Think healthy, live well. There is nothing more valuable than good health. UNE offers a choice of medical insurance plans that are designed to help you and your family stay healthy and provide comprehensive coverage when you need it. 

Eligibility

  • Full- or half-time faculty or staff (self)
  • Spouse or Domestic Partner
  • Dependent Children (and those of a Domestic Partner) until the end of the month they turn 26 years of age
  • Participation in health coverage may begin the first of the month after your hire or qualifying event. If your hire or event occurs on the first of the month, then benefits begin on the date of hire or qualifying event.
  • Coverage ends the last day of the month in which you physically work in a benefits-eligible position.
  • Please review the Summary Plan Descriptions for more eligibility details and consult with Human Resources for specific situations.

COVID-19 and understanding your Harvard Pilgrim health insurance

In this time when there are often more questions than answers, we wanted to share some information on how Harvard Pilgrim will be covering COVID-19 treatments with some important points of interest. Additional information is also available in the Harvard Pilgrim Response to COVID-19 for March 11, 2020 (PDF) and the Maine Emergency Measures Responding to the Coronavirus Pandemic (PDF). Harvard Pilgrim sent members an email on March 19, 2020, with additional information.

  • COVID-19 Testing is covered in full
  • COVID-19 Treatment: No changes to plans, plan cost-share applies (copay, deductible, coinsurance)
  • Telemedicine is covered in full for any reason. How to access Telemedicine information and instructions (PDF)
  • Pharmacy: You can get a one-time refill of your prescription medications before the scheduled refill date
  • Members will have access to out-of-network providers for the initial COVID-19 test when no in-network providers are available
  • No prior authorization and referrals are required, where applicable, so that members can get timely medically necessary testing and treatment for COVID-19
  • The CARES Act (PDF), which took effect on March 27, 2020, now permits FSA and HSA reimbursement of over-the-counter products and medications without the need of a prescription, along with menstrual care products.  

If you are not feeling well, contact your primary care provider to discuss active symptoms or use the online CDC symptom self-check tool.

Benefits and coverage questions

Harvard Pilgrim Member Services

(888) 333-4742

  • Monday, Tuesday, and Thursday 8 a.m.–6 p.m.
  • Wednesday 10 a.m.–6 p.m.
  • Friday 8 a.m.–5:30 p.m.

Health plan support and clinical coordination

Harvard Pilgrim Care Management

(866) 750-2068

  • Monday–Friday 8:30 a.m.–5 p.m.

Special Notices

Health Care on the Move

We get it — everyone is on the go these days. We continue to find ways to bring you your health care in ways that are convenient for you. Set up these mobile apps to get access to your health and dental information, ID card, and other resources on your mobile device.

Set up your Harvard Pilgrim Online Account (PDF)

Set up your Delta Dental Mobile App (PDF)

Retiree Medical Insurance Coverage

The University of New England offers a program for long-term employees to continue on the university medical plan under certain circumstances prior to age 65. The cost for continuing medical coverage for early retirees will be borne completely by the former employee. The purpose of this extension of benefits is to allow access to group coverage prior to their eligibility for Medicare for employees wishing to retire early. 

The following criteria must be met in order to qualify:

  1. Employee must have completed 20 years of service at the time that this continuation of coverage becomes effective
  2. Employee must have attained age 60 prior to their retirement date
  3. Coverage continues until the date the retiree and eligible dependent become entitled to Medicare

Please contact Human Resources for more information.

Medicare Part D – Notice of Creditable Coverage

The prescription drug coverage listed under the University of New England's medical plan is expected to payout, on average, at least as much as the standard Medicare prescription drug coverage will pay in a calendar year and is considered "creditable coverage." If you or your covered dependents are enrolled in any prescription drug coverage listed in this notice of creditable coverage (PDF) and are or become covered by Medicare, you may decide to enroll in a Medicare prescription drug plan later and not be subject to the late enrollment penalty as long as you had creditable coverage within 63 days of your Medicare prescription drug plan enrollment. Please read the notice of creditable coverage (PDF) carefully and keep this notice with your important records.

Additionally, Health Advocate is a free and confidential resource to help you, your spouse, dependent children, parents, and parents-in-law answer questions regarding Medicare. 

Learn about the ABC's of Medicare (PDF)

Options

Health Basic

This in-network plan provides a moderate co-payment option and has mid-level monthly premium costs. Learn more about your Basic Health plan.

Health Enhanced

This in-network plan provides lower co-payments and has the highest monthly premiums. Learn more about your Enhanced Health plan.

High Deductible Health Plan with Health Savings Account (HSA)

This plan offers in and out of network benefits at a low monthly premium. In 2020, UNE will be providing $2,600 ($1,300 in January and $1,300 in July) to eligible participants' HSA, and participants have the option to contribute additional money (within limitations set by the IRS). Learn more about the High Deductible Health Plan and the HSA option.

Vision Benefits

Vision benefits are included as part of your health plan when you elect one of our health care plans.

Summary of Vision Benefits (PDF)

Pharmacy Benefits

Understanding your pharmacy benefits will assist you in making the most effective decisions. Search your medications quickly and easily.

Choose the year and then "Premium 3-Tier" to find out how your prescription medications are covered.

Overseas Urgent and Emergency Care

With UNE's presence in Morocco and the increased global connections across the University, this information will be of assistance to anyone covered under the health plans who is traveling overseas. 

Out of country claims processing (PDF)

Resources

Online Health Resources

Create a Harvard Pilgrim account to access information about your medical health plan.

Harvard Pilgrim Health Online registration instructions (PDF)

 

MyHealthMath: MyHealthMath can help you choose the right Harvard Pilgrim plan for you.

Looking for a Doctor?

  1. Go to the Harvard Pilgrim provider search
  2. Under Standard Plans
  3. Select PPO and search for providers based on your needs. 

It is helpful to remember:

  • Insurance bills under doctors, not facilities, so it is best to search for a doctor's name.
  • Nurse Practitioners bill under the doctor's name, so it is best to search by the doctor's name.
  • Hospitals are searchable to confirm that they are in-network.

Health Advocate

This is a free and confidential benefit that helps you and your family (spouse, dependent children, parents, and parents-in-law) get answers involving your medical, hospital, dental, mental health, medications, and other health care issues.

  • Find the right doctors, dentists, and other providers.
  • Locate the right treatment facilities.
  • Get explanations of coverage stipulations and alternatives for uncovered services.
  • Get to the bottom of billing mistakes and coverage denials.
  • Negotiate fees and payment arrangements.
  • Find in-home care, adult daycare, assisted living, and long-term care.
  • Clarify Medicare, Medicaid and Medicare Supplemental Plans.
  • Get tips on Protecting Against Identity Theft (PDF)
  • See more in the Health Advocate Features Brochure (PDF)

Normal business hours are Monday–Friday, between 8 a.m. and 9 p.m. EST, but staff is available after hours and on weekends. 

1 (866) 695-8622

Other Health Forms

Benefits Guide (PDF)
Overview of the primary benefits offered by UNE.

Domestic Partner Affidavit (PDF)
This certifies the necessary requirements for unmarried domestic partners’ eligibility to be included in health and dental insurance coverage. 

Discounts and Savings flyer (PDF)
This helps you and your family find savings on your way to well being.

Harvard Pilgrim Care Team flyer (PDF)
This team can help address your health care concerns and alleviate worries

This website uses cookies to understand how you use the website and to improve your experience. By continuing to use the website, you accept the University of New England’s use of cookies and similar technologies. To learn more about our use of cookies and how to manage your browser cookie settings, please review our Privacy Notice.