- Not available for
- A special needs health plan for people age 65+, who are on or eligible for MassHealth Standard and who may have Medicare Parts A and B.
With Tufts Health Plan Senior Care Options members receive health care coverage under a single plan that coordinates and integrates all the services covered by MassHealth Standard (Medicaid) and Medicare. Members will have no out-of-pocket expenses for covered services and for prescription drugs in our formulary or select over-the-counter drugs prescribed by the member's doctor.
Also, in addition to the medical and prescription coverage, Tufts Health Plan Senior Care Options may provide coverage for community-based services like:
· Personal care services · Social day care
· Home delivered meals · Transportation to medical visits
· And other additional community-based services you may qualify for and need
*For additional benefit information please see the Summary of Benefits (coming soon).
At Tufts Health Plan Senior Care Options, you will be the center of a Primary Care Team. This team will meet with you to learn more about your specific needs and work with you, your family, and your doctor to create an Individualized Plan of Care. They’ll help you get the support and services for which you qualify as your needs change.
Your Primary Care Team may include: you, your Primary Care Physician, your Care Manager, a Care Coordinator, your Specialists, a Geriatric Support Services Coordinator, and others, based upon your medical and social service needs.
Tufts Health Plan Senior Care Options is a voluntary MassHealth benefit in association with the Executive Office of Health and Human Services, the state agency that oversees the state Medicaid program, and the Centers for Medicare and Medicaid Services, the federal agency that oversees the federal Medicare program. Enrollment in Tufts Health Plan Senior Care Options is voluntary. There is a continuous enrollment and disenrollment period which means you can enroll or disenroll at any time.
Learn More: To learn more about our plan or how to enroll,
please call 1-855-670-5927 (TTY: 1-855-670-5940).
Submit a Complaint about Your Medicare Plan (for individuals enrolled in Tufts Health Plan Senior Care Options (HMO SNP) plan)
To request a prior authorization for your prescription medication, you will need to submit a Medicare Part D Coverage Determination Request
To request an appeal for a denied prescription medication, you will need to submit a Medicare Part D Coverage Redetermination (Appeal) Request
Our plans are available for people 65 or older who live in the service area. The HMO SNP is available to anyone who has both MassHealth Standard (Medicaid) and Medicare Part A and Part B. The SCO is available to anyone who has MassHealth Standard Only. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations and restrictions may apply.