Plans + Benefits
We understand that you and your employees have unique needs, whether you're a small business, a mid-sized firm or a large national employer.
That’s why we provide a full range of flexible plan designs and broad network options to choose from. We'll work with you to find the plan solution that best meets your particular health benefit goals and budget.
At Tufts Health Plan, we offer a better experience for your employees. To illustrate, most plans have fourth-quarter deductible carryover that helps members save money when they need services at the start of a new benefit year.* Or, when emergency room care is needed, all of our plans provide peace of mind so members know they won’t receive surprise medical bills from us after the fact. And, if members have a chronic condition, we have compassionate nurse care managers who can assist them in navigating the health care system so they can get better and be healthier—and happier.
Flexible Plan Designs
With an HMO plan, care is coordinated through a primary care physician (PCP). This is a great plan option for employers that want to keep costs lower by keeping care in-network.
A PPO plan allows for members to receive care from any doctor without the need of a referral from a primary care physician. If providing your employees with the flexibility to see any provider they choose is important to you, a PPO is the ideal option.
Advantage HMO and PPO
Advantage plans feature lower premiums than traditional HMO and PPO plans in exchange for cost-sharing through a deductible, coinsurance and co-payments.
Advantage Saver HMO and PPO
Advantage Saver plans are qualified High-Deductible Health Plans that may be paired with a Health Savings Account. Saver plans include the lowest premiums of any of our plan designs.
Many employers want to provide employees access to our full provider network, while also providing them the opportunity to lower costs. A tiered network is a plan in which providers are grouped into “tiers” based on the value of care they provide, encompassing both cost and quality. Learn all the benefits of why tiered networks are smarter, not smaller.
Our Carelink plan is a solution for large Masschusetts- and Rhode Island-based employers that have a large population of employees who live outside the Tufts Health Plan service area (Massachusetts, Rhode Island and New Hampshire). Employees can enroll in this national network plan regardless of where they live.
Cigna Out-of-Area PPO
Our Cigna Out-of-Area PPO is a national solution for small and large Massachusetts- and Rhode Island-based employer groups. Unlike CareLink, only members who live outside the Tufts Health Plan service area may enroll.
*Fourth-quarter deductible carryover applies to non-Saver plans; it does not apply to HSA-compatible Advantage Saver plans.