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- Features lowest copayments but the highest monthly plan premiums and does not include prescription drug coverage.
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Tufts Medicare Preferred HMO Prime No Rx Plan features our lowest copayments when you need services for a higher monthly plan premium. It does not include prescription drug coverage.
Our Tufts Medicare Preferred HMO plans all offer comprehensive medical coverage beyond Original Medicare. The only difference between our plans are the monthly premium and copayment amounts. With Tufts Medicare Preferred HMO plans you choose a primary care physician (PCP) from among the more than 1,600 doctors in our plan (if you don’t currently have a PCP who is on our plan, our representatives can help you find one that meets your needs).
Our Tufts Medicare Preferred HMO Prime No Rx plan includes comprehensive coverage for care*, including:
- Medically necessary doctor visits, hospitalizations and emergency care
- Routine vision and hearing exams
- $150 per year towards eyewear (lenses, frames and upgrades) or contact lenses, but not both
- $150 per year towards fitness club membership, instructional fitness classes, and/or nutritional counseling
* Copayments, deductibles and coinsurances apply
Expect more if you’re healthy and when you need us most.
With Tufts Medicare Preferred HMO plans, our goal is to keep you healthy, active and vital so you can keep doing the things you love. Some of the ways that Tufts Medicare Preferred HMO plans help you are by collaborating with your doctors to create programs that promote disease prevention and by helping you keep up with important health screenings.
Projected Cost Sheet
| Annual Cost | |
|---|---|
| Annual Medical Out-of-Pocket Max | $3,400 |
| Medical Copayments | |
| Doctor Office Visits | $10 |
| Specialty Office Visits | $15 |
| Drug Copayments | |
| Tier 1 – Generic Drugs | Not Covered |
| Tier 2 – Preferred Brand Drugs | Not Covered |
| Tier 3 - Non-Preferred Brand Drugs | Not Covered |
| Tier 4 - Specialty Tier Drugs | Not Covered |
| Rx Deductibles | n/a |
We also know that there may be times you need more help too. Tufts Medicare Preferred HMO plans provide support programs to assist you in managing chronic conditions and, if you are hospitalized, have care managers who can guide you through the health care system and help you coordinate services you may need. You expect your health plan to cover you if you’re sick or get hurt. Expect more.
Our coordinated approach to healthcare
The PCP you choose works with certain plan specialists he/she uses for referrals, called a “referral circle,” to provide the medical care you need. This means in most cases, you will not have access to the entire Tufts Medicare Preferred HMO network, except in an emergency or urgent care situations, or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Tufts Health Plan Medicare Preferred will be responsible for the costs.
This coordinated approach to care helps ensure that you receive the right level of care in the right setting at the right time.
Massachusetts Plan Service Area
To join a Tufts Medicare Preferred HMO plan you must live in Barnstable, Bristol†, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth††, Suffolk or Worcester counties.
† Excluded towns in Bristol County are Berkley, Dighton, and Tauton
†† Excluded towns in Plymouth County are Lakeville and Middleborough
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Tufts Medicare Preferred HMO Prime No Rx Plan
Massachusetts Plan Service Area
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