Tufts Health Plan Senior Care Options (HMO-SNP) Member Resources

Medicaid Recertification started on April 1, 2023!
April 1, 2023, MassHealth began their standard renewal process for all MassHealth members. You will need to take action to maintain your coverage. For information on the recertification, please use the link below:

Recertification Information

Plan Documents

• 2024 Summary of Benefits
• 2024 Formulary PDF
• Provider Directory
• Online Formulary
• Notice of Privacy Practices

View All Documents

Forms

• Appointment of Personal Representative (AOR) Form
• Wellness Allowance Form
• OTC Reimbursement Form
• Member Reimbursement Form

View All Forms

Member Resources

• Preferred Extras
• My Ombudsman Program
• Doctor Search
• Drug Search
• Portal Guide
• Over-the-Counter (OTC) Savings Guide
• MassHealth Over-the-Counter Drug List

Wellness Articles

• NEW - Tufts Health Plan Senior Care Options Members OTC Benefit
• Age Well
• How Does Your Care Manager Help You Get the Right Care?
• Tufts Health Plan Senior Care Options (HMO-SNP) Members Get Free Rides!

Prior Authorization Medical Review Criteria

For all products, when prior authorization is required, Tufts Health Plan Senior Care Options (HMO-SNP) uses written criteria based on sound clinical evidence to evaluate the medical appropriateness of health care services. These criteria are objective and based on current clinical and medical evidence and applied with consideration of individual needs and characteristics (e.g., age, comorbidities, prior treatment and complications), and the availability of services within the local delivery system.

View Medical Review Criteria

^{Tufts Health Plan Senior Care Options is an HMO-SNP plan with a Medicare contract. Enrollment in Tufts Health Plan depends on contract renewal. The HMO-SNP is available to anyone who has both MassHealth Standard (Medicaid) and Medicare Parts A and B. The SCO is available to anyone who has MassHealth Standard only. Other eligibility requirements may apply.}