Care management
We're with you on your health care journey
At Tufts Health Plan, your health is our top priority. So whether you need routine checkups or help with managing a specific condition, we’re with you every step of the way.
Support when you need it across the entire spectrum — from preventive care to chronic and complex conditions.
We can help you make and keep appointments, find out what resources and benefits you can get, and coordinate your care with your providers. We also can help you learn about alternatives and resources for continuing care, and how to obtain them when your benefits are exhausted. Call us at 888-766-9818, (TTY:711) extension 53532 Monday through Friday, from 8 am to 5 pm., to talk to a care manager.
You can also call 888-766-9818, (TTY:711) extension 53532 to get complex care medical management services, or your in-network physician can refer you to the program.
Preventive care
Good health starts with preventive care. It’s important to stay healthy for the ones you love by going for routine checkups, screenings, immunizations and more – all at no cost to you.1 Find out more about preventive care.
Do you have a chronic condition? If so, you’re not alone.
The CDC broadly defines chronic diseases as “conditions that last one year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States.”
Let us help make things easier for you
We offer a variety of programs to help members – including children — manage chronic or complex conditions, or make the transition back home after a recent inpatient stay. Our programs are staffed by dedicated Nurse Care Managers with an average of 20+ years of clinical experience. We also have Behavioral Health Care Managers who work with you to address the behavioral health issues that may be impacting your physical health.They both reach out telephonically to provide assistance at the member’s convenience.
The following are examples of some, but not all, of the programs we offer. We can also help individuals who have multiple conditions.
- Do you have a chronic condition such as diabetes, heart or respiratory disease?
- Are you pregnant?
- Have you been diagnosed with cancer?
- Have you recently experienced a stroke?
- Do you have memory loss?
- Are transitioning home after a recent stay in a hospital, rehabilitation, or skilled nursing facility?
- Does your child need complex pediatric care?
Knowledge is power
If you’re registered on our member website, we encourage you to check out relevant articles, videos, and tools to help take control of your condition. If you’re not registered on our member website, it only takes a few minutes to do so.
No matter where you are on your health care journey, we’re with you.
Our Nurse Care Managers are Here to Help
To find out how our Nurse Care Managers can help with your health care journey, call 888-766-9818 x53532
What is a Nurse Care Manager? Watch our video.
- Preventive care may not be eligible for 100% coverage with some plans — please check your benefit document to confirm. For plans that do provide 100% coverage, preventive care must be received from a provider in the Tufts Health Plan network. Only certain services qualify as preventive. If you have any questions about whether a service is preventive, please check your benefit document or call Member Services at the number on your ID card.
Please note: you may receive non-preventive services during a routine visit that require a cost-share. Examples of these services include but are not limited to pregnancy tests, throat cultures, allergy tests, x-rays, ultrasounds, setting of bones and casts, and cardiac stress tests.