What Is an Out-of-Pocket Maximum and How Does it Help Me?

As a member of a Tufts Medicare Preferred HMO plan, there is a cap to the amount of money you’ll need to spend for medical services each calendar year.

As a member of a Tufts Medicare Preferred HMO plan, there is a cap to the amount of money you’ll need to spend for medical services each calendar year.

This is called the out-of-pocket maximum. The out-of-pocket maximum gives you peace of mind because you can be sure you won’t pay more than that amount during the year.

Having an out-of-pocket maximum is one of the advantages to an HMO plan. If you relied only on Original Medicare for your health coverage, there is no limit on the amount you may need to spend in a year.

Resources & Tools

Drug Search

Use the drug search tools to find out if your drugs are covered and which tier they fall under on your plan type.

Find a Doctor

Find a doctor within your Tufts Health Plan Medicare Preferred HMO network or your Tufts Health Plan Senior Care Options network.

Health Library A-Z

Tufts Health Plan has partnered with Healthwise to provide members with access to a library of high-quality content on conditions, treatments and more.