Helpful tips if you live outside of our service area

Harvard Pilgrim members whose plans have national networks and who live outside of our plans’ service areas can receive in-network care in other parts of the country from participating UnitedHealthcare providers.1 Here’s some information to help you determine if you’re eligible and tips for making the most of your plan.

Plans with national networks

These Harvard Pilgrim plans have national networks:2

  • Access America
  • Access America Ocean State
  • Access America Value
  • POS
  • PPO

For HMO plans, please note: 

  • None of our HMO plans, including tiered or limited network HMOs, have national networks
  • Only HMO members who are registered out-of-area dependents can receive care from UnitedHealthcare providers outside of the service area. Call Member Services or check with your employer to find out if your dependent is eligible to register.
  • If you have HMO coverage, you can receive care from out-of-network providers if there are specific exceptions outlined in your Benefit Handbook, such as in a medical emergency
     

Check your plan’s directory

Be sure to check your plan’s provider directory to find the UnitedHealthcare providers who participate in your plan’s network. Log in to your secure member account and enter your ZIP code in the search tool for the best results. 

You can also call Member Services if you need help finding a provider.

Call us if you need help

Doctors, hospitals and other UnitedHealthcare providers outside of New England may not be familiar with Harvard Pilgrim or your ID card. 

When you call to make an appointment:

  • Look at the back of your ID card for a UnitedHealthcare Choice Plus or Options PPO network logo in the lower right corner
  • Depending on which logo is there, be sure to tell your provider’s office that your plan includes the Choice Plus or Options PPO network 

You can ask your provider’s office to call the United Health Shared Services number on the back of your ID card (800-693-5254) to confirm your eligibility.

If your provider’s office won’t accept your insurance, call Member Services at 888-333-4742 (TTY: 711). One of our representatives can speak with the office staff to explain Harvard Pilgrim’s relationship with UnitedHealthcare and confirm your coverage.

Disclosures

1The service area for Access America and Access America Value plans includes Maine, Massachusetts and New Hampshire. 
The service area for Access America Ocean State plans includes Maine, Massachusetts, New Hampshire and Rhode Island. 
The service area for HMO, POS and PPO plans includes Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. 

2 Some plans are administered by HPHC Insurance Company and United HealthCare Services Inc. or its affiliates.