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Covering the Medicare Gap with Tufts Health Plan

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Medicare Part A & B coverage is not completely comprehensive, leaving you financially responsible for these gaps in coverage. The reality is that these costs can quickly rise when you become ill or injured depending on the extent of care you need. Additionally, there is no prescription drug coverage, annual out-of-pocket maximum, or spending cap for expenses related to Original Medicare (Parts A & B) services.

You can guard against these unforeseen Medicare expenses by purchasing a Medicare Advantage (Part C) or Medicare Supplement plan. These plans can help by providing more consistent costs, annual out-of-pocket maximums and additional benefits not covered by Original Medicare (Parts A & B).

How Tufts Medicare Preferred Can Help

Medicare Advantage Plans
(Medicare Part C)

5-Star Plan: Eligible individuals can enroll any time! 
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Medicare Advantage Plans provide all the coverage of Original Medicare (Parts A & B), while offering additional benefits like optional prescription drug coverage, vision, fitness reimbursements and yearly out-of-pocket maximums for medical expenses. Our Medicare Advantage Plans use a Health Maintenance Organization (HMO) approach where you choose a Primary Care Physician (PCP) who coordinates your care and is responsible for referring you to specialists or facilities when needed, to ensure you receive the right care at the right time. We have over 1,900 PCPs to choose from and can help you select a PCP if you don't currently have one. Our Medicare Advantage plans are available with and without prescription drug coverage with premiums starting as low as $0 per month.

Coverage

All coverage offered by Medicare Parts A & B, optional Part D Coverage and additional coverage. Some restrictions apply to access to doctors and facilities outside the Tufts Medicare Advantage Network.

Gaps Filled

  • Part A: Coverage beyond established limits and timeframes
  • Part B: Set copayments and co-insurance costs for Medicare- approved procedures
  • Part D: Optional Part D prescription coverage

Added Benefits

  • Vision
  • Hearing
  • Health & Wellness programs
  • Annual out of pocket maximum for medical services of $3,400

View Tufts Medicare Advantage Plans


Senior Care Options Plan: 

5-Star Plan: Eligible individuals can enroll any time! 
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Tufts Health Plan Senior Care Options is available to individuals who are at least 65 years old and have Medicare and MassHealth Standard (Medicaid) or just MassHealth Standard (Medicaid). This plan provides members who qualify with medical and prescription benefits along with a Primary Care Team, whose key goal is to improve the coordination of care you receive.

 

Coverage

All coverage offered by Medicare Parts A & B, plus additional coverage. Some restrictions apply to access to doctors and facilities outside the Tufts Medicare Advantage Network.

Gaps Filled

All out-of-pocket expenses for covered medical expenses and prescription drugs

Added Benefits

  • Prescription drug coverage
  • Managed care
  • Community-based services (personal care, social day care, meals, transportation)

View Tufts Senior Care Options Plan


Medicare Supplement Plans: 

Medicare Supplement plans are provided through private 3rd party insurance companies and are designed to fill the gaps in Original Medicare (Parts A & B) coverage. When you purchase a Medicare Supplement plan, Original Medicare remains your primary insurer, allowing you to see any doctor or facility that accepts Medicare with no need for referrals. The Medicare Supplement plan becomes your secondary insurer, covering many of the out-of-pocket expenses associated with Original Medicare, like deductibles, co-pays and co-insurance, however, prescription drug coverage is not included.

Coverage

All coverage offered by Medicare Parts A & B, plus additional coverage.

Gaps Filled

  • Parts A & B: deductibles, co-pays and co-insurance
  • Access to medical care nationwide from doctors who accept Medicare with no referrals or network restrictions
  • Deductibles, copays and coinsurance covered up to 100% depending on plan

Added Benefits

Depending on plan selected

  • Vision
  • Weight Management Reimbursement
  • Fitness Reimbursement

View all Tufts Medicare Supplement Plans
 


Group Plans (Employer Coverage)

These plans are offered through your employer in the form of HMO Medicare Advantage Plans, Supplemental Plans and Prescription Drug Plans. To find out if your employer is offering Tufts Health Plan Medicare Preferred Group Plans, contact us at 1-800-890-6600.

View Tufts Group Plan Information