Story

What is a virtual health plan, and is it right for me?

Telehealth used to be the exception. As recently as two years ago, less than one in five people used telehealth for their healthcare needs. Since the pandemic, the rate has jumped 38 times. Now nearly half of Americans use telehealth as part of their healthcare. Experts agree telehealth isn’t going anywhere. Nor should it. Increasing access to physical and mental health services is a win-win for patients and providers. As healthcare trends continue in this direction, we’ll see more and more innovations in telehealth. A recent innovation includes the introduction of virtual care-focused health plans. But what exactly is a virtual health plan and how do you know if it’s right for you? Harvard Pilgrim Health Care, Connecticut’s only not-for-profit health insurer, is here to help. Offering a variety of plans, ranging from traditional health plans to a blend of traditional and virtual components to completely virtual, Harvard Pilgrim can help you decide which of their plans are right for you. Answer the questions below to get started:

Is a virtual health plan right for me?

I (or my family) am mostly healthy and mainly attend preventive visits.

I find it difficult to see my primary care provider (PCP) and wind up spending more time in the waiting room than I’d like.

I have a chronic condition that can be monitored remotely (such as diabetes, high blood pressure, etc).

I tend to be at my primary care provider (or our pediatrician) often between my children or myself.

As a local partner with the strength of a national network, Harvard Pilgrim’s seamless, New England HMO network has outstanding providers that members know and trust, while their relationship with United Healthcare offers a national reach. And, of course, all of Harvard Pilgrim’s Connecticut health insurance plans offer access to care through digital and telehealth options. Harvard Pilgrim was the first to offer virtual primary care (PCP) group plans in Connecticut, providing affordable alternatives to care. Now, new, virtually-based health plans — SimplyVirtual HMO and Virtual Choice HMO — have innovative, 24/7 access to a primary care provider. With SimplyVirtual HMO plans, members have the freedom to receive virtual visits from anywhere – at home, in the workplace or while traveling on vacation. Virtual Choice HMO plans are flexible and family-friendly giving members a choice of virtual or office-based primary care. For more on getting started with Harvard Pilgrim, click here.

I (or my family) have frequent doctor visits or live with a chronic condition.

My schedule is so busy, I find it hard to fit in appointments.

I have access to a mobile device, tablet or laptop, and am typically comfortable with using or learning technology.

Are your children 19 or under?

I prefer in-person time with my PCP.

I have access to a mobile device, tablet or laptop, and am typically comfortable with using or learning technology.

It’s likely that many of my medical needs treated by my PCP could be addressed in a virtual visit.

Traditional Health Plan

With your lifestyle, schedule and technology use, a traditional health plan may work best for you. Learn more about Harvard Pilgrim Health Care’s traditional health plan options:

• Full and limited network plans, most do not require referrals • Care within Harvard Pilgrim’s robust New England Network

HMO Plans

• Covered in-network and includes national network • No need for referrals

PPO Plans

Virtual Health Plan

With your lifestyle, schedule and technology use, you may benefit from a virtual health plan. Learn more about Harvard Pilgrim Health Care’s current virtual plan options:

SimplyVirtual HMO is a virtual health plan that provides virtual access to in-network healthcare professionals 24 hours a day. If you find it hard to make time to see a doctor, SimplyVirtual allows you to get quality care on your schedule. By partnering with Doctor on Demand, Harvard Pilgrim’s innovative solution to your lifestyle and technology puts you in control. Virtual Choice HMO combines the convenience of telehealth with the ability to alternatively choose an in-person primary care provider (PCP). Powered by Doctor on Demand, see a quality healthcare specialist in real time right on your smartphone or tablet.

SimplyVirtual and Virtual Choice

I have access to a mobile device, tablet or laptop, and am typically comfortable with using or learning technology.

I (or my children 19 and over) have access to a mobile device, tablet or laptop, and are typically comfortable with using or learning technology.

Access to quality care—when and where you need it.

My schedule is so busy, I find it hard to fit in appointments.

I prefer in-person time with my PCP.

I have access to a mobile device, tablet or laptop, and am typically comfortable with using or learning technology.

Are your children 19 or under?

I (or my children 19 and over) have access to a mobile device, tablet or laptop, and are typically comfortable with using or learning technology.

I have access to a mobile device, tablet or laptop, and am typically comfortable with using or learning technology.

It’s likely that many of my medical needs treated by my PCP could be addressed in a virtual visit.

• All members under the age of 19 select a PCP from Harvard Pilgrim’s HMO network and receive office-based care in both plans • All members in virtual plans received office-based care from specialists

Learn more

With a traditional health plan from Harvard Pilgrim, you can be assured you will receive personalized, quality and best-in-class service. With a full range of HMO and PPO plan options Harvard Pilgrim offers plan designs for small and large group employers including robust national solutions.

As a local partner with the strength of a national network, Harvard Pilgrim’s seamless, New England HMO network has outstanding providers that members know and trust, while their relationship with United Healthcare gives Harvard Pilgrim plans national reach. And, of course, all of Harvard Pilgrim’s Connecticut health insurance plans offer access to care through digital and telehealth options. Harvard Pilgrim was the first to offer virtual primary care (PCP) group plans in Connecticut, providing affordable alternatives to care. Now, new, virtually-based health plans — SimplyVirtual HMO and Virtual Choice HMO — have innovative, 24/7 access to a primary care provider. With SimplyVirtual HMO plans, members have the freedom to receive virtual visits from anywhere – at home, in the workplace or while traveling on vacation. Virtual Choice HMO plans are flexible and family-friendly giving members a choice of virtual or office-based primary care. To learn more visit https://www.harvardpilgrim.org/hapiguide /health_plan_CT/