Tufts Health Plan Commercial and Tufts Health Direct Members
Waiving member costs for Coronavirus testing and related telemedicine
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.
Effective immediately and until further notice, and in accordance with the Massachusetts Division of Insurance Bulletin and CDC Guidance, Tufts Health Plan will provide Tufts Health Plan Commercial and Direct Members with access to the following:
- No out-of-pocket costs for medically necessary Coronavirus testing, counseling and vaccinations. 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.
- No copayments 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.
This will also apply to members of our self-funded groups that have not opted-out.
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 related to Coronavirus will be waived for the duration of this COVID-19 situation for Commercial members. 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.
- Tufts Health Plan Commercial members (not including Direct) can also use our telehealth solution powered by Teladoc1. With telehealth from Teladoc, members can access U.S.-based, board-certified providers for general medical needs and diagnoses from anywhere in the world for $0 copay. Members can contact a Teladoc doctor 24/7 if they’re concerned about their symptoms or have questions about Coronavirus. For the duration of this crisis, there will be no member cost for this service to our employer-sponsored (self-funded) groups as well who have opted for this benefit.
- Tufts Health Plan also offers access to our Nurse 24 telephonic service to all Tufts Health Plan Commercial and Direct members at no cost, through which you can speak to a registered nurse 24/7 to receive medical advice on appropriate care. Tufts Health Plan Commercial members should call 866.201.7919; Direct members should call 888.697.6546.
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.
We permit members a one-time refill of their prescriptions prior to the expiration date so that they will have a supply of their medications should they need it.
We also waive the refill limitation for one 30-day prescription of a maintenance medication to a 90-day duration.
If a member has multiple maintenance medications, each drug will be allowed to be waived just once.
Contacting Member Services
For clinical questions or concerns about the Coronavirus, please call 866.201.7919 (Massachusetts Commercial members) or 888.697.6546 (Tufts Health Direct members) for access to a registered nurse.
For other health plan coverage questions, please call the Member Services phone number on your member ID Card.
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:
The Massachusetts Department of Health
The Rhode Island Department of Public Health
The New Hampshire Department of Health and Human Services
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. All employees are able to work remotely to ensure continued service to our members, employers and brokers. Please reference our overview of our continuity plan for our organization for more information, or your account service team. We will continue to keep you abreast of any changes to this policy in the coming days or weeks. You can view the CCP here.