We understand that you have unique needs. At Tufts Health Plan, you get a better experience, period. Most of our plans1 have a fourth-quarter deductible carryover to help you save money when you need services at the start of a new benefit year.2 Or, when emergency room care is needed, all of our plans provide peace of mind so you know you won’t receive surprise medical bills from us after the fact. And, if you have a chronic condition, we have compassionate nurse care managers who can assist you in navigating the health care system so you can get better and be healthier—and happier.
With an HMO plan, high-quality health care is coordinated through a primary care physician (PCP). An HMO requires some cost-sharing on your part, mainly in the form of a copay.
A PPO plan allows you to receive care from any doctor without the need for a referral from a PCP. This gives you the flexibility to see any provider you choose.
Advantage plans feature lower monthly costs than traditional HMO and PPO plans in exchange for cost-sharing through a deductible, coinsurance, and co-payments.
Advantage Saver plans are qualified High-Deductible Health Plans that may be paired with a Health Savings Account (HSA). Saver plans include the lowest monthly payment of any of our plans.
With a tiered plan, you get access to our full provider network - and the opportunity to lower your costs. A tiered network groups providers into “tiers” based on the value of care they provide, encompassing both cost and quality.
Every doctor and every hospital in the Your Choice network has been carefully evaluated based on many criteria, and meets our standards for quality of care. Depending on your plan, you will get care from providers in a 2-Tier system or a 3-Tier system.
Lifespan Premier Choice plans help you choose the most efficient providers offering the highest-quality care. In this way, tiered networks support you in being an active, informed health care decision maker.
Our Carelink plan is a solution for employees working at large Massachusetts- and Rhode Island-based employers that live outside the Tufts Health Plan service area (Massachusetts, Rhode Island, and New Hampshire). You can enroll in this national network plan regardless of where you live.
Our Cigna Out-of-Area PPO is a national solution for employees working at small and large Massachusetts- and Rhode Island-based employers. Unlike CareLink, you can only enroll in this plan if you live outside the Tufts Health Plan service area.
Do you have a Medicare plan through Tufts Health Plan? Learn about your Medicare plan on the Tufts Medicare Preferred website.
If you have questions about an unexpected bill or if you need to seek health care services from an out-of-network provider, please call the Member Services number on your member ID card.
We’re committed to delivering you the highest level of service.
1Not all plans are listed. Your plan details may differ – refer to your benefit document for the most recent/accurate details about your plan.
2Fourth-quarter deductible carryover applies to non-Saver plans; it does not apply to HSA-compatible Advantage Saver plans
3Available to employees of Rhode Island-based employers.