Support + Assistance from Tufts Health Plan

For members impacted by substance use disorder

Tufts Health Plan benefits

Tufts Health Plan benefits cover a broad range of treatment options for addiction:

  • Inpatient detoxification and Acute Residential Treatment
  • Partial Hospital Programs and Intensive Outpatient Programs
  • Outpatient therapy and medication management
  • Medication-Assisted Treatment, including Methadone Maintenance and prescription of Suboxone
  • All of our coverage for SUD services is aligned with our medical benefits – no extra barriers, no additional costs. Admission for detox is the same cost share as admission for an appendectomy.
  • Our pharmacy coverage includes the medications used to treat addiction
  • $0 cost on Naloxone (Narcan), the medications that can reverse an opioid overdose

Learn More About Types of Treatment

Tufts Health Plan network

Tufts Health Plan has a deep, broad contracted network with facilities, programs, and practitioners located throughout our service areas.

  • Our ambulatory network is open to any qualified practitioner who would like to participate; in fact we’ve added more than 100 additional Licensed Alcohol and Drug Counselors to our panel over the past year
  • Practitioners can self-identify as treating substance use disorder, and this information is available to members searching our web directory for a contracted practitioner
  • We’ve surveyed providers in our network to identify those who specialize in treatment of SUD, and those who specifically note adherence to evidence-based practices in the care of SUD patients
  • Our staff will help you find the programs and services you need, when you need them. If you can’t find what you are looking for in the network, call us and we will help you access the care you need AND get the most favorable coverage available under your benefits!

Case management

Tufts Health Plan is committed to providing the support members and families need to address alcohol and opioid addictions and other substance use disorders, by helping to connect them with providers, programs, and other resources.

Addictions Recovery Care Management Program (ARCM)

The Tufts Health Plan ARCM Program provides support to our members who are in early recovery from the use of opiates, alcohol, or other substances.

The program typically works with members who have recently entered or completed acute treatment in a hospital or residential treatment center for a diagnosis of substance use disorder. Care managers work with members to understand and follow through with their aftercare plans, and begin to take charge of their recovery.

The program also works with members who have recently needed medical care for a substance use-related illness. This includes members who have gone through detoxification on a medical unit, have been hospitalized due to a medical condition during which substance use problems were identified, or for  medical problems that were caused or worsened by substance use.

Care managers help to coordinate the different programs, providers and facilities involved with the member’s care and help to establish goals and a plan to move forward. 

For more information about this program, call the member services number listed on your health insurance card.

More information

Programa de Gestión de Casos
Alcohol + Substance Use Disorder Resources and Support Groups