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Harvard Pilgrim patients covered by Tufts or Blue Cross next year

MIT faculty and employees who get their medical care through Harvard Pilgrim Health Care and Harvard Vanguard physicians will be covered next year through Tufts Health Plan or a new Blue Cross health maintenance organization, rather than Harvard Pilgrim Health Care (HPHC).

Laura Avakian, MIT Vice President for Human Resources, in a letter sent Tuesday to the MIT community, said the change will permit lower costs and allow people living in other New England states to utilize health maintenance organizations (HMOs) for their care. (The full text of her letter can be found on line.)

The change for patients at Harvard Vanguard Medical Associates was made possible in the past year when the doctors' group opened their doors to other insurers as well as HPHC. The new Blue Cross plan, Network Blue New England, will also cover physicians who use Blue Cross to process their bills and payments.

Meetings to discuss the changes will be held by the Benefits Office at the following times and locations:

��������� Campus -- Tuesday, Oct. 10 and Friday, Oct. 13, in the 3rd floor Mezzanine Lounge of the Student Center. Presentations at 9am and noon. Staff will be available for consultations from 8:30am&endash;2pm.

��������� Haystack Observatory -- Wednesday, Oct. 11 in the conference room. Presentations at 9am and noon. Staff will be available for consultations from 8:30am&endash;3pm.

��������� Bates Linear Accelerator -- Thursday, Oct. 12 in the library. Presentations at 9am and 11am. Staff will be available for consultations from 8:30am&endash;noon.

��������� Lincoln Laboratory -- Tuesday, Oct. 17 and Thursday, Oct. 19 in the auditorium. Presentations at 1pm and 3pm. Staff will be available for consultations from noon&endash;4:30pm.

Ms. Avakian wrote, "Members of HPHC will be able to continue their relationship with their Harvard Vanguard Medical Associates primary care physician (PCP) through Network Blue New England or Tufts Health Plan.

"Essentially, the shift from HPHC to Network Blue New England changes the mechanics by which claims are paid while preserving members' access to physicians and equivalent coverage.

"We anticipate that this change will result in little or no disruption in your medical care. In the unlikely event that your PCP does not accept patients of Network Blue New England or Tufts Health Plan, the Benefits Office staff will work with you to assure that you have continual coverage and the health plans will work to encourage your PCP to participate in their networks."

"An important feature of Network Blue New England is that its provider network includes Connecticut, New Hampshire, Rhode Island, Maine and Vermont, extending HMO membership options to members of our community for whom this has not been available. For members of collective bargaining units, the application of this change is subject to contractual obligations."

The changes were made after an extensive study of the health plans coverage and cost, in light of reports of annual health care inflation as high as 13 percent, prescription drug costs increasing at more than 20 percent and the "issues raised by instability in the health care market," she said.

The physician directories are available on the web. A printed directory is available by contacting the Benefits Office. The physician networks are Network Blue New England, Tufts Health Plan and Massachusetts Physician Profiles.

You may contact the Benefits Office on campus at its new location in Rm E19-215, x3-6151 or at the Lincoln Laboratory Benefits Office, Rm A-128, Lincoln extension 7055.

Ms. Avakian said, "I encourage you to use this time before the November open enrollment period to consider your medical needs and to evaluate your health plan options. Our goal is for this transition to be as seamless as possible for HPHC members and their families."

A version of this article appeared in MIT Tech Talk on September 27, 2000.

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