Important Update for Families with HPHC Quality or Explorer Plans

HPHC Quality or Explorer Insurance Plans

A health insurance form is on a clipboard next to a stethoscope and a pen.

Effective July 1, 2024, Pediatric Associates at Northwoods and other practices in the Affiliated Pediatric Practices (APP) network will no longer be covered under the Harvard Pilgrim Healthcare (HPHC) Quality HMO plan. This change comes as Harvard Pilgrim/GIC has reclassified our network status, moving us from tier 2 (in-network provider) to tier 3 (high cost/excluded provider).


Here’s What You Need to Know:


1.    Why This Change?: The decision to change our network status was made by Harvard Pilgrim/GIC, not by our practices. This adjustment affects all APP practices, as well as pediatric specialists and hospitals affiliated with Mass General Brigham (MGB).

2.    What’s Affected?: This update impacts all APP network practices and related MGB specialists and facilities.


What You Can Do:


  • Check Your Insurance Options: During open enrollment, take a moment to review your insurance plan options to make sure that Pediatric Associates at Northwoods and MGB specialists are included.
  • Confirm Coverage: Listing our physicians on your enrollment form doesn’t automatically guarantee coverage. Please double-check with your insurance plan to ensure you’re covered.
  • Plan Changes: After open enrollment ends, you won’t be able to change your insurance plan. Our office is unable to assist with these changes.


Need Help?

  • Insurance Questions: For questions about which physicians are included in specific plans, please contact your insurance provider directly.
  • Office Assistance: Our staff has limited information on insurance plans, so we encourage you to reach out to your insurance provider for detailed queries.

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We want to make sure your child continues to receive the best care, so please be sure to review your insurance options carefully during this enrollment period.


Thank you for your understanding!

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