Harvard Pilgrim Health Care

Effective January 1, 2020, OptumRx became HPHC’s partner for pharmacy services for the WSHG Active Plans, including mail order prescriptions.  Click here for the members Frequently Asked Questions (FAQ)

Harvard Pilgrim Health Care Website

Presentation
AVOID Costly Trips to the Emergency Room

Effective July 1, 2026
HPHC Benchmark HMO Plan
HPHC HSA Qualified HMO Plan
HPHC PPO Plan – out of area plan
HPHC Preventative Drug List– medications at copay level (no deductible when enrolled in the HSA High Deductible Health Plan)

Effective July 1, 2025
HPHC Benchmark HMO Plan
HPHC HSA Qualified HMO Plan
HPHC PPO Plan – out of area plan
HPHC Preventative Drug List– medications at copay level (no deductible when enrolled in the HSA High Deductible Health Plan)

Senior Plan – Effective January 1,  2026
HPHC Medicare Enhance
SilverScript Part D Plan Summary
SilverScript Part D Formulary

Senior Plan – Effective January 1,  2025
HPHC Medicare Enhance
SilverScript Part D Plan Summary
SilverScript Part D Formulary

Other Information

Choice Net Hospital Tier
Urgent Care
HPHC Preventative Services
Behavioral Health
HPHC Wellness Reimbursement Form

WSHG Health Plan Comparison Chart & Rates