Healthy Living Essentials: Benefits

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$150 Wellness Allowance Fitness Reimbursement

Our Wellness Allowance benefit helps you lead a healthy lifestyle - and it pays you back. Members of a Tufts Health Plan Medicare Advantage HMO plan can receive $150 (or $300 for our Smart Saver Rx and $100 for PPO RX plan members) reimbursement each year1 for fees related to:

  • Membership in a qualified health or fitness club
  • Fitness classes such as yoga, Pilates, tai chi, and aerobics
  • Nutritional counseling sessions
  • Participation in the Enhanced Wellness Program, including memory fitness activities
  • Matter of Balance program
  • Chronic Disease Self-Management program
  • Diabetes Workshop program
  • Healthy Eating for Successful Living program
  • Healthy IDEAs program
  • Powerful Tools for caregivers class
  • The Arthritis Foundation exercise program
  • Fit for your life activity program
  • AAA senior driving program
  • Licensed acupuncturists


$150 Eyewear Reimbursement

With our eyewear benefit, you can get up to $150 ($250 for Smart Saver members) toward the full retail price, (not sale price) for one complete pair of prescription eyeglasses and/or contact lenses from a provider in the EyeMed network2. Or, get up to $90 ($150 for Smart Saver members) toward the price for one complete pair of eyeglasses and/or contact lenses from a store not in the EyeMed network. (Discounts cannot be combined.)

What's EyeMed?

EyeMed Vision Care is the network we use to provide your eyewear benefit. The EyeMed network includes more than 26,000 eye care providers including national chains such as LensCrafters, Pearle Vision, and Target Optical. See your Provider Directory for a list of providers in the EyeMed network by town.


$150 Weight Management Program Reimbursement

Members of a Tufts Health Plan Medicare Advantage HMO or PPO plan are also eligible for a $150 rebate each year3 towards fees associated with weight management programs that include: 

  • Weight Watchers
  • Hospital-based weight loss programs


$0 Health Screenings

Getting regular screenings is one of the best ways to stay healthy. Screenings help find illness or disease before you start to see the signs and feel the symptoms. The copayment for many screenings is $0. These include:

  • Physical Exam
  • Breast Cancer Screening
  • Cholesterol Screening
  • Glaucoma Screening
  • Prostate Cancer Screening
  • And more


Travel Coverage

An important part of enjoying your next trip is knowing that you are covered for emergency and urgent care anywhere in the world. As a member of Tufts Health Plan, you do not need a referral from your primary care physician before getting emergency or urgent care. 

Here's the difference between emergency and urgently needed care:

  • A medical emergency is when you believe your health is in serious danger.
  • Urgently needed care is when you need medical care right away because of an illness, injury, or unexpected condition -  but your health is not in serious danger.

If you receive emergency or urgent care when traveling you may need to pay out of pocket. Simply save your receipts, and call Member Services for reimbursement details4.

 

1. $150 ($300 for Smart Saver and $100 for PPO RX members) is the total reimbursement amount each year (Jan.1–Dec. 31) for covered programs and activities including acupuncture visits not covered by Medicare, health education programs, nutritional counseling, fitness benefits (including one fitness tracker or heart rate monitor), physical fitness programs, wellness programs, alternative therapies, and massage therapy. Please see your Evidence of Coverage (EOC) for more details.

2. You can get up to $150 ($250 for Smart Saver members) toward the full retail price (not sale price) for eyeglasses, prescription lenses, frames, and/or contact lenses including upgrades from a provider in the EyeMed Vision Care Network. Or get up to $90 ($150 for Smart Saver members) from a provider not in the EyeMed network. Only one purchase is allowed per calendar year up to the benefit amount; any unused amount after the single purchase will expire and cannot be applied toward another purchase during the calendar year. If you use a non-EyeMed provider, you would need to pay out of pocket and submit for reimbursement. Discounts can’t be combined. Please refer to your Evidence of Coverage for more details.

3. $150 is the total reimbursement amount each year (Jan. 1–Dec. 31). This benefit does not cover costs for pre-packaged meals/foods, books, videos, scales, or other items or supplies.

4. Reimbursement applies to emergency and urgent care situations only. You may be responsible for any copays that apply.