Healthy Living Essentials: Benefits
$150 Wellness Allowance Fitness Reimbursement
Our Wellness Allowance benefit helps you lead a healthy lifestyle - and it pays you back. Members of a Tufts Health Plan Medicare Advantage HMO plan can receive $150 (or $350 for our Saver Rx, Smart Saver Rx, and Access PPO plan members) reimbursement each year1 for fees related to:
- Membership in a qualified health or fitness club
- Fitness classes such as yoga, Pilates, Tai Chi, and aerobics
- Nutritional counseling sessions
- Participation in the Enhanced Wellness Program, including memory fitness activities
- Matter of Balance program
- Chronic Disease Self-Management program
- Diabetes Workshop program
- Healthy Eating for Successful Living program
- Healthy IDEAs program
- Powerful Tools for caregivers class
- The Arthritis Foundation exercise program
- Fit for your life activity program
- AAA senior driving program
- Licensed acupuncturists
$150 Eyewear Reimbursement
With our eyewear beneﬁt, you can get up to $150 toward the full retail price, (not sale price) for one complete pair of prescription eyeglasses and/or contact lenses from a provider in the EyeMed network2. Or, get up to $90 toward the price for one complete pair of eyeglasses and/or contact lenses from a store not in the EyeMed network3. (Discounts cannot be combined. Access PPO plan members do not have an EyeMed participating provider requirement.)
EyeMed Vision Care is the network we use to provide your eyewear beneﬁt. The EyeMed network includes more than 26,000 eye care providers including national chains such as LensCrafters, Sears Optical, Target Optical, and JCPenney Optical. See your Provider Directory for a list of providers in the EyeMed network by town.
$150 Weight Management Program Reimbursement
Members of a Tufts Health Plan Medicare Advantage HMO or PPO plan are also eligible for a $150 rebate each year4 towards fees associated with weight management programs that include:
- Weight Watchers
- Hospital-based weight loss programs
$0 Health Screenings
Getting regular screenings is one of the best ways to stay healthy. Screenings help find illness or disease before you start to see the signs and feel the symptoms. The copayment for many screenings is $0. These include:
- Physical Exam
- Breast Cancer Screening
- Cholesterol Screening
- Glaucoma Screening
- Prostate Cancer Screening
- And more
An important part of enjoying your next trip is knowing that you are covered for emergency and urgent care anywhere in the world. As a member of Tufts Health Plan, you do not need a referral from your primary care physician before getting emergency or urgent care.
Here's the difference between emergency and urgently needed care:
- A medical emergency is when you believe your health is in serious danger.
- Urgently needed care is when you need medical care right away because of an illness, injury, or unexpected condition - but your health is not in serious danger.
If you receive emergency or urgent care when traveling you may need to pay out of pocket. Simply save your receipts, and call Member Services for reimbursement details5.
1. $150 ($350 for Saver Rx, Smart Saver Rx, and Access PPO plan members) is the total reimbursement amount each year (January 1 - December 31) whether used for a health club, fitness classes, nutritional classes, or wellness programs.
2. Get up to $150 towards the full retail price (not sale price) of one complete pair of prescription eyeglasses and/or contact lenses once every calendar year from a provider in the EyeMed network, OR up to $90 from a store not in the EyeMed network (discounts can't be combined). Can be applied to complete pair of eyeglasses (lens, frames, & lens options) and/or contact lenses. $150 discount cannot be combined with any other discounted offer. Sale items excluded and cannot be combined with store discounts, coupons, or promotional codes.
3. The $90 out-of-network beneﬁt cannot be combined with the $150 in-network beneﬁt. Examples of out-of-network stores include national chains such as BJ's, Costco, and Walmart. You must ﬁle a request for payment to receive the $90. Please use the out-of-network vision services claim form. For more information, call EyeMed at 1-866-308-1863 (TDD/TTY 1-866-308-5375).
4. $150 is the total reimbursement amount each year (Jan. 1–Dec. 31). This benefit does not cover costs for pre-packaged meals/foods, books, videos, scales, or other items or supplies.
5. Reimbursement applies to emergency and urgent care situations only. You may be responsible for any copays that apply.