Harvard Pilgrim Stride^SM Medicare Advantage Plan

As we noted in the October issue of the provider newsletter, we recently made the decision to discontinue our Harvard Pilgrim Health Care Stride^SM (HMO/ HMO-POS) Medicare Advantage plans in New Hampshire, effective Jan. 1, 2025. As a result, the product is no longer available.

Please continue to submit claims for Stride^SM (HMO/HMO-POS) Medicare Advantage members as you normally would. We will process claims through the claims timely submission time frame for Stride, which is 365 days post date of service. Members had access to their Stride benefits and services through Dec. 31, 2024, and were instructed to seek out alternative options available in the market for 2025.

We’re continuing to make the following resources available to you as you continue to submit claims for Stride^SM (HMO/HMO-POS) Medicare Advantage members.

Helpful Resources:

• Provider Portal for Medicare Advantage
• Stride^SM (HMO/HMO-POS) Medicare Advantage Provider Manual
• Quick Reference Guide and Referral/Auth Quick Reference Guide

Pharmacy:

• Pharmacy Formulary
• Pharmacy PA Requirements 
• Pharmacy Step Therapy Requirements

Claims and Referral Forms:

• Claim Overpayment Refund Form
• Claim Review Form
• Claims Appeals Form
• Referral Form