Back to Insights and Updates for ProvidersOctober 2023

Inform Point32Health if you offer concierge medicine services

Harvard Pilgrim Health Care Commercial  |  Harvard Pilgrim Stride (HMO) Medicare Advantage  |  Tufts Health Plan Commercial  |  Tufts Medicare Preferred

Point32Health would like to remind any providers who are planning to offer concierge medicine services to eligible members that you are required to provide Point32Health at least 90 days’ advance notice prior to establishing a concierge-style practice.

It is important that you provide notice because all health plans must identify providers who offer concierge medicine services in our Harvard Pilgrim Health Care and Tufts Health Plan provider directories, and we need your help to make sure that information is accurate and up to date.

If you intend to offer these services, please notify us by sending an email to your contract specialist or associate contract specialist letting us know, and be sure to attach copies of the marketing materials you make available to patients informing them that you will offer concierge medicine services and when you will begin doing so.

Among other requirements, you’re required to specify to prospective patients that your practice requires payment of a subscription fee as a condition of accepting patients and for certain amenities and/or services that are not covered by Harvard Pilgrim/Tufts Health Plan. Your marketing materials must clearly differentiate services (i.e., amenities covered by the additional fee versus services covered by Point32Health).

Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

Joseph O’Riordan, Susan Panos, Stephen Wong,

Kristin Edmonston,
Production Coordinator

Kristina Cicelova,
Graphic Designer