Who they are
Harvard Pilgrim Health Care merged with Tufts Health Plan under Point32Health in 2021. The Point32 umbrella increasingly means shared infrastructure across the two plans.
The behavioral health contracting entity
Harvard Pilgrim's behavioral health is managed in-house by Point32Health, current as of November 2023 (an earlier arrangement with Optum ended October 31, 2023). One exception is publicly documented: behavioral health for the Stride (HMO / HMO-POS) Medicare Advantage product is still managed through an arrangement with United Behavioral Health, doing business as Optum. For its general lines, facilities contract with Point32Health directly.
Levels of care
Harvard Pilgrim contracts across the behavioral health continuum — inpatient psychiatric, detoxification, residential treatment, partial hospitalization (PHP), intensive outpatient (IOP), and outpatient. Covered benefits vary by plan.
Websites & portals
- harvardpilgrim.org
Member and plan site.
- point32health.org
Point32Health corporate site.
Scope
Regional commercial across New England (Massachusetts, New Hampshire, Maine, Connecticut).
Notable context
Point32Health (Harvard Pilgrim plus Tufts Health Plan) is a clear example of regional-payer consolidation — and, through HPI, it now also owns MedCost.
State guides
Where Harvard Pilgrim Health Care appears in our state-by-state guide to the payer landscape:
Want to know if TierBench holds actual rate data for this payer?
See Payer CoverageContracting with this payer?
Book a 20-minute call and we'll walk through where your rates stand against the market — or explore the data yourself.