Copay Reimbursement Program

The Copay Reimbursement Program has been negotiated by Harvard and HUCTW to help HUCTW members with the costs of copayments for office visits, hospitalization and ER visits, high tech imaging appointments (MRIs and CAT scans), and prescription drugs. You are eligible for this program if you are an HUCTW staff member enrolled in a Harvard health insurance plan (HUGHP or BCBSMA, or one of the Dumbarton Oaks plans), and if your copayments in any of the areas listed below exceed the amounts (or “copayment caps”) listed for your salary range. Non-union staff are not eligible for this program. The program does not apply to dental plan or vision plan copayments. To understand the categories of copayments, please see the chart on page 3 of Health Plan Program and PremiumsThe deadline for submitting your copay expenses for reimbursement is March 31 of the following year.

How does the program work?

The program is a reimbursement program, so you pay for your copayment expenses up front (each time you go to the doctor, the ER, etc, you pay a copayment) and then you can get reimbursed for any payments over the cap. Once your expenses have reached one of the copayment “caps” listed, you may submit a copayment reimbursement form and FAQ (PDF) to the program. Harvard has contracted with a company called Voya Financial to manage the program – you submit your documentation to Voya Financial and they will send you a check or direct deposit reimbursing you for your eligible expenses within a few weeks.

What is the deadline for the reimbursement program?

The program is based around the calendar year, and you can submit for reimbursement at any point during the year. The final submission deadline for any given calendar year (CY) is March 31 of the following calendar year. For example, if you want to be reimbursed for CY2023 expenses, you must submit your reimbursement form to Benefit Strategies by March 31, 2024.

What documentation do I need to provide when I apply?

Applicants need to submit the application form and show proof of payment. You can do this in one of two ways:

OPTION 1–easiest and fastest:
Download a list of your copayments (or “claims”) from your insurance provider’s website and attach this to your reimbursement application.

Alternatively, you can also ask your insurance provider or health care provider to mail you a list of all your copayments/claims for the entire calendar year. If you choose this method, you will want to request this list at least one month before you plan to submit your reimbursement form. If you have family members on your plan and are submitting their expenses, you will want to ask for similar lists for all your family members.

Once you receive the list(s), you can attach it to your reimbursement form and write, “see attached” where the form asks you to write out your claims. If you use this method, you do not need to submit any receipts, nor do you need to write out a list of your copayments since you have already attached a list. Again, downloading this list from your insurer’s website is the fastest way to generate the required claims list.

OPTION 2–individual receipts:
If you don’t want to use the method above, you can instead write out a list of your qualifying copayment expenses on the reimbursement form and include each receipt. Please use a separate sheet of paper if the table on the form does not have enough rows for all of your expenses. If you use this method, you must submit a supporting receipt for every expense on your list, which you typically get from your health care provider each time you pay. If you choose this method, you will not receive reimbursement for expenses that are not both documented on the itemized list and supported with receipts or other proof of payment from the provider or insurer.

What do I do if I have a question for Voya Financial about my reimbursement application?

Contact Voya Financial via their web portal. You can also call or email Voya Financial:

Copayment Caps

Your copayments must exceed the amounts (“Copayment Caps”) listed for your salary range (PDF) in order to apply for the program. For example, if you earn under $75,000, you can apply to be reimbursed for office visit expenses once your costs reach $225 for an individual, or once they reach $550 for a family. If you are on a family plan and any individual in your family reaches one of the copayment caps for an individual, you can apply for reimbursement for that individual using the individual cap.

You cannot be reimbursed for the same expenses from both a Health Flexible Spending Account (FSA) and the Copayment Reimbursement Plan, but you may use an FSA to cover costs up to the cap threshold and use the Copayment Reimbursement Plan for costs above the cap threshold.

Copayment Reimbursement Forms, Instructions, and Related Information:

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Please let us know if you have any questions about the above: huctw.info@huctw.org, 617-661-8289

 

Keywords: copayment, copay, co-payment, co-pay, reimbursement, medical