Several of your 2026 plan benefits offer a reimbursement for qualified items and services. You pay out-of-pocket for these services, then your plan reimburses you. 

• Weight Management: $150 per calendar year¹
• Wellness Allowance: $150 per calendar year ($300 per calendar year for Smart Saver Rx, and $100 for PPO RX members)²
• Eyewear Benefit: $150 per calendar year in the EyeMed network ($250 for Smart Saver Rx), or $90 per calendar year out-of-network ($150 for Smart Saver Rx). Only out-of-network services need to be paid out-of-pocket and submitted for reimbursement. 

How can you request a reimbursement? 

Each benefit has its own reimbursement request form with instructions for submitting. Forms can be found at thpmp.org/forms. Requests for 2025 must include proof of payment in the form of paid, itemized receipts and be submitted no later than March 31, 2026. Proof of payment must be in the member’s name or, alternatively, in the name of the member’s representative on record. 

How long does it take to receive a reimbursement? 

Once received, your reimbursement request(s) will be processed within: 

• 60 calendar days for Weight Management and Wellness Allowance reimbursements
• Up to 30 days for out-of-network Eyewear Benefit reimbursements 

How can you request a reimbursement for something else? 

If you need to request a reimbursement for another purpose, such as a prescription or a dental service, you can find additional requests forms at thpmp.org/forms:

• Part D Prescription Reimbursement Form—Submit along with the original pharmacy receipt. Reimbursements take up to 14 days to be processed.
• HMO Dental Claim Form—Submit along with proof of services and proof of payment. Reimbursements take up to 30 days to be processed.

What 2025 expenses are reimbursable?

• Weight Management—Program fees for weight loss programs such as Weight Watchers, or hospital-based weight loss programs.¹
• Wellness Allowance—Costs of qualified fitness, nutritional, or wellness programs. Examples include gym memberships, in-person and online fitness classes, nutritional counseling, chronic disease self-management programs, diabetes workshops, licensed acupuncture visits, and more.
• Eyewear Benefit—HMO members get up to $150 ($250 for Smart Saver Rx) toward the full retail price of a pair of prescription eyeglasses and/or contact lenses from any provider in the EyeMed network. The discount will be applied at the time of service and a reimbursement request is not required. If you use an out-of-network provider, you are covered for up to $90 ($150 for Smart Saver Rx), and you pay out of pocket and submit for a reimbursement. 

Discounts cannot be combined.

For a complete list of covered services, see your Evidence of Coverage, available at thpmp.org/documents.

Benefit information described is for Tufts Health Plan Medicare Advantage HMO and PPO RX plan members. Benefit information may be different if you receive your benefits from a current or former employer.

¹$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.

²$150 ($300 for Smart Saver and $100 for PPO RX plan) 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.