Check Your Benefits and Member Handbook Online
You have many resources to help you understand your Tufts Health Plan coverage and benefits
At mytuftshealthplan.com, you can check your benefits and coverage through your secure online account. Your Member Handbook can also help answer many questions you may have about your coverage, and give you information such as:
- A general description of your plan’s benefits and services
- The types of payments you may make for covered services, including copayments, deductibles, and coinsurance
- How to get the care you need, and how your coverage may change if you get care outside your plan’s service area, or from doctors and other providers not in our network
- What’s in your Summary of Benefits and Coverage (SBC). To access your SBC, log into tuftshealthplan.com/sbc and enter your company code and name. If you do not have your company code, contact Member Services.
- When and how to get emergency care
- How you can learn about providers in our network
- How to learn about your rights and responsibilities as a plan member
- How we review new treatments, instruments, or tools—as well as new uses for them—before we decide how to cover them
- How to get care from PCPs, specialists, and behavioral health care providers, as well as hospital services
- How to get care when your doctor’s office is closed
- How you can tell us your complaints and ask for a review of decisions we may make about your benefits, your relationship to Tufts Health Plan, or how we will cover services
- How we manage the drugs we cover
- How you can submit a bill or ask for money back for out-of-pocket payments you make for covered services
- How you can get help if you need a translator
- To read or print your Member Handbook: Visit member Forms + Documents section of your plan type, and search for “Handbooks”.
- To get a copy mailed to you: Call a member service representative at the number on your member ID card.
- To check your coverage in detail: Save and read your SBC, a full description of your Tufts Health Plan coverage, which you get when you become a member. Please call a member service representative at the number on your member ID card for more information or help in obtaining your SBC.
You may also receive a copy of your SBC upon enrollment and you may also view it by logging into tuftshealthplan.com/sbc.