As you are likely aware, Harvard Pilgrim Health Care and Tufts Health Plan maintain policies to outline coverage and services for preventive care in accordance with provisions of the Patient Protection and Affordable Care Act (PPACA). Members are entitled to receive full coverage for preventive care services identified on these policies, with no cost-sharing responsibility, when these services are rendered by an in-network provider.
For the 2025 plan year, we’ve made minor updates to the Harvard Pilgrim Patient Protection and Affordable Care Act (Federal Health Care Reform) Policy, which pertain to BRCA testing, cervical cancer screening, colonoscopy bowel preparations, and HIV screening.
In addition, we’ve replaced Tufts Health Plan’s previous Preventive Services Payment Policy with equivalent Patient Protection and Affordable Care Act (Federal Health Care Reform) Policies, which apply to Tufts Health Plan Commercial plans and Tufts Health Direct and can be found in Tufts Health Plan’s Commercial and Tufts Health Public Plans Provider Manuals.
We hope the alignment of the policy format helps further our goal of delivering an increasingly seamless provider experience and a higher degree of familiarity and consistency across our Point32Health product lines.