The 9 Best Ways Your Plan Helps You Fight Inflation in 2023

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1

Get up to $500 to stay fit.

Our Wellness Allowance benefit helps you lead a healthy lifestyle. And it pays you back:

  • Depending on the plan you are in, you can get up to $350 each year for fees you pay for membership in a qualified health or fitness club; wellness programs; acupuncture; fitness classes such as yoga, Pilates, tai chi, or aerobics; and much more!1
  • Plus, use our Weight Management programs reimbursement to reach your weight loss goals! You can get up to $150 toward the program fees of WeightWatchers® or hospital-based weight loss programs!2

For details, see your Evidence of Coverage (EOC) booklet.

2

It only costs $10 (or $0) to see your doctor.

Many services that you see your primary care physician (PCP) for, such as an annual physical, cost $0. But seeing your PCP for a general appointment has a low $10 copay ($0 copay for HMO Smart Saver Rx members and Access PPO members (OON: $20).3 This helps make it easier for you to see your PCP if you need to. You'll notice that most of your benefits have set copay amounts. This makes it easier to know exactly what a service will cost you.

Learn how to get the most from your next doctor visit

3

Use your extra discounts to save on hearing aids, massage therapy, and more.

Did you know Tufts Health Plan Medicare Advantage HMO and PPO plan members get extra discounts? With Preferred Extras4, you can save on great programs and services such as hearing aids, weight loss programs, massage therapy, acupuncture, and much more!

See a complete list of Preferred Extras discounts

4

You can save up to $212 on prescription drug costs with home delivery.

If your plan includes prescription drug coverage, you can avoid going to the pharmacy and have prescriptions you take regularly delivered to your door. With OptumRx Home Delivery Pharmacy, you may be able to save up to $53 for a 90-day supply of prescription medications (depending on the plan you are in and the tier your drug is on). That’s a potential savings of up to $212 a year!5 With home delivery, your medications are conveniently mailed to your home. Starting January 1, 2023, to sign up, call OptumRx at: HMO: 1-800-299-7648, PPO: 1-800-460-0322.  

Learn more about home delivery

5

You can save $150 on eyeglasses.

You can get up to $150 toward the full retail price (not sale price) for eyewear (prescription lenses and/or frames) and/or contact lenses from a provider in the EyeMed network!

Or, get up to $90 toward the price for eyewear (prescription lenses and/or frames) and/or contact lenses from a store not in the EyeMed network. (Discounts cannot be combined. Access PPO plan members do not have an EyeMed participating provider requirement.)

Learn more about your eyewear discount

6

You can save big on hearing aids.

You're covered for up to 2 hearing aids per year, 1 hearing aid per ear. The best part? There are five technology levels to choose from and pricing is fixed, with copays ranging from $250 to $1,150 for each hearing aid. You're also covered for a $0 hearing aid evaluation once per year.6

Learn more about your hearing aid discount

7

$0 health screenings.

Getting regular screenings is one of the best ways to stay healthy. Take advantage of a $0 copay for many screenings, including cancer, cholesterol, glaucoma, and many more. (Access PPO plan members pay 40% cost sharing for most covered screenings received out of network.)

See all preventive screenings

8

Up to $1,500 of dental coverage.7

Depending on the plan you are in, the Tufts Health Plan Medicare Preferred Dental Option offers you the opportunity to either add dental coverage or enhance existing dental coverage.

Smart Saver Rx plan—Includes $1,500 of supplemental dental coverage for preventive, basic, and major dental services.


Saver, Basic, and Value plans—Include a $1,000 supplemental dental benefit that covers preventive and basic services. Plus, for an additional monthly premium of $19.50, you can upgrade to the Tufts Health Plan Medicare Preferred Dental Option to enhance the included dental coverage by reducing cost share on basic services and adding coverage for major services.


Prime and Prime Rx Plus plans—Do not include supplemental dental coverage, but you may add $1,000 of dental coverage for preventive, basic, and major dental services for an additional $31 monthly premium.

 

Access PPO plan - Includes $1,000 of supplemental dental coverage for preventive, basic, and major dental services.

 

Members of Saver, Basic, Value, or Prime plans can sign up for the Tufts Health Plan Medicare Preferred Dental Option8:
Sign up by December 7, 2022, for a January 1, 2023, effective date, or
Sign up by January 31, 2023, for a February 1, 2023, effective date.

Just fill out and submit this form. If you signed up for the Dental Option in 2022, your coverage will automatically renew. For complete coverage details see your Evidence of Coverage (EOC).


The Tufts Health Plan Medicare Preferred Dental Option is not available if you receive your benefits from a current or former employer.

Learn more about the Tufts Health Plan Medicare Preferred Dental Option

9

Use your OTC benefit (Saver Rx, Smart Saver Rx, and Access PPO plan members only)

Tufts Medicare Preferred Saver Rx, Smart Saver Rx, and Access PPO plan members can use their OTC benefit to spend on health-related items such as toothbrushes, aspirin, allergy relief items, adhesive bandages, sunscreen, and more!

See OTC Details

 

1$150 (or $350 for members in our Saver Rx, Smart Saver Rx, and Access PPO plans) is the total reimbursement amount each year (January 1–December 31) whether used for a health club, fitness classes, nutritional counseling, or wellness programs.

2$150 is the total reimbursement amount each year (January 1–December 31). This benefit does not cover costs for pre-packaged meals/foods, books, videos, scales, or other items or supplies.

3Benefits, copays, and discounts may be different if you receive your benefits from a current or former employer.

4Discounts and services included in the Preferred Extras program are not plan benefits and are not subject to the Medicare appeals process.

5Applies to Rx plans. Savings may be different depending on the plan you are in or if you receive your benefits from a current or former employer. Tufts Medicare Preferred Prime Rx members can save up to $45 for a 90-day supply of prescription medications—a potential savings of up to $180 a year. Tufts Medicare Preferred Prime Rx Plus members can save up to $30 for a 90-day supply of medications—a potential savings of $120 a year. Tufts Medicare Preferred Access PPO plan members can save up to $49 for a 90-day supply or $196 per year.

6Hearing aid evaluation and hearing aids must be with a Hearing Care Solutions provider. Benefit may not apply if you receive your benefits from a current or former employer.

7Benefit and network limits may apply. The plan is administered by Dominion Dental Services, Inc., which operates under the trade name Dominion National. Services must be performed by providers in the Dominion PPO Network. To check to see if your dentist is in network or to find a dentist, go to thpmp.org/dentist. Tufts Health Plan Medicare Preferred Dental Option is not available if you receive your benefits from a current or former employer.

8If purchased, the Tufts Health Plan Medicare Preferred Dental Option replaces the embedded dental benefit. Tufts Health Plan Medicare Preferred Dental Option is not available if you receive your benefits from a current or former employer.

This information is not a complete description of benefits. Call 1-800-701-9000 (TTY: 711) for more information.

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

  • Tufts Medicare Preferred Saver Rx, Smart Saver Rx, and Access PPO plan members can use their OTC benefit of $240 every calendar year ($60 every calendar quarter) to spend on health-related items such as toothbrushes, aspirin, allergy relief items, adhesive bandages, sunscreen, and more!1