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 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. Or call us at 1-855-393-3154 (TTY: 711).
My Ombudsman
My Ombudsman is an independent program that helps members and their families and caregivers access services provided by MassHealth and its managed care plans.
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).
Frequently asked questions
Need help understanding your health plan? We can help.
How much do I pay for Tufts Health One Care?
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. If you pay a premium to MassHealth for CommonHealth, you must keep paying the premium to MassHealth to keep your coverage.
What’s covered by Tufts Health One Care?
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:
How much do I pay for prescription drugs?
You pay $0 for all your prescription drugs covered by Tufts Health One Care.
How do I choose a health care provider in the Tufts Health One Care provider network?
Checking our network is easy. Use our 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.
Can I talk to someone for help?
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 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.
- 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 info@myombudsman.com.
- 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. 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.