Coronavirus Update

Information about access to health care services in response to the COVID-19 outbreak

April 01, 2020  

Tufts Health Plan is committed to providing our members with accurate, reliable information about access to health care services in response to the COVID-19 (“Coronavirus”) outbreak.

Please note, in accordance with local stay-at-home advisories, all Tufts Health Plan offices are closed until further notice. We encourage our members to call the number on their ID cards with any questions related to their health benefits.

Effective immediately and until further notice, and in accordance with guidance provided by state public health departments and CDC Guidance, the following is in place for all Tufts Health Plan members, except where noted:

Waiving Member Costs:

  • There are no out-of-pocket costs for medically necessary Coronavirus testing, counseling and vaccinations. This coverage applies at in-network providers, urgent care, emergency rooms and other facilities, and at out of network providers in the event a member cannot easily find an in-network provider to provide timely services.
  • We are waiving member cost shares - including co-payments, coinsurance, and deductibles for medically necessary Coronavirus treatment*. This coverage applies at in-network providers, urgent care center, emergency rooms and other facilities, and at out of network providers in the event a member cannot easily find an in-network provider to provide timely services.
  • These cost-sharing changes will also apply to members of our self-funded groups that have not opted-out.

Drug refills:

We are making it easier for you to get increased access to the prescription drugs you will need during this period of emergency by:

  • Allowing for early refill of prescription medication without waiting to finish your current fill
  • Allowing refill for up to a 90-day supply to the extent consistent with clinical guidelines, except for controlled substances (subject to CMS rules)

24 Hour Nurse Lines

Depending on your health plan benefits, Tufts Health Plan also offers access to 24/7 Nurse Line, where members can speak to a registered nurse to receive medical advice on appropriate care.

  • Tufts Health Plan Commercial members should call 866.201.7919.
  • Tufts Health Direct, Together and Unify members should call 888.697.6546.

You can also call your provider with questions. If it’s an emergency call 911.

Contacting Member Services

If you have questions regarding your health plan coverage, please call the Member Services phone number on your member ID card.

Remember, depending on your health plan benefits, Tufts Health Plan also offers access to 24/7 Nurse Line, where members can speak to a registered nurse to receive medical advice on appropriate care.

  • Tufts Health Plan Commercial members should call 866.201.7919.
  • Tufts Health Direct, Together and Unify members should call 888.697.6546.

Telehealth can help members avoid contact with the Coronavirus in medical offices

People with mild, flu-like symptoms should call their health care provider before going to a health care facility.

  • Many providers offer telehealth services. Ask your primary care provider if they do. All out-of-pocket costs for telehealth visits with network providers related to Coronavirus will be waived until further notice. This also includes telephone consultations. Telehealth enables members to make inquiries regarding symptoms or treatment for the Coronavirus in order to reduce the need for members to go to medical offices where the risk of coming in contact with the Coronavirus may be higher. This will also apply to members of our self-funded groups that have not opted-out.
  • Also until further notice, fully-insured members who access primary care or behavioral health services from Tufts Health Plan network providers via telehealth (unrelated to the Coronavirus) will have no cost share.*
  • Tufts Health Plan Commercial members (not including Direct) can also use our telehealth solution powered by Teladoc, teladoc.com/tuftshealthplan. With telehealth from Teladoc, members can access U.S.-based, board-certified providers for general medical needs and diagnoses from anywhere in the world and for $0 copay for plans issued or renewed in 2020.  Members can contact a Teladoc doctor 24/7 if they’re concerned about their symptoms or have questions about Coronavirus.  Until further notice, there will be no member cost for this service for our members, including members of self-funded groups that have elected this benefit and have not opted-out of cost sharing modifications.*

What should individuals do if they think they have been exposed to the virus?

People with COVID-19 or with other flu-like symptoms should stay home and follow all quarantine procedures. Their close contacts should be advised to stay home. If someone has more significant symptoms, they should go to their health care provider, urgent care or the emergency room. But they are advised to call in advance and follow any protocols that the facility has in place.

Older individuals should be especially cautious during this time. Updated news and information for our Medicare Preferred members can be found here.

Where can individuals find additional information and updates about Coronavirus?

They should visit the CDC website at www.cdc.gov and click on “Coronavirus Disease 2019.” Other excellent sources of information include the following:

Our policy in case the company needs to close down due to a pandemic

Tufts Health Plan has an extensive policy in place to ensure the continued service of our members and clients if we are required to close our physical locations in any of our markets.  Most of our employees are currently working remotely to ensure continued service to our members, providers, employer groups and brokers.  Please reference our corporate continuity plan (CCP) summary for our organization for more information, or your account service team.  We will continue to keep you abreast of any changes to this policy as it develops. You can view the CCP Summary here.

*Members of high-deductible health plans may be billed for deductible at a later date if the visit is unrelated to covid-19.