So Harvard Pilgrim bought and merged with Tufts. They are now in the process of merging plans onto their new “Point32Health” network. My company had a contract with Tufts that ran until April, so when that contract ended we were migrated to Harvard/Point32. We were told “nothing is changing, we’re just being absorbed into Harvard Pilgrim”.

Our plan officially “switched” to Harvard on April 15th. I just received a message from my psychiatrist that my visit on April 17th will not be covered because the doctor I saw was covered under Tufts, but not under Harvard Pilgrim. I thought that was weird, since I was told our providers would stay I’m network.

As it turns out, Harvard had been absorbing Tufts CLIENTS, but has set a date of July 1st for when they’ll absorb Tufts PROVIDERS. So for 10 weeks I will be billed full price to see any of my current providers because I’ve been absorbed by Harvard before Harvard will accept any Tufts providers.

Is that fucked up? I’ve been trying to find any sort of warning or information telling us this might be an issue, but the only thing I find basically tells us nothing will change. It feels like I’ve been tricked into having uncovered medical appointments.

The most frustrating part is that my normal psychiatrist is covered under both networks anyway, but she is out on maternity leave and I saw the doctor who was covering for her, who was covered under Tufts but not Harvard (until July). The psychiatrist office was understanding about the situation, as they said Harvard has been very unclear about what is going on (exacerbated by the ransomware attack) and ended up cutting the bill in half, which was very nice. And it’s not really about the money, it’s $100 after the discount so it’s not going to break the bank. But I still feel as though Harvard should be paying for this, and should not have forced Tufts client over before absorbing their provider network. Am I wrong?

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