Lifespan Premier Choice HMO
Lifespan Premier Choice HMO (health maintenance organization) is a collaboration between Tufts Health Plan and Lifespan – the premier health system in Rhode Island. Tufts Health Plan offers a suite of new tiered health plans that provide access to top-quality care while managing rising health care costs. It’s a win-win for employers and employees. Our tiered network benefit design is offered to large and small groups.
- Only available to Rhode Island employer groups
- Employers choose from 5 two-tiered plan designs
- Fully insured or self insured plan options
- Cost incentives for using Lifespan network
- In-network access to Tufts Health Plan network
Lifespan Premier Choice HMO options include two tiers of in-network coverage. Employees must select a PCP to coordinate their care with network providers and specialists. Referrals are required for non-emergency services.
How the Plan Works
Lifespan Premier Choice HMO opens up possibilities for you and your employees with two levels of in-network care. Employees pay different levels of copayments, coinsurance and/or deductibles for covered services delivered by Tier 1 and Tier 2 providers.
Tier 1 provides cost savings (in the form of lower deductibles and copays) when employees choose care that’s referred within the Lifespan health system. It includes a robust network of more than 1,800 physicians across Rhode Island. The cost-sharing structure encourages employees to choose Tier 1 providers while still offering the choice of Tier 2 providers.
Tier 1 Level Services:
- Maternity services: For routine and non-routine pregnancy and deliveries, including newborn care, employees can access any hospital in the Tufts Health Plan network at the Tier 1 level.
- Behavioral health: For all behavioral health services and treatments, employees can access any facility in the Tufts Health Plan network at the Tier 1 level.
- PCP access: Nearly 500 Rhode Island PCPs refer care within the Lifespan health system.
- Specialized services: University Medicine Foundation practices included for specialized care needs.
Tier 2 gives employees access to the full Tufts Health Plan network of the remaining nearly 29,000 providers in Rhode Island, Massachusetts and New Hampshire.
Note: This a summary of the plan features. Please refer to the benefit document for a detailed explanation of coverage. If there is a difference between the information in this document and the benefit document, the terms of the benefit document will govern.
Superior Customer Service
Our Member Services department offers your employees a staff of highly trained professionals. One phone call is all it takes to reach our Member Specialists. They are available to answer members’ questions about the plan and their benefits. We also offer language-translation services and TTY capabilities as needed.
For more information, contact your sales office:
Watertown 800-208-8013 | Worcester 800-208-9545 | Providence 800-455-2012