← Well Fall 2020

Benefit Changes and Enhancements

What's new for 2021

Below is a summary of medical benefit changes and digital tool enhancements available to commercial members. All medical benefit changes will be effective on January 1, 2021. All digital tool enhancements are available today.

Medical benefit changes1

Insulin Pumps
Covered; cost share varies by plan design.

Medical Injectables
Covered; cost share varies by plan design.

Low Protein Foods
Covered in full.

Oral Chemotherapy
Covered in full.

Digital tool enhancements

Intuitive Provider Search
New features include expanded search capabilities such as specialty and language, and user-friendly home page.

NEW! Pharmacy Savings Tool
MyPrescription Shopper2 analyzes a members’ prescriptions to search for cost savings, including dosage or medication changes, as well as refill options. Enrolled members are alerted to these savings through text or email.

Secure Member Account Access – Mobile
Mobile app enhancements include direct access to our wellness portal and Telehealth virtual health care services (provided by Teladoc©). Members can also access tax forms and update or select a primary care provider (PCP).

Virtual Health Care
Telehealth virtual health care services (provided by Teladoc©) are covered in full for all plans – available 24/7. Psychiatrists can now order lab tests for quicker diagnosis.

  1. Insulin pumps and medical injectables are covered, however the member cost share may vary depending on plan design. Low protein foods and oral chemotherapy medications are covered in full but Saver plan members must meet their deductible first. Some plans may also require coinsurance. Members should consult their plan benefit documents for exact details on required cost share.
  2. MyPrescription Shopper and Telehealth (powered by Teladoc©) are available to fully-insured groups; other groups may elect to add these programs - additional fees may apply. All medical benefit changes and digital tool enhancements described above are for commercial members of Tufts Health Plan only, excludes Tufts Health Direct.