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Support + Assistance from Tufts Health Plan
For Members Impacted by Substance Use Disorder
Tufts Health Plan benefits cover a broad range of treatment options for addiction:
- Inpatient detoxification and Acute Residential Treatment
- Partial Hospital Programs and Intensive Outpatient Programs
- Outpatient therapy and medication management
- Medication-Assisted Treatment, including Methadone Maintenance and prescription of Suboxone
- All of our coverage for SUD services is aligned with our medical benefits – no extra barriers, no additional costs. Admission for detox is the same cost share as admission for an appendectomy.
- Our pharmacy coverage includes the medications used to treat addiction
- $0 cost on Narboxone & Naloxone, the medications that can reverse an opioid overdose
Tufts Health Plan has a deep, broad contracted network with facilities, programs, and practitioners located throughout our service areas
- Our ambulatory network is open to any qualified practitioner who would like to participate; in fact we’ve added more than 100 additional Licensed Alcohol and Drug Counselors to our panel over the past year
- Practitioners can self-identify as treating substance use disorder, and this information is available to members searching our web directory for a contracted practitioner
- We’ve surveyed providers in our network to identify those who specialize in treatment of SUD, and those who specifically note adherence to evidence-based practices in the care of SUD patients
- Our staff will help you find the programs and services you need, when you need them. If you can’t find what you are looking for in the network, call us and we will help you access the care you need AND get the most favorable coverage available under your benefits!
Tufts Health Plan is committed to providing the support members and families need to address alcohol and opioid addictions and other substance use disorders, by helping to connect them with providers, programs, and other resources.
Tufts Health Plan Substance Use Transitions Program
The Tufts Health Plan Substance Use Transitions Program provides support to our members who are in early recovery from the use of opiates, alcohol, or other substances.
The program typically works with members who have recently entered or completed acute treatment in a hospital or residential treatment center for a diagnosis of substance use disorder. Care managers work with members to understand and follow through with their aftercare plans, and begin to take charge of their recovery.
The program also works with members who have recently needed medical care for a substance use-related illness. This includes members who have gone through detoxification on a medical unit, have been hospitalized due to a medical condition during which substance use problems were identified, or for medical problems that were caused or worsened by substance use.
Care managers help to coordinate the different programs, providers and facilities involved with the member’s care and help to establish goals and a plan to move forward.
Substance Use Disorder Navigator
Our Substance Use Disorder Navigator is available to members and their families to find resources that will help them to keep moving forward on the road to recovery. The Navigator is someone a family can call on with their concerns and get help. The Navigator will provide information on providers, treatment programs, and community resources available that will be helpful in supporting the member and their family. The Navigator can assist in answering any questions they may have about their condition, and help to coordinate available resources.
For more information about these programs, call the member services number listed on your health insurance card.