FAQs (Frequently Asked Questions)

What is Tufts Health Unify?
 

Tufts Health Unify (Medicare-Medicaid Plan) is our One Care plan for people ages 21 – 64. It combines your Medicare and MassHealth programs into one high-quality comprehensive health plan, all at no cost to you. 

We partner with a network of trusted doctors, specialists, hospitals and community organizations from all across the state to better coordinate your care.

Will I get the same Medicare and MassHealth benefits in Tufts Health Unify that I get now?

Yes, you will get your Medicare and MassHealth benefits covered directly from Tufts Health Unify. 

  • To help coordinate your care, we also work with you and a team of skilled and caring providers to keep you connected to the services you need.
  • You may also get other benefits the same way you do now, directly from a state agency like the Department of Mental Health or the Department of Developmental Services.
  • See a list of Tufts Health Unify benefits.
Can I go to the same doctor that I see now?
 

In many cases, you can. To find out if your doctor or health care provider accepts Tufts Health Unify, use our Find a Doctor, Hospital or Pharmacy tool. Or give us a call at 855.393.3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m.

How do I choose and keep a doctor with Tufts Health Unify?
 

All Tufts Health Unify members need to have a primary care provider (PCP). You can choose your own PCP in our network, or we can choose one for you. You can see most of our network doctors without prior authorization (permission). For certain network doctors and for most out-of-network doctors, including specialists, your PCP has to get permission from us before scheduling a service for you. 

If you need emergency or urgent care, you can use providers outside of our network.

Would I be able to switch my primary care provider (PCP) once I join?
 

Yes. You can use our Find a Doctor, Hospital or Pharmacy tool to find a new PCP in our network. Then you can change your PCP online through Tufts Health Member Connect, our online self-service tool. Or you can call us to let us know your new choice.

How does Tufts Health Unify manage my care?
 

After you join Tufts Health Unify, a Tufts Health Plan care manager will call you to set up your initial health needs assessment. A care manager is a health care professional, such as a nurse, behavioral health (mental health and/or substance use) clinician or a social worker, who will act as your key point of contact. Care managers are dedicated to making sure you get the high-quality care you deserve, at the right time and in the right place — at home, at a provider’s office or hospital, at a community center, in school, in person or by phone.

A Tufts Health Plan care manager will help: 

  • Develop a customized care plan to meet your personal health goals
  • Coordinate services with your doctors, specialists, and long-term services and supports (LTSS) providers, if appropriate
  • Arrange for services and durable medical equipment (DME), if needed
  • Track your progress using our online tools 

Your care manager may also put you in contact with other medical, behavioral or social need providers, if necessary.

How much does Tufts Health Unify cost?

There are no premiums or co-payments for eligible members of Tufts Health Unify. 

If you pay a premium to MassHealth for CommonHealth, you must continue to pay the premium to MassHealth to keep your coverage.

How long does my membership last?

To maintain eligibility, a member must remain eligible for both Medicare and Medicaid.

Am I eligible for Tufts Health Unify?

You may be eligible for Tufts Health Unify if you:

City/Town Zip Codes
Billerica 01821, 01822
Chelmsford 01824
Dracut 01826
Lowell 01850, 01851, 01852, 01853, 01854
North Billerica 01862
North Chelmsford 01863
Tewksbury 01876
Tyngsborough 01879
Westford 01886
  • Are between the ages of 21 and 64
  • Are now enrolled in both Medicare and MassHealth

 ​The Commonwealth of Massachusetts determines eligibilty, not Tufts Health Plan.

For information on Tufts Health Unify and other options for your health care, call the MassHealth Customer Service Center at 800.841.2900 (TTY: 800.497.4648), Monday through Friday, 8 a.m. to 5 p.m., or visit mass.gov/masshealth/onecare (link opens outside of Tufts Health Plan's website).

How do I enroll in Tufts Health Unify?[/q]

If you received a package from MassHealth about your eligibility for the One Care program:

  • Fill out the enclosed Enrollment Decision Form 
    • Mail to MassHealth (postage-paid envelope included)
    • Or fax to MassHealth at 617.988.8975
  • Or call MassHealth at 800.841.2900 (TTY: 800.497.4648), Monday through Friday, from 8 a.m. to 5 p.m. 

If you haven’t received a package from MassHealth, or are unsure about your eligibility:

  • Call MassHealth at 800.841.2900 (TTY: 800.497.4648), Monday through Friday, from 8 a.m. to 5 p.m.

Need help? Call us at 855.393.3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m.

How long will it take me to become a Tufts Health Unify member?

If you are already a Medicare and MassHealth member, you may be able to enroll in Tufts Health Unify at any time by calling MassHealth at 800.841.2900 (TTY: 800.497.4648), Monday through Friday, from 8 a.m. to 5 p.m.

Once you enroll, your membership will start on the first day of the following month.

Will I have co-payments for my medications?

No, there are no co-payments for eligible members of Tufts Health Unify

For more pharmacy coverage information, see the Tufts Health Unify List of Covered Drugs (PDF). 

You can also call us at 855.393.3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m.

Who will have access to my health information?

We are required by law to keep your individual health information, known as protected health information (PHI), private and secure in our organization, including oral, written and electronic PHI. We do this in a number of ways, such as using computer passwords and screensavers. Employees do not talk about PHI in public areas and are not allowed to see PHI if they do not need it for their job. While we make sure that people without permission do not see or change your records, we may share your PHI with MassHealth and Medicare, if they need it. Sometimes we need your written permission to release your PHI. You have the right to approve any release of your PHI beyond these federal and state agencies, and you have the right to get your medical records from your health care provider.

For a copy of our Notice of Privacy Practices, call us at 855.393.3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m.

What should I do in an emergency?

In a health emergency, don’t wait. Call 911 or your local emergency number, or go to the nearest emergency room right away. For behavioral health (mental health and/or substance use) emergencies, you may also call your local emergency services program (ESP) provider. For a statewide listing of emergency rooms and ESPs, check our Find a Doctor, Hospital or Pharmacy tool or call us at 855.393.3154 (TTY: 711), 7 days a week, from 8 a.m. to 8 p.m.

Are there any services that Tufts Health Unify does not cover?
 

Tufts Health Unify offers many benefits and services, including doctors’ office visits and checkups, prescriptions, emergency services, hospital stays and much more.

Some services we don’t cover include:

  • Cosmetic surgery (with some exceptions)
  • Experimental treatments (with some exceptions)
  • Personal comfort items, like air conditioners, radios and televisions
  • Certain laboratory services

For a complete list of services we don’t cover, please see our Tufts Health Unify Member Handbook (PDF) or call us at 855.393.3154 (TTY: 711), seven days a week, 8 a.m. to 8 p.m.

More questions?

Call us at 855.393.3154 (TTY:  711), seven days a week, 8 a.m. to 8 p.m. We’re happy to help! 

For information on Tufts Health Unify and other options for your health care, call the MassHealth Customer Service Center at 800.841.2900 (TTY: 800.497.4648), Monday through Friday, from 8 a.m. to 5 p.m., or visit mass.gov/masshealth/onecare (link opens outside of Tufts Health Plan's website).

If you need a Member Handbook or the List of Covered Drugs in an alternative format, please call us at 855.393.3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. We will do our best to accommodate your request.

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