Membership & Account

Q: When should I expect to receive my Member ID Card? A: Members should expect to receive their Member ID Card anywhere from 10-20 days after they have enrolled in a Harbor Health plan. If after this time you have not received it, please call Harbor Health Member Support at (855) 481-0225.

Q: I need my Member ID card but haven't received it in the mail yet. What should I do? A: Members who need their Member ID card before it arrives in the mail should call Harbor insurance support at (855) 481-0225.

Q: Is my insurance active before my card arrives? A: Yes. Your coverage is active as of the effective date of your group policy. You don't need your physical card to get care. If you need to see a doctor before your card arrives, call us at (855) 481-0225. We'll give you your Member ID and help make sure your visit goes smoothly.

Q: Where can I find my Member ID number, Group Plan ID, or pharmacy info? A: All of this information will be on your Member ID Card and in your Harbor Health Member Portal. If you need this information before receiving your card or activating your portal, please call Harbor Health Member Support at (855) 481-0225.

Q: How do I access my Harbor Health Insurance account? A: Once you receive your Member ID Card, you can activate your Member Portal account at harborhealth.com/plans/activate. You need your Legal First Name, Legal Last Name, Member ID (which you can find on your card), and your Date of Birth to activate your account.You do not need a Member Portal account to receive care.

You can find your Member ID on your insurance card.

Q: What is in my Harbor Health Member Portal account? A: Your portal is where you can see everything about your care in one place. View your Member ID card, check what's covered under your benefits, and track your claims and costs. You can also see any prior approvals for your care and compare prices before you get treatment.

Q: I need to update my address, where/how can I do this? A: To update your address, reach out to your company’s HR department or lead. They’ll update your Harbor Health information. Changes are usually reflected the following Monday.

Q: I can’t find my Harbor Health account username. Where can I find it? A: Your username was sent to your email when you activated your account. If you’re unsure, please check your email, including your spam folder, for your username. If you can’t find your username or have trouble logging in, you can reset your username & password through the forgot username page: https://app.harborhealth.com/auth/forgot-username

Q: What is the Patient Portal and why do I need one? A: The Athena Patient Portal lets you message your Harbor Health care team if you’ve been to or seek care at one of our Harbor Health clinics, ask billing questions related to care you’ve received from one of our Harbor Health clinics, reschedule appointments, and request refills or get prescription support. You can create an account here. You don't need an account to get care, but once you set one up, it's the easiest way to reach us between visits.

Q: Where can I find more details about my plan benefits? A: You can view this on your Harbor Health Insurance member portal. You can access the portal here.

Q: Where can I find plan forms like claim forms, referral forms, and pre-authorization forms? A: Download the forms you need in the Plan Documents tab in our Employer Resources page.

Q: How can I find if my medication is covered or on the Harbor Health formulary (drug list)? A: You can access the drug list on the drug formulary search. This will take you to Harbor's formulary lookup tool. If you have any questions about your prescription benefit, call us at (855) 481-1620.

Getting Clinical Care & Help

If you're seeking to understand more about providers in our network outside of our clinicians at Harbor Health Medical Group or VillageMD, please refer below to the Harbor Network section.

Q: How can I find care at a Harbor Health Clinic?
A: For immediate needs, describe your symptoms and we'll help you find the right care - which may include Express Care at one of our clinics or a virtual visit. You can also call us at (855) 481-0225 and we'll help you get care quickly. You do not need to have had a prior visit with a Harbor Health PCP before scheduling an Express Care visit.

Q: What should I do if I have an urgent medical need?
A: If you have a medical emergency, call 911. For urgent questions or symptoms, call our nurse line at (855) 481-1115 – a nurse can help you figure out the right next step. You may also be able to book an Express Care visit based on your symptoms. You don't need to be an existing patient to use Express Care.

Q: How can I pay less when I see a specialist? A: When a Harbor primary care provider or in-network PCP refers you to a specialist, you may pay $0 for that visit. Here's how it works:

See a Harbor Health or in-network primary care provider They refer you to a specialist for your situation For many services, that referral means you pay nothing

You're never required to get a referral, but it's one of the ways Harbor is designed to save you money. Not sure if this applies to your situation? Call us at (855) 481-0225 and we'll walk you through it.

Q: How can I get a referral? How does Harbor help me find a specialist? A: If you've been to a Harbor clinic before, call us at (855) 481-0225 or message your primary care provider directly online. Don't have a Harbor Health Medical Group primary care provider yet? Feel free to continue working with your existing primary care provider if they are in-network.

If you’d like to establish with a Harbor Health Medical Group primary care provider, schedule online by clicking “Book Now” or call us at (855) 481-0225. We'll help you find the right specialist, and check their quality and cost. When your in-network primary care provider refers you to a specialist, Harbor Health Insurance covers more of the bill. That's how Harbor is designed to work for you.

Insurance Benefits & Cost

Q: What if I need emergency care at a hospital that's not in Harbor's network? A: Go get care. Emergency services are covered no matter where you are, even at out-of-network hospitals. Your emergency room copay still applies, but you won't be responsible for the full out-of-network cost. If you have questions about a bill after an ER visit, call us at (855) 481-0225.

Q: What does Harbor cover for mental health? A: Mental health visits are $0 for most plans, and you don't need a referral. This includes: Therapy and counseling (in-person or video visits) Psychiatry Telehealth platforms in our network like Sondermind and Headway If you need inpatient or residential mental health care that requires prior authorization, call us at (855) 481-0225 and we'll help you navigate it.

Q: How many physical therapy visits are covered? A: Your plan covers up to 30 physical therapy visits per year. That's a combined limit, so if you're doing PT for your shoulder and your knee, both count toward the 30. If you need more visits, your physical therapist can request additional sessions based on medical necessity. Call us at (855) 481-0225 if you have questions about where you stand.

Q: What's covered for pregnancy and delivery? A: Prenatal visits are covered as preventive care at $0. For delivery, In-Area plan members pay $0 for delivery services at Harbor Health and in-network facilities. Your hospital stay follows federal guidelines: up to 48 hours for vaginal delivery, 96 hours for C-section. For your specific plan's maternity benefits, call us at (855) 481-0225 and we're happy to walk through it with you.

Harbor Health Network

Q: My doctor isn't in Harbor's network. Can I still see them? A: If you're in the middle of treatment or have a health condition that requires ongoing care, you may be able to continue seeing your current doctor temporarily. Please see our Transition and Continuity of Care Member Guide or call us at 855-481-0225 and we'll walk you through whether you qualify and help you submit a request. If you don't qualify, you can still see your doctor, you'll just pay the full cost of the visit.

Q: Where can I check which doctors, clinics, labs, and facilities are in-network? A: If you are on an in area plan, view the full In-Area Provider Directory. The best way to save on healthcare costs and services is to start with getting care directly from Harbor clinicians: a Harbor primary care doctor, through our Express Care clinics, and getting a referral/specialist through Harbor. As a reminder, if your provider is not in-network and you receive care, you may be responsible for any costs associated with that visit. A: If you are on an out of area plan, view our out-of-area provider directory.

Q: I have a surgery scheduled or I'm in the middle of treatment with a doctor who isn't in Harbor's network. Can I continue my care? A: You may be able to. You can fill out and submit a Transition & Continuity of Care Request Form, or call us at (855) 481-0225 and we'll help you submit a request to continue with your current doctor while you complete your treatment. The sooner you call, the better as the approval process can take a few weeks since we coordinate directly with your doctor's office.

Q: What are the turnaround times for Prior Authorization requests? A: For Prior Authorization requests, the turnaround times are 24 hours for urgent requests, and 48-72 hours for non-urgent requests.