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Answers to Common Questions Regarding Your Coverage and the Coronavirus

This article will be updated with new information as it becomes available. Last updated 11/17 with updated Telehealth/Telemedicine coverage.

As a community, we are all feeling the impact of the coronavirus (COVID-19) outbreak. At Tufts Health Plan, we are committed to making sure you have access to necessary health care services during this challenging time. We have made numerous plan changes to make it easier to get services related to the coronavirus. Below are answers to common questions you may have regarding your coverage and the coronavirus: 

Who do I call at Tufts Health Plan if I am impacted by the coronavirus?

If you need medical attention due to the coronavirus, call your primary care physician’s (PCP’s) office for next steps. If you have any questions about your coverage and how it relates to the coronavirus, you can find benefit details in What We're Doing to Help During Coronavirus, and as always, our Customer Relations team is available to answer any questions you have about your plan. Just call 1-800-701-9000 (TTY:711).

Where do I get tested for the coronavirus?

A useful tool to help determine if you should be tested for coronavirus is Buoy, a free web-based tool to check your symptoms and learn about the care options available to you. Buoy is officially partnered with the State of Massachusetts.

Check Your Symptoms with Buoy

If you believe you need to be tested for the coronavirus, call your PCP for details and instructions. 

Will Tufts Health Plan cover the cost of a coronavirus test?

Yes. There is no out-of-pocket cost for a medically necessary coronavirus test. This coverage applies at in-network providers, urgent care centers, emergency rooms and other facilities, and at out-of-network providers in the event you cannot easily find an in-network provider to provide timely services. Additionally, you may visit testing sites set up by the state. Check Stop the Spread to find locations of testing sites near you. Consistent with Federal and State guidance coronavirus tests will only be covered or reimbursed if they are medically necessary as determined by a health care provider in accordance with current CDC and state public health department guidelines. COVID-19 tests that are not ordered or referred by a provider are not covered benefits. Testing will not be covered solely for general workplace health and safety, public health surveillance or for other purposes not primarily intended for a member’s individual COVID-19 diagnosis or treatment.

Additional coverage details related to the coronavirus

What if I am impacted by the coronavirus and unable to see an in-network provider?

There is no out-of-pocket cost for medically necessary treatment related to the diagnosis of the coronavirus. This applies at in-network providers and out-of-network providers if you are unable to find an in-network provider to provide timely services.

Additional coverage details related to the coronavirus

Do I need a referral to receive services related to the coronavirus?

No. You are not required to get a referral from your PCP for medically necessary testing, counseling, or treatment related to the coronavirus.

Additional coverage details related to the coronavirus

Can I refill my current prescriptions so I have a larger supply in case of extended isolation?

Yes. Due to the coronavirus pandemic, we are making it easier to get increased access to the prescription drugs you need. You can refill prescription medication early without waiting to finish your current fill. You can also refill up to a  90-day supply, to the extent consistent with clinical guidelines. (Controlled substances are excluded from this policy, subject to CMS rules).

Additional coverage details related to the coronavirus

Should I consider telehealth/telemedicine?

With telehealth/telemedicine, you can have a telephone consultation, or use your smartphone or computer for video consultations. This helps you avoid going to your doctor’s office where you could encounter the coronavirus. In-network telehealth/telemedicine services are provided to Tufts Health Plan Medicare Preferred members at no cost (out-of-network telehealth/telemedicine services are not covered). For non-COVID-related telehealth services received after 12/31/2020, copays will be the same as an in-person visit. Please contact your PCP or other in-network providers for information on the types of telehealth/telemedicine care they can provide.

Additional coverage details related to the coronavirus

Where can I find information about coverage for coronavirus?

Coverage information related to the coronavirus, in addition to prevention tips, symptom information, and general health information is available in Coronavirus Information.  

What is Tufts Health Plan doing to prevent service disruptions?

Tufts Health Plan has an extensive policy in place to ensure you continue to receive the benefits and services you need. Our employees are currently working remotely to provide continued service to our members. Our Customer Relations department is available to answer any questions you have about your plan. Just call 1-800-701-9000 (TTY: 711). View plan information related to the coronavirus.

If I am diagnosed with coronavirus will I be denied coverage?

As always, we are committed to providing the benefits and services you need to stay healthy. You will not lose your coverage with Tufts Health Plan if you are diagnosed with coronavirus.  

 

Plan changes related to the coronavirus described above are in effect from March 6 until further notice. 

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