Plan Documentation
Medicare Advantage HMO Plans
Tufts Health Plan Medicare Preferred HMO member cards look like the samples below:
Prescription (Rx) and Pharmacy Documents
2022 Tufts Health Plan Medicare Part B Step Therapy Policy
Step therapy is when Tufts Health Plan requires a member to try a preferred drug to treat a medical condition before a non-preferred drug will be covered. If you have been treated with a non-preferred drug within the past 365 days, the step therapy requirements will not apply to you. The Medicare Part B Step Therapy Policy includes the list of Medicare Part B prescription drugs that require step therapy, and what the preferred drugs are.
View Document called 2022 Tufts Health Plan Medicare Part B Step Therapy Policy2022 Tufts Health Plan Medicare Preferred HMO Employer Group Formulary
This document is a comprehensive formulary containing the prescription drugs covered by Tufts Health Plan Medicare Preferred Medicare Advantage HMO Group Plans.
View Document called 2022 Tufts Health Plan Medicare Preferred HMO Employer Group Formulary2022 Tufts Health Plan Medicare Preferred HMO Individual Formulary
This document is a comprehensive formulary containing the prescription drugs covered by Tufts Health Plan Medicare Preferred Medicare Preferred individual HMO plans.
View Document called 2022 Tufts Health Plan Medicare Preferred HMO Individual Formulary2022 Tufts Health Plan Medicare Preferred Prior Authorization Medical Necessity Guidelines
This document details the Tufts Health Plan Medicare Preferred Medical Necessity Guidelines. These guidelines are used by Tufts Health Plan to determine medical necessity and appropriateness of health care services for the purpose of determining coverage under the applicable health benefit plan.
View Document called 2022 Tufts Health Plan Medicare Preferred Prior Authorization Medical Necessity Guidelines2022 Tufts Health Plan Medicare Preferred Step Therapy Prior Authorization Medical Necessity Guidelines
This document details drugs that may require prior authorization or Step Therapy to be covered by Tufts Health Plan Medicare Preferred plans. Prior Authorization means that your doctor, or prescriber, must first show that you have a medically necessary need for the drug before Tufts Health Plan will cover the drug cost. Step Therapy is a type of prior authorization that in most cases requires a less expensive drug, that has been proven effective for your condition, is prescribed before moving up a "step" to a more expensive drug.
View Document called 2022 Tufts Health Plan Medicare Preferred Step Therapy Prior Authorization Medical Necessity Guidelines2022 Tufts Medicare Preferred HMO Pharmacy Directory (Prime Rx, Prime Rx Plus, Group Retiree Plans)
This directory provides a list of pharmacies in the Tufts Medicare Preferred HMO network for Prime Rx, Prime Rx Plus and Group Retiree Plans. This directory does not apply to Smart Saver Rx, Saver Rx, Basic Rx or Value Rx plans. Please note that this directory is for members in Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester counties.
View Document called 2022 Tufts Medicare Preferred HMO Pharmacy Directory (Prime Rx, Prime Rx Plus, Group Retiree Plans)2022 Tufts Medicare Preferred HMO Pharmacy Directory (Smart Saver Rx, Saver Rx, Basic Rx, Value Rx)
This directory provides a list of pharmacies in the Tufts Medicare Preferred HMO network, Smart Saver Rx, Saver Rx, Basic Rx, and Value Rx plans only. Please note that this directory is for members in Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester counties.
View Document called 2022 Tufts Medicare Preferred HMO Pharmacy Directory (Smart Saver Rx, Saver Rx, Basic Rx, Value Rx)Part D Late Enrollment Penalty (LEP) Right to Review Reconsideration Notice
This document allows you to learn about your right to ask Medicare to review your Medicare Part D late enrollment penalty. Updated: 02/01/2021
View Document called Part D Late Enrollment Penalty (LEP) Right to Review Reconsideration NoticeTufts Health Plan Medicare Preferred HMO & PDP Transition Process
This document details what to do if your current prescription drugs are not included in the Tufts Health Plan Medicare Preferred formulary, or drug list, or are restricted in some way.
View Document called Tufts Health Plan Medicare Preferred HMO & PDP Transition ProcessProvider Directories
2022 Tufts Medicare Preferred HMO Provider Directory
This directory provides a list of providers in the Tufts Medicare Preferred HMO network. Please note that this directory is for members in Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester counties.
View Document called 2022 Tufts Medicare Preferred HMO Provider DirectoryPlan Rating Documents
2022 Tufts Medicare Preferred HMO Medicare Star Ratings
This document details the Star Rating given to Tufts Health Plan Medicare Preferred HMO plans. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov.
View Document called 2022 Tufts Medicare Preferred HMO Medicare Star RatingsAppeals and Grievances Documents
Fraud, Waste & Abuse
The document provides details around how Tufts Health Plan members can contact the Tufts Health Plan Fraud Hotline with questions, concerns and/or complaints related to possible wasteful, fraudulent, or abusive activity.
View Document called Fraud, Waste & AbuseTufts Health Plan Medicare Preferred HMO Appeals and Grievances Document
This document explains how to submit a complaint to Tufts Medicare Preferred in the form of an appeal or grievance.
View Document called Tufts Health Plan Medicare Preferred HMO Appeals and Grievances DocumentSummary of Benefits
2022 Tufts Medicare Preferred HMO Plans | Summary of Benefits (All Counties)
This document provides a summary of the coverage and costs associated with Tufts Health Plan Medicare Preferred HMO plans in the following Massachusetts counties: Barstable, Bristol, Essex, Hampden, Hamshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester.
View Document called 2022 Tufts Medicare Preferred HMO Plans | Summary of Benefits (All Counties)Legal Documents
Legal, Security, and Privacy Practices
This document details the legal, security, and privacy practices related to the Tufts Health Plan website.
View Document called Legal, Security, and Privacy PracticesNotice of Non-Discrimination - Tufts Health Plan Medicare Preferred HMO
Tufts Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
View Document called Notice of Non-Discrimination - Tufts Health Plan Medicare Preferred HMONotice of Privacy Practices
This notice describes how health information about you may be used and disclosed, and how you can get access to this information.
View Document called Notice of Privacy PracticesTufts Health Plan Medicare Preferred Disclaimers
View Document called Tufts Health Plan Medicare Preferred DisclaimersEvidence of Coverage
2022 Evidence of Coverage | Tufts Medicare Preferred HMO Basic No Rx (HMO)
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Basic No Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Basic No Rx (HMO)2022 Evidence of Coverage | Tufts Medicare Preferred HMO Basic Rx (HMO)
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Basic Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Basic Rx (HMO)2022 Evidence of Coverage | Tufts Medicare Preferred HMO Basic Rx Custom (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Basic Rx Custom (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Custom Prime Rx (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Custom Prime Rx (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Custom Prime Rx II (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Custom Prime Rx II (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Custom Prime Rx Plus (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Custom Prime Rx Plus (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Harvard University (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Harvard University (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Fit Rx (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Fit Rx (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime No Rx
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Prime No Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime No Rx2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime No Rx (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime No Rx (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Prime Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx BOS (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx BOS (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Custom (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Custom (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx HP Inc. Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx HP Inc. Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Plus
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Prime Rx Plus plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Plus2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Plus (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Plus (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Standard (HMO) Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Prime Rx Standard (HMO) Employer Group2022 Evidence of Coverage | Tufts Medicare Preferred HMO Saver Rx (HMO)
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Saver Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Saver Rx (HMO)2022 Evidence of Coverage | Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Smart Saver Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Smart Saver Rx (HMO)2022 Evidence of Coverage | Tufts Medicare Preferred HMO Value No Rx (HMO)
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Value No Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Value No Rx (HMO)2022 Evidence of Coverage | Tufts Medicare Preferred HMO Value Rx (HMO)
This document provides detailed coverage information for the Tufts Medicare Preferred HMO Value Rx plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Value Rx (HMO)2022 Evidence of Coverage | Tufts Medicare Preferred HMO Value Rx Employer Group
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred HMO Value Rx Employer GroupAnnual Notice of Change
2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic No Rx (Essex, Suffolk)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Basic No Rx, in Essex and Suffolk counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic No Rx (Essex, Suffolk)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic No Rx (Worcester)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Basic No Rx in Worcester county. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic No Rx (Worcester)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Essex, Suffolk)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Basic Rx in Essex and Suffolk counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Essex, Suffolk)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Hampden, Hampshire)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Basic Rx in Hampden and Hampshire counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Hampden, Hampshire)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Other Counties)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Basic Rx in Barstable, Bristol, Middlesex, Norfolk, and Plymouth counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Other Counties)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Worcester)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Basic Rx in Worcester county. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Basic Rx (Worcester)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime No Rx (Essex, Suffolk)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime No Rx plan in Essex and Suffolk counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime No Rx (Essex, Suffolk)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime No Rx (Other Counties)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime No Rx plan in Barstable, Bristol, Middlesex, Norfolk, and Plymouth counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime No Rx (Other Counties)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime No Rx (Worcester)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime No Rx plan in Worcester county. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime No Rx (Worcester)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Essex, Suffolk)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime Rx plan in Essex and Suffolk counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Essex, Suffolk)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Hampden, Hampshire)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime Rx plan in Hampden and Hampshire counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Hampden, Hampshire)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Other Counties)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime Rx plan in Barstable, Bristol, Middlesex, Norfolk, and Plymouth counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Other Counties)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Worcester)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime Rx plan in Worcester county. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx (Worcester)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx Plus (Essex, Suffolk)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime Rx Plus plan in Essex and Suffolk counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx Plus (Essex, Suffolk)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx Plus (Hampden, Hampshire)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime Rx Plus plan in Hampden and Hampshire counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx Plus (Hampden, Hampshire)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx Plus (Other Counties)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Prime Rx Plus plan in Barstable, Bristol, Middlesex, Norfolk, and Plymouth counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Prime Rx Plus (Other Counties)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Saver Rx (All Counties)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Saver Rx plan in Barstable, Bristol, Middlesex, Norfolk, Plymouth, Worcester, Essex, Suffolk, Hampden and Hampshire counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Saver Rx (All Counties)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value No Rx (Essex, Suffolk)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Value No Rx in Essex and Suffolk counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value No Rx (Essex, Suffolk)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value No Rx (Other Counties)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Value No Rx in Barstable, Bristol, Middlesex, Norfolk, and Plymouth counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value No Rx (Other Counties)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value No Rx (Worcester)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Value No Rx in Worcester county. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value No Rx (Worcester)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Essex, Suffolk)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Value Rx in Essex and Suffolk counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Essex, Suffolk)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Hampden, Hampshire)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Value Rx in Hampden and Hampshire counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Hampden, Hampshire)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Other Counties)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Value Rx in Barstable, Bristol, Middlesex, Norfolk, and Plymouth counties. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Other Counties)2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Worcester)
This documents details the year-over-year changes to the Tufts Health Plan Medicare Preferred HMO Value Rx in Worcester county. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Medicare Preferred HMO Value Rx (Worcester)Medicare Supplement Plans
Tufts Medicare Preferred Supplement member cards look like the sample below:
Policy Documents
2022 Tufts Health Plan Medicare Preferred Medicare Supplement Dental Option Policy Addendum
This document provides detailed coverage information for the Tufts Health Plan Medicare Preferred Supplement Dental Option. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Tufts Health Plan Medicare Preferred Medicare Supplement Dental Option Policy Addendum2022 Tufts Health Plan Medicare Preferred Medicare Supplement Policy - Tufts Medicare Preferred Supplement Core Plan
This document provides detailed coverage information for the Tufts Health Plan Medicare Preferred Supplement Core plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Tufts Health Plan Medicare Preferred Medicare Supplement Policy - Tufts Medicare Preferred Supplement Core Plan2022 Tufts Health Plan Medicare Preferred Medicare Supplement Policy - Tufts Medicare Preferred Supplement One A Plan
This document provides detailed coverage information for the Tufts Health Plan Medicare Preferred Supplement 1A plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Tufts Health Plan Medicare Preferred Medicare Supplement Policy - Tufts Medicare Preferred Supplement One A Plan2022 Tufts Health Plan Medicare Preferred Medicare Supplement Policy - Tufts Medicare Preferred Supplement One Plan
This document provides detailed coverage information for the Tufts Health Plan Medicare Preferred Supplement 1 plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Tufts Health Plan Medicare Preferred Medicare Supplement Policy - Tufts Medicare Preferred Supplement One PlanLegal Documents
Legal, Security, and Privacy Practices
This document details the legal, security, and privacy practices related to the Tufts Health Plan website.
View Document called Legal, Security, and Privacy PracticesAppeals and Grievances Documents
Fraud, Waste & Abuse
The document provides details around how Tufts Health Plan members can contact the Tufts Health Plan Fraud Hotline with questions, concerns and/or complaints related to possible wasteful, fraudulent, or abusive activity.
View Document called Fraud, Waste & AbuseSenior Care Options Plan (HMO-SNP)
Tufts Medicare Preferred Senior Care Options member cards look like the samples below:
Prescription (Rx) and Pharmacy Documents
2022 Tufts Health Plan Medicare Part B Step Therapy Policy
Step therapy is when Tufts Health Plan requires a member to try a preferred drug to treat a medical condition before a non-preferred drug will be covered. If you have been treated with a non-preferred drug within the past 365 days, the step therapy requirements will not apply to you. The Medicare Part B Step Therapy Policy includes the list of Medicare Part B prescription drugs that require step therapy, and what the preferred drugs are.
View Document called 2022 Tufts Health Plan Medicare Part B Step Therapy Policy2022 Tufts Health Plan Senior Care Options (HMO-SNP) Formulary
This document is a comprehensive formulary containing the prescription drugs covered by Tufts Health Plan Senior Care Options plan.
View Document called 2022 Tufts Health Plan Senior Care Options (HMO-SNP) Formulary2022 Tufts Health Plan Senior Care Options (HMO-SNP) Prior Authorization Medical Necessity Guidelines
This document details the Tufts Health Plan Senior Care Options Medical Necessity Guidelines. These guidelines are used by Tufts Health Plan to determine medical necessity and appropriateness of health care services for the purpose of determining coverage under the applicable health benefit plan.
View Document called 2022 Tufts Health Plan Senior Care Options (HMO-SNP) Prior Authorization Medical Necessity Guidelines2022 Tufts Health Plan Senior Care Options (HMO-SNP) Step Therapy Prior Authorization Medical Necessity Guidelines
This document details drugs that may require prior authorization or Step Therapy to be covered by Tufts Health Plan Senior Care Options plan. Prior Authorization means that your doctor, or prescriber, must first show that you have a medically necessary need for the drug before Tufts Health Plan will cover the drug cost. Step Therapy is a type of prior authorization that in most cases requires a less expensive drug, that has been proven effective for your condition, is prescribed before moving up a "step" to a more expensive drug.
View Document called 2022 Tufts Health Plan Senior Care Options (HMO-SNP) Step Therapy Prior Authorization Medical Necessity GuidelinesTufts Health Plan Senior Care Options (HMO-SNP) Transition Process
This document details certain circumstances in which the plan can offer a temporary supply of a drug when your drug is not included in the Tufts Health Plan Senior Care Options formulary, or drug list, or is restricted in some way.
View Document called Tufts Health Plan Senior Care Options (HMO-SNP) Transition ProcessProvider Directories
2022 Tufts Health Plan Senior Care Options (HMO-SNP) Provider Directory
This directory provides a list of providers in the Tufts Health Plan Senior Care Options plan network.
View Document called 2022 Tufts Health Plan Senior Care Options (HMO-SNP) Provider DirectoryPlan Rating Documents
Tufts Health Plan Senior Care Options (HMO-SNP) Medicare Star Ratings
This document details the Star Rating given to Tufts Health Plan Senior Care Options plan. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov.
View Document called Tufts Health Plan Senior Care Options (HMO-SNP) Medicare Star RatingsAppeals and Grievances Documents
Fraud, Waste & Abuse
The document provides details around how Tufts Health Plan members can contact the Tufts Health Plan Fraud Hotline with questions, concerns and/or complaints related to possible wasteful, fraudulent, or abusive activity.
View Document called Fraud, Waste & AbuseTufts Health Plan Senior Care Options (HMO-SNP) Appeals and Grievances
This document explains how to submit a complaint to Tufts Medicare Preferred in the form of an appeal or grievance.
View Document called Tufts Health Plan Senior Care Options (HMO-SNP) Appeals and GrievancesSummary of Benefits
2022 Tufts Health Plan Senior Care Options | Summary of Benefits
This document provides a summary of the coverage and costs associated with the Tufts Health Plan Senior Care Options Plan.
View Document called 2022 Tufts Health Plan Senior Care Options | Summary of BenefitsLegal Documents
Legal, Security, and Privacy Practices
This document details the legal, security, and privacy practices related to the Tufts Health Plan website.
View Document called Legal, Security, and Privacy PracticesNotice of Non-Discrimination - Tufts Health Plan Medicare Preferred Senior Care Options
Tufts Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
View Document called Notice of Non-Discrimination - Tufts Health Plan Medicare Preferred Senior Care OptionsNotice of Privacy Practices Senior Care Options
This notice describes how health information about you may be used and disclosed, and how you can get access to this information.
View Document called Notice of Privacy Practices Senior Care OptionsEvidence of Coverage
2022 Evidence of Coverage | Tufts Health Plan Senior Care Options (HMO-SNP)
This document provides detailed coverage information for the Tufts Health Plan Senior Care Options (HMO-SNP) plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Health Plan Senior Care Options (HMO-SNP)Annual Notice of Change
2022 Annual Notice of Change | Tufts Health Plan Senior Care Options (HMO SNP)
This documents details the year-over-year changes to the Tufts Health Plan Senior Care Options. It outlines how the costs and coverages for this plan have changed compared to the previous year.
View Document called 2022 Annual Notice of Change | Tufts Health Plan Senior Care Options (HMO SNP)Prescription Drug Plan (PDP)
Tufts Medicare Preferred Prescription Drug Plan (PDP) member cards look like the sample below:
Prescription (Rx) Drugs and Pharmacy Documents
2022 Tufts Health Plan Medicare Preferred PDP Employer Group Formulary
This document is a comprehensive formulary containing the prescription drugs covered by Tufts Health Plan Medicare Preferred Group Retiree Prescription Drug Plans.
View Document called 2022 Tufts Health Plan Medicare Preferred PDP Employer Group Formulary2022 Tufts Health Plan Medicare Preferred Prior Authorization Medical Necessity Guidelines
This document details the Tufts Health Plan Medicare Preferred Medical Necessity Guidelines. These guidelines are used by Tufts Health Plan to determine medical necessity and appropriateness of health care services for the purpose of determining coverage under the applicable health benefit plan.
View Document called 2022 Tufts Health Plan Medicare Preferred Prior Authorization Medical Necessity Guidelines2022 Tufts Health Plan Medicare Preferred Step Therapy Prior Authorization Medical Necessity Guidelines
This document details drugs that may require prior authorization or Step Therapy to be covered by Tufts Health Plan Medicare Preferred plans. Prior Authorization means that your doctor, or prescriber, must first show that you have a medically necessary need for the drug before Tufts Health Plan will cover the drug cost. Step Therapy is a type of prior authorization that in most cases requires a less expensive drug, that has been proven effective for your condition, is prescribed before moving up a "step" to a more expensive drug.
View Document called 2022 Tufts Health Plan Medicare Preferred Step Therapy Prior Authorization Medical Necessity Guidelines2022 Tufts Medicare Preferred PDP Employer Group Pharmacy Directory
This directory provides a list of providers and pharmacies in the Tufts Health Plan Medicare Preferred Group Retiree Prescription Drug Plan network.
View Document called 2022 Tufts Medicare Preferred PDP Employer Group Pharmacy DirectoryTufts Health Plan Medicare Preferred HMO & PDP Transition Process
This document details what to do if your current prescription drugs are not included in the Tufts Health Plan Medicare Preferred formulary, or drug list, or are restricted in some way.
View Document called Tufts Health Plan Medicare Preferred HMO & PDP Transition ProcessAppeals and Grievance Documents
Fraud, Waste & Abuse
The document provides details around how Tufts Health Plan members can contact the Tufts Health Plan Fraud Hotline with questions, concerns and/or complaints related to possible wasteful, fraudulent, or abusive activity.
View Document called Fraud, Waste & AbuseLegal Documents
Legal, Security, and Privacy Practices
This document details the legal, security, and privacy practices related to the Tufts Health Plan website.
View Document called Legal, Security, and Privacy PracticesEvidence of Coverage
2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP
This document provides detailed coverage information for the Tufts Medicare Preferred Group PDP plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP 2
This document provides detailed coverage information for the Tufts Medicare Preferred Group PDP 2 plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP 22022 Evidence of Coverage | Tufts Medicare Preferred Group PDP 3
This document provides detailed coverage information for the Tufts Medicare Preferred Group PDP 3 plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP 32022 Evidence of Coverage | Tufts Medicare Preferred Group PDP 4
This document provides detailed coverage information for the Tufts Medicare Preferred Group PDP 4 plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP 42022 Evidence of Coverage | Tufts Medicare Preferred Group PDP Custom
This document provides detailed coverage information for the Tufts Medicare Preferred Group PDP Custom plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP Custom2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP Plus
This document provides detailed coverage information for the Tufts Medicare Preferred Group PDP Plus plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP Plus2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP V
This document provides detailed coverage information for the Tufts Medicare Preferred Group PDP V plan. This information covers the 2022 calendar year, from January 1, 2022 through December 31, 2022.
View Document called 2022 Evidence of Coverage | Tufts Medicare Preferred Group PDP V