Copay Reimbursement Program

This 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.

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 the submission deadline for any given calendar year is March 31 of the following calendar year (CY). For example, if you want to be reimbursed for CY 2017 expenses, you must submit your reimbursement form to Benefit Strategies by March 31, 2018.

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 way to provide proof of payment is to call your insurer (Harvard Pilgrim or HUGHP/Blue Cross Blue Shield) and ask them to mail you a list of all your copayments and claims for the entire calendar year. 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.

Here you will find instructions on how to request these lists of copayments (PDF) from Harvard’s two health insurers: Harvard Pilgrim and Harvard University Group Health Plan (HUGHP)/Blue Cross Blue Shield by phone. Also below, you will find instructions on how to request a similar list of your prescription payments (PDF) from the Catamaran/OptumRX website.

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. 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 claim?

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:

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, in 2017, if you earn under $75,000, you can apply to be reimbursed for office visit expenses once your costs reach $180 for an individual, or once they reach $440 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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