About your plan

With Tufts Health One Care, you have a team that is dedicated to you. We are excited to help you get the services and support you need.

One Care

Your member handbook and summary of benefits

Your handbook and benefits summary have details about what your plan covers, your rights and much more. Go to TuftsHealthOneCare.org to view or download the Member Handbook and Summary of Benefits. You also can find our Provider and Pharmacy Directory, List of Covered Drugs, and Annual Notice of Changes.

To get printed copies, call us at 1-855-393-3154 (TTY: 711). We can also give you a copy in other formats, such as large print or braille, or in the language you prefer. You can also call Member Services to request future mailings in your preferred language or alternate format. We will keep your standing request in our records so that you will not need to make a separate request each time. If you need to change your standing request at any time, please call 1-855-393-3154 (TTY: 711).

Your member ID card

We will send you a member ID card in the mail. You’ll get it shortly before your plan starts. If any information on your card(s) is wrong, please call member services at 1-855-393-3154 (TTY: 711) and let us know.

Bring your Tufts Health One Care member ID card when you visit your providers or pick up drugs at the pharmacy.

Covered drugs

Your plan covers a broad range of prescription and over-the-counter  drugs. Some drugs need prior approval (authorization). For a full list of drugs your plan covers, visit TuftsHealthOneCare.org and check the current List of Covered Drugs. For a full list of drugs your plan covers, visit TuftsHealthOneCare.org and check the forms and documents section. Or call us at 1-855-393-3154 (TTY: 711).

My Ombudsman

My Ombudsman is an independent, free program that helps members and their families and caregivers access services provided by MassHealth and your One Care plan.

The program also:

  • Provides members with information and resources
  • Looks into member problems
  • Helps resolve members’ concerns

To contact My Ombudsman, call 1-855-781-9898 (TTY: 711).

You pay $0.

One Care is at no cost to members as it combines your Medicare and MassHealth benefits. You do not have to pay a premium*, deductible or co-payments when you get services from an in-network doctor or other health care provider. 

*Note: If you already pay a premium to MassHealth for CommonHealth, you must keep paying the premium to MassHealth to keep your coverage.

Your health plan covers all the medical, behavioral health, dental and vision benefits of Medicare and MassHealth.

If you have a question about a specific benefit:

  • Check the Member Handbook or Summary of Benefits. You can find them at TuftsHealthOneCare.org in the forms and documents section.
  • Call our Member Services team at 1-855-393-3154 (TTY: 711).

You pay $0 for all your prescription drugs covered by Tufts Health One Care.

Checking our network is easy. Use our online provider search tool at Tuftshealthplan.com/OneCareProviders to search our network of excellent and trusted doctors, hospitals and pharmacies.

Plus, there are a few more things you can do to choose the right health care provider for you:

  • Talk to your current primary care provider (PCP). Your PCP can make sure you get the right care and see the right provider for your needs. If your current PCP is in the Tufts Health One Care network, you can continue to see your PCP
  • Think about what matters to you. For example, you may need to search for a provider’s specialty, office location and accessibility, gender or languages spoken. You can find this information listed by provider on our website’s provider search tool.
  • If you need to, update your PCP with Tufts Health One Care. As a member, you have been assigned to a PCP who is in our network. We sent your PCP’s name and contact information with your member ID card. You can change your PCP at any time.

Health care can be complicated. These helpful resources can help you find the information you need:

  • Cityblock care coordinator — If you have questions navigating your care. Call Cityblock at 1-833-904-2273.
  • SHINE, or Serving the Health Insurance Needs of Everyone — SHINE counselors give free advice and can work with you and your caregivers to help you understand your health insurance. They are trained to assist people with disabilities who have Medicare and MassHealth. You can reach a counselor by phone at 1-800-243-4636 or on the web at http://www.mass.gov/health-insurance-counseling
  • My Ombudsman — If you have questions, concerns, or problems related to the One Care program, contact My Ombudsman. My Ombudsman’s staff can answer your questions or refer you to the right place to find what you need. Call My Ombudsman at 1-855-781-9898 or email [email protected].
  • Tufts Health One Care Member Services — Our team can help you understand your benefits, find a provider and more. We have bilingual staff. We also have translation services if your first language is not English. Translation services are free. You can reach our member services team at 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m., excluding holidays. (Please note: our hours shift to Monday through Friday, from April 1 through September 30).
One Care

Check your covered services and health plan benefits

Find out what medical, behavioral health, dental and vision benefits are covered by your plan.

One Care

Get care from a doctor, other health care provider or your personal care team

Find out how to access routine, urgent and emergency care.

One Care

Get a ride to your appointments

Find out how to get free transportation to medical appointments.

Need help?

Call us at 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. (Please note: our hours shift to Monday through Friday, from April 1 through September 30). We have bilingual staff available and can provide translation services if your preferred language is not English. Translation services are free.

We respect the privacy and confidentiality of your protected health information

View our Notice of Privacy Practices (“the Notice”) for details on how we protect your privacy. The Notice informs you how we use and/or disclose your PHI. For more information or a paper copy of the Notice, call the Member Services number on the back of your member ID card.

Helpful contact information

For information on your plan coverage, benefits, and your rights and responsibilities, or to ask for a printed copy of your Member Handbook in alternative formats, such as large print or braille, please call us at 1-855-393-3154 (TTY: 711).

We can give you material in other formats and different languages. We have bilingual staff available and free translation services in more than 300 languages.

Disclaimers

Tufts Health One Care is a Dual Special Needs Plan (D-SNP) health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook (2026).

If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. (Please note: Our hours shift to Monday through Friday, from April 1 through September 30). The call is free.

Si habla español, tiene disponible los servicios de asistencia de idioma gratis. Llame al 1-855-393-3154 (TTY: 711), siete días de la semana, de 8 a.m. a 8 p.m. (Ten en cuenta lo siguiente: Del 1 de abril al 30 de septiembre, nuestro horario pasa a ser de lunes a viernes). La llamada es gratuita.

You can get this document for free in other formats, such as large print, formats that work with screen reader technology, braille, or audio. Call 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. (Please note: Our hours shift to Monday through Friday, from April 1 through September 30). The call is free.

The List of Covered Drugs and/or pharmacy and provider networks may change from time to time throughout the year. We will send you a notice before we make a change that affects you.

Benefits may change on January 1 of each year.

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