Harvard Pilgrim Health

One of the barriers to mental health is confusion navigating the process of copays, deductibles, and reimbursement. We’re setting out to demystify the insurance process by answering your questions about using Harvard Pilgrim Health insurance for behavioral health!

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What does Harvard Pilgrim Health cover for therapy?

Does Harvard Pilgrim Health pay for therapy?

Yes, some Harvard Pilgrim Health plans do offer coverage for mental health and substance use treatment, and everyone covered under Harvard Pilgrim Health has access to the company’s Behavioral Health Access Center at 888-777-4742. The details of your coverage will depend on your specific plan, so you should refer to your plan documents and/or speak with member services to get more information.

Does Harvard Pilgrim Health cover online therapy?

Your coverage will depend on the details of your plan. Online sessions can be a convenient alternative to in-person visits and can also help you manage medication without visiting your therapist’s office. To find out whether your plan covers online therapy, you can contact customer service or refer to your plan documents.

What kind of coverage does Harvard Pilgrim Health offer for mental health?

Coverage for mental health under Harvard Pilgrim Health varies from plan to plan. For all members, The Behavioral Health Access Center at 888-777-4742 is available to help you understand your mental health coverage and treatment options.

You can also go directly to My Plan Documents to log in and get your benefit and coverage details.  

How much are therapy sessions under a Harvard Pilgrim Health plan?

The cost per therapy session will depend on your plan and the kind of mental health coverage it provides. To learn more, you can refer to your personalized online account at My Plan Documents.

What is my copay for therapy with Harvard Pilgrim Health?

Most Harvard Pilgrim Health plans have a copay, which is a preset amount you pay for for covered health services at the time you receive care. However, the amount of your copay depends on the details of your specific plan. Although you will not pay a copay when you use a doctor or facility that is out-of-network, you are responsible for paying coinsurance, which is a percentage of the total bill. Coinsurance is usually much more expensive than an in-network copay.

For more information about the copay for your specific plan, refer to My Plan Documents for details.

What is my deductible for therapy with Harvard Pilgrim Health?

Like copays, deductibles vary from plan to plan under Harvard Pilgrim Health. Usually, your deductible for your entire insurance plan is set when you sign up for therapy. You can go directly to My Plan Documents to see what your deductible is.

What happens if I don’t use a Harvard Pilgrim Health therapist?

If you don’t use a Harvard Pilgrim Health therapist, you’ll be responsible for navigating out-of-network benefits. This process can be confusing, so it’s best to call Harvard Pilgrim Health directly to sort out all the details. The number for member services is typically on the back of your insurance card.

When you call your insurance company, be sure to ask:

  • What is my annual deductible?

  • Do I have an additional out-of-network deductible?

  • What is my coinsurance for outpatient mental health?

  • Do I need a referral from a primary care physician or an in-network therapist to see an out-of-network therapist?

  • How do I submit out-of-network claims for reimbursement?

Claims and reimbursements for Harvard Pilgrim Health

How do I complete Harvard Pilgrim Health claims for therapy?

To complete a behavioral health claim for Harvard Pilgrim Health, you can download a claim form here. Then, you should submit your completed claim form by mail, along with itemized bills or receipts for your treatment.

What is the Harvard Pilgrim Health claims address?

You can mail completed claims forms to:

United Behavioral Health

P.O. Box 30602

Salt Lake City, UT 84130

How should I get therapy if I don’t have insurance?  

If you want to find a therapist but don’t have insurance, you can visit Zencare to look for therapists who have sliding scale fee options, or who offer sessions within your price range.

What is the number for Harvard Pilgrim Health behavioral health?  

You can call the number on your insurance card, or you can contact The Harvard Behavioral Health Access Center at 888-777-4742.

Finding a therapist for Harvard Pilgrim Health

How can I find Harvard Pilgrim Health therapists?

If you live in Rhode Island or the greater Boston area, to find a therapy provider who takes your Harvard Pilgrim Health insurance, you can visit Zencare. Select Harvard Pilgrim Health as your insurance company under "Payment Options" to view therapists who are in-network, or click on the links below.

Visit therapists’ profiles to watch an introductory video, check up-to-date availability, and book a free initial call to find the right therapist for you.

Live outside those areas? Visit Harvard pilgrim’s online directory, but note that information is often out of date. Reach out to multiple therapists, and don’t be discouraged!