A Limited Provider Network Option
Select HMO members get great coverage at a great price. Many covered health care services require only a copayment, without a deductible, and the Select HMO Plan requires no claims forms or paperwork.
Select HMO members have coverage within our Select Network—a limited network of hospitals and providers in Massachusetts. Finding a primary care provider (PCP) is easy— just visit tuftshealthplan.com, click doctor search, and choose the Select Network. Our provider search function allows you to customize your search based on the information most relevant to you.
How Your Plan Works
You must select your primary care provider from the Tufts Health Plan Select Network. In most cases, the PCP you choose will provide or authorize your health care. When you visit your PCP, just show your Tufts Health Plan member ID card and pay the applicable copayment for many covered services. Preventive services are covered in full. You’ll be covered for the care you need without having to fill out claim forms. If you require specialized care, your PCP will assess your medical needs and, if necessary, refer you to a specialist in the Tufts Health Plan Select Network. If you need to go to the hospital, your PCP will arrange your admission. In most cases you will be admitted to the hospital with which your PCP is affiliated.
Emergency Medical Care Is Covered
Emergency medical care is covered subject to the plan’s emergency room copay, whether or not you receive care from a provider in our network. Members do not need PCP referrals for emergency care in an emergency room.
In the event of a medical emergency, always seek care by going to the nearest medical facility or, if needed, call 911.
Please note: If you receive care in an emergency room but are not admitted as an inpatient, you or someone acting on your behalf should notify your PCP or Tufts Health Plan within 48 hours after you receive care.
Making the Most of Your Plan
Tufts Health Plan is a national leader in innovation, patient safety, and quality. As a Tufts Health Plan member, you will have access to discounts, programs, and services that will help you reach your wellness goals, including:
- Savings on nutritional counseling, acupuncture, massage therapy, and health and wellness education
- Membership discounts at 80 participating fitness clubs, as well as Curves.®
- A free home visit for you and your baby following delivery or adoption
- Programs to help you manage your health
- A courteous, professional member services team ready to help with questions related to your Tufts Health Plan coverage
Limited Network: This plan provides access to a network that is smaller than Tufts Health Plan’s standard network. In this plan, members have access to network benefits only from the providers in the Select Network. Please consult the Select Network provider directory by visiting the provider search tool at tuftshealthplan.com and clicking on Find a Doctor to determine the providers in the Select Limited Provider Network. If you need a paper copy of the provider directory, please contact Member Services.
Questions? Just Ask Us.
If you have questions, a Member Respresentative is ready to help. Call us toll free at 800-462-0224.