Copay Reimbursement Program

The Copay Reimbursement Program was negotiated by Harvard and HUCTW to help HUCTW members with the costs of copayments for doctor’s visits, hospital visits, ER visits, and high tech imaging appointments (MRIs and CAT scans). You are eligible for this program if you are an HUCTW staff member enrolled in a Harvard health plan, and if your copayments in any of the areas listed below exceed the amounts (or “copayment caps”) listed for your salary range below. Non-union staff are not eligible for this program. The deadline for submitting 2019 expenses for reimbursement has been extended to June 1, 2020.

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 get reimbursed. Once your expenses have reached one of the copayment “caps” listed, you may submit a copayment reimbursement form (PDF) to the program. Harvard has contracted with a company called Benefit Strategies to manage the program – you submit your form to Benefit Strategies and they will send you a check 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. But 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 CY2019 expenses, you must submit your reimbursement form to Benefit Strategies by March 31, 2020. (deadline extended to June 1, 2020)

What documentation do I need to provide when I apply?

Applicants need to show proof of payment. You can do this in one of two ways:

OPTION 1:
The easiest and fastest way to provide proof of payment is to download a list of your copayments (or “claims”) from your insurance provider’s website, either Harvard Pilgrim or HUGHP/Blue Cross Blue Shield (unless you work at Dumbarton Oaks*) and attach it to your application. If you don’t have an online account, you will need to set one up, but this should only take a few minutes. Once logged in,  you can typically find a list of copayments/claims under “Claims” or “My Claims” under the main menu for the page. If you have any trouble logging in or finding the list, call 888-333-4742 for Harvard Pilgrim or 866-822-0570 for HUGHP/Blue Cross Blue Shield. You will likely want to have your insurance card with you for this call. You may need to create separate online accounts for other family members on your plan (using the patient number on their insurance cards) to print their claim lists.

Alternatively, you can also ask your insurance provider to mail you a list of all your copayments/claims for the entire calendar year. However, 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.

*Dumbarton Oaks union members should logon to the Kaiser Permanente website or CareFirst website get a copies of their annual claims, or request the list of claims over the phone, and attach this list to your application, following the instructions above.

OPTION 2:
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. 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 can typically  get from your health care provider. 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 Benefit Strategies about my reimbursement application?

The Benefit Strategies website (benstrat.com) offers a Live Chat feature, where you can chat online with a customer service representative. You can also call or email Benefit Strategies:

  • Hours: Monday – Thursday 8:00AM – 6:00PM, Friday 8:00AM – 5:00PM
  • Email: hvdflex@benstrat.com | Tel: 855-483-3539 | Fax: 603-232-1854
  • Online Chat: Available by clicking the “Get Help” button on benstrat.com during regular business hours.
  • Benefit Strategies Harvard page: https://www.benstrat.com/clients/harvard/

Copayment Caps

Your copayments must exceed the amounts (“Copayment Caps”) listed for your salary range (PDF) below 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.

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 threshold and use the Copayment Reimbursement Plan for costs above the threshold.

Copayment Reimbursement Forms and Instructions:

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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