endodontic therapy and procedures.
  • The dental coverage also includes dentures partial dentures and repairs and adjustments to dentures.
  • The Dental Reimbursement form is available on this page: Dental Reimbursement Form
  • The Dental Addendum to EOC provides coverage details and is available on this page: Dental Addendum to EOC link

Note:  Reimbursements can take up to 9 weeks.

All EOC information and forms can be found at the Harvard Pilgrim Medicare consumer/member website at:  www.hpforlife.org  then look for “Already a Member” and follow the prompts.

If you have any questions, please contact Medicare Broker support: