General
We continuously examine our business to ensure we offer our members affordable, high-quality health plans and products in the market. After a careful analysis, we made the difficult decision to discontinue our Harvard Pilgrim StrideSM (HMO/HMO-POS) Medicare Advantage plan in New Hampshire effective Jan. 1, 2025.
All StrideSM (HMO/HMO-POS) Medicare Advantage members are affected. Approximately 10,000 members are currently enrolled in Harvard Pilgrim StrideSM (HMO/HMO-POS) plans in New Hampshire.
No, we are committed to serving New Hampshire and are not exiting the state. We will continue to offer a Harvard Pilgrim Medicare Supplement plan and our Harvard Pilgrim commercial products for employer groups and plans on the New Hampshire exchange.
We have no plans for any additional changes to our markets.
No, these products will continue to be offered.
Members
See responses to general questions above.
To assist members with this we have an extensive communication plan to ensure that affected members are informed about their Stride plan ending. This includes sending letters to all impacted members prior to Oct. 15, conducting phone outreach, and providing assistance in selecting a new Medicare plan.
New Hampshire Stride Members can choose to enroll in our Harvard Pilgrim Medicare Supplement plan. Alternatively, there are numerous plans that offer Medicare Advantage and Medicare Prescription Drug plan options for any affected members seeking a Medicare Advantage or Medicare Prescription Drug plan in 2025. We included a list of plan options in the notification mailing sent to Stride members at the beginning of October. Contact a Medicare Advantage broker or utilize the Medicare.gov plan finder to explore plan options in your area.
This should not impact care for the remainder of 2024. Members will be covered on their Harvard Pilgrim Medicare Advantage plan through the end of the year. As of Jan. 1, they will need new Medicare coverage. We are working with our members to ensure a smooth transition to a new plan for 2025.
As Harvard Pilgrim is not offering a Medicare Advantage plan in New Hampshire in 2025, this means that your coverage with us will end on Dec. 31, 2024. As a result, you should review the Medicare options available to you and select one of the other Medicare plans available in your area or you can choose the Original Medicare option and purchase a separate Medicare Prescription Drug plan. A list of alternate Medicare plan options was included in the letter you received.
Medicare beneficiaries select plans during the Medicare Annual Enrollment Period, which runs from Oct. 15 to Dec. 7, 2024 for the plan year beginning Jan. 1, 2025. We encourage you to select a plan during this period. If you don’t take action before Dec. 31, 2024, you will lose your prescription drug coverage on Dec. 31, 2024 and will only be covered by Original Medicare as of Jan. 1, 2025.
However, you have other opportunities to join a Medicare health or drug plan. Because your Harvard Pilgrim Stride plan will no longer be available to you, and to provide you additional time to evaluate your options, you have a special opportunity to join a new plan any time until Feb. 28, 2024. This Special Election Period (SEP) allows you to enroll in any Medicare Supplement or Medicare Advantage plan from Dec. 8, 2024 through Feb. 28, 2025. If you enroll in a plan during the SEP period, your plan’s effective date will be the first date of the following month.
If you don’t join a plan with prescription drug coverage or a stand-alone Prescription Drug Plan with Original Medicare by Feb. 28, 2025, you won’t have prescription drug coverage in 2025 and you may have to pay a lifetime Part D late-enrollment penalty if you join a Medicare prescription drug plan later.
You can also choose a Medicare Supplement or Medigap plan. Harvard Pilgrim offers a Medicare Supplement plan, as do other carriers. You have specific Medigap plan rights, which are outlined in the letter that we sent to you at the beginning of October.
You need to choose how you want to get your Medicare health and prescription drug coverage. Review your options for Medicare coverage and decide which is best for you:
- Option 1: You can join another Medicare Advantage health plan. A Medicare Advantage health plan is offered by a private company that contracts with Medicare to provide benefits. These plans cover all services that Original Medicare covers and may offer extra coverage such as vision, hearing, or dental. Most Medicare Advantage health plans include prescription drug coverage.
- Option 2: You can change to Original Medicare. Original Medicare is fee-for-service coverage managed by the federal government. If you choose Original Medicare, you’ll need to join a separate Medicare Part D prescription drug plan to get prescription drug coverage. You may also want to buy a Medicare Supplement Insurance (Medigap) policy to fill in the gaps in Original Medicare coverage.
For assistance in evaluating your options:
- Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
- Review the list of other plan options that was included with the letter that we sent to you at the beginning of October.
- Visit Medicare.gov. For information and tools to explore plan options in your area.
- Call the organization ServiceLink at 1-866-634-9412 (Monday to Friday, 8:30 a.m. to 4:30 p.m.). Counselors are available to answer your questions, discuss your needs and offer information about options, and the service is free.
No, Medicare isn’t part of the Health Insurance Marketplace. By going to Medicare.gov, you will be sure that you are reviewing Medicare plans and not Marketplace plans.
If you were on a Medicare Supplement plan and enrolled into Harvard Pilgrim Stride after Jan. 1, 2024, you may be eligible to go back to your original issue age for Medicare Supplement. This may save you money. You must apply for a HPHC Medicare Supplement plan of equal or lesser coverage and use the Age Rate Guarantee process to apply. Please contact Harvard Pilgrim Stride’s sales contact center at 877-431-4742 or your Medicare Broker about this option.
Providers
See responses to general questions above.
Please continue to provide services to these members though the end of the year and submit claims as you do today.
The claims timely filing submission time frame for StrideSM (HMO/HMO-POS) is 365 days. Therefore, you can submit claims for these members through Dec. 31, 2025. You should continue to submit claims as you do today.
No action is needed. You will continue to remain a participating provider in our other Harvard Pilgrim products. References to the StrideSM (HMO/HMO-POS) products will be removed from the contract as the agreements come up for renewal.
We have an extensive provider communications plan, which includes direct outreach to providers who service a large number of our StrideSM (HMO/HMO-POS) members and articles in the October and November issues of our provider newsletter, Insights and Updates for Providers, for all other providers. Conversations with key providers have already begun.