Tufts Medicare Preferred HMO Prime Rx Plus plan features our lowest copayments when you use services for a higher monthly plan premium. Tufts Medicare Preferred HMO Prime Rx Plus plan is our only plan that includes prescription drug coverage while in the gap or donut hole.

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 Rx Plus plan includes comprehensive coverage for care*, including:

1. Medically necessary doctor visits, hospitalization and emergency care
2. Routine vision and hearing exams
3. $150 per year towards eyewear (lenses, frames and upgrades) or contact lenses, but not both
4. $150 per year towards fitness club membership, instructional fitness classes, and/or nutritional counseling
5. Medical and prescription drug coverage all in one plan with no deductibles
6. Copayments for generic (tier 1) prescription drugs starting at $8 for 30-day retail supply
7. Coverage in the gap for Part D brand drugs (the price you pay may include a 50% discount provided by drug manufacturers)

* 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.

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.

Tufts Medicare Preferred HMO Prime Rx Plus Plan

Massachusetts Plan Service Area