About Your Plan
By joining Tufts Health Direct, you've made a great move toward a healthy life. Here are all the important details you'll need.
Your benefits and costs
To quickly see what’s covered under your plan and your copayments and out-of-pocket costs, take a look at our Benefits and Costs. We explain important terms, like deductible and coinsurance, in the “Cost-sharing Made Clear” section.
Your Member Handbook
Your handbook includes more details about your plan coverage, benefits, and rights and responsibilities. View or download the Member Handbook.
To get a printed copy of your Member Handbook, including alternative formats such as large print or braille, call us at 888-257-1985 (TTY: 711). We can also give you information in other formats and different languages. We have bilingual staff available, and we offer translation services in more than 200 languages. All translation services are free to members. To request materials in other formats or languages, call us at 888-257-1985 (TTY: 711).
Your Member ID Cards
When you join Tufts Health Direct, you will get a member ID card in the mail about 10 days after your effective date. Each member of your family will receive a unique member ID card. If any information on your card(s) is wrong, please call member services at 888-257-1985 (TTY: 711).
See which prescription drugs are covered.
Prescription drugs are covered when ordered by your physician/provider. Some brand-name drugs require prior authorization or may not be covered. For a complete, up-to-date list of which drugs are covered, and what to do if a drug you need isn’t covered, click here or call us at 888-257-1985 (TTY: 711).
Easy, personalized ways to improve your health
At Tufts Health Plan, we make it easy and affordable to take care of your health, diet, fitness and more.
Fitness Center Reimbursement
Get back up to three months of fitness center membership fees for staying active! After you’ve been a Tufts Health Direct member for four consecutive months, you can apply for a reimbursement using the Fitness Center Reimbursement form. For more discounts and perks click here.
Manage your weight and create a healthy diet with the help of a dietitian through our Good Measures* program. To learn more, go visit Good Measures or call 844-398-9510. *Tufts Health Plan has a minority ownership interest in Good Measures.
Tap into a new source of motivation with a lifestyle program called Omada that offers support from peers, a health coach and more. To learn more, click here or call 888-409-8687.
Care management is our way of making sure you get the support you need no matter what. Our care managers can help you:
- Manage symptoms and feel your best with conditions like asthma and diabetes
- Deal with long-term medical needs like cancer, caring for a sick newborn
- Get behavioral health care for things like depression or substance use issues
To get personal help from the Tufts Health Plan team, call 888-257-1985 (TTY: 711)
Get the care you need, when you need it
With Tufts Health Direct, it’s easy to connect with the providers and health care advice you need.
Talk to a nurse any time
Call our 24/7 NurseLine any time at 888-MY-RN-LINE (888-697-6546) if you:
- Need help deciding whether or not you should go to the emergency room
- Want information about your condition and/or treatment options
- Have questions about drugs or procedures
This service does not replace your PCP or other providers.
Care during regular office hours
Call your primary care provider (PCP) or specialist to schedule an appointment during regular business hours. To find a PCP or specialist in our network, use our Find a Doctor, Hospital or Pharmacy tool.
Care after hours
Call your PCP’s office for instructions if you need care after hours. Or visit a MinuteClinic walk-in clinic found in some CVS stores. Visit minuteclinic.com to find a site near you.
You need your Tufts Health Direct member ID card when you visit your providers or pick up medications at the pharmacy.
Call your primary care provider (PCP) or behavioral health provider in an urgent situation that is not an emergency or go to an in-network urgent care center.
Call 911 or go to the nearest emergency room right away if you need emergency care for:
- Chest pain
- Uncontrolled bleeding
- A mental health or substance use crisis
These examples are not a complete list of when you should seek emergency care.
Get care in your own language
Our Provider Directory shows if a provider speaks other languages in addition to English.
Get rewarded for taking care of your health
EXTRAS discounts and perks
Eligible Tufts Health Direct members can get these great EXTRAS discounts and perks:
- A $50 or $25 gift card to use for a convertible or booster car seat.
- A fitness band or supermarket gift card for adults who have a yearly checkup.
- A gift card for completing five routine diabetes screenings.
- 20% off regular-price CVS-brand health items when using a CVS ExtraCare Card.*
Click here for up-to-date information about EXTRAS, including eligibility. You can also download the EXTRAS form(s). To request EXTRAS, follow the directions on the form and send us the completed form. Note: EXTRAS are subject to change.
*Note: The CVS discount will be available until December 31, 2022. The discount will not be available starting January 1, 2023 when OptumRx becomes our pharmacy benefits manager.
We’re here for you!
We want to make it as easy as possible for you to get the information and services you need from Tufts Health Direct.
You can reach our member services team at 888-257-1985 (TTY: 711), Monday through Friday, from 8 a.m. to 5 p.m., excluding holidays. Our team can help you:
- Understand your benefits and medical bills
- Find a provider or urgent care clinic
- Get new a member ID card if you lose yours
… and more.
We have bilingual staff available and can provide translation if your first language is not English.
Our member portal is an easy, convenient way to find the information you need, 24/7! Search for a provider or pharmacy, change your PCP, view your member ID card and more. Register here.
Our website is another great way to find the information you need. Click here to view your plan details and find helpful tools:
- Find a provider or pharmacy
- Search for a drug on the Preferred Drug List
- Get benefit details
- View or download a Member Handbook