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- About Your Plan
- Choosing a PCP
- Frequently Asked Questions
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Frequently Asked Questions
What is CareLink?
CareLink is a health plan program offered by Tufts Health Plan and CIGNA HealthCare. CareLink provides comprehensive, nationwide health care coverage. Its members have access to Tufts Health Plan-participating providers in Massachusetts and Rhode Island and to CIGNA Open Access Plus-participating providers in all other states.
Do I have to choose a Primary Care Provider?
You are not required to choose a Primary Care Provider. However, we believe a Primary Care Provider is a valuable resource for you and a key personal health advocate.
Can I keep my current doctor?
Depending on your coverage, you may be required to choose a provider in the CareLink network to receive covered health care services. Because the CareLink network of participating providers is extensive, it's likely your doctor is already in our network.
How do I determine if my doctor is in the CareLink network?
Click here to search the CareLink network, or call toll free 1-866-352-9114 to speak with a member specialist. You can also check the CareLink Provider Directory in your company's Human Resources Department.
Can I see a provider who is out-of-network?
If your plan includes out-of-network coverage, you are free to choose providers who do not participate in the CareLink network. If you receive covered health care services from providers who do not participate in the CareLink network, you will be covered at the out-of-network level of benefits, which means you will pay deductibles and coinsurance and will have higher out-of-pocket costs.
Do I need a referral to see a specialist?
CareLink members do not need referrals to receive covered services from participating specialists.
Will CareLink cover me for emergency care?
CareLink members have 24-hour emergency coverage no matter where they're at home or traveling anywhere in the world. In an emergency, always seek care at the nearest medical facility. Call 911 for emergency medical assistance, if needed. If 911 services are unavailable in the area, call local emergency medical services or the police for help.
What is Low-tech Imaging?
Low-tech imaging includes services such as x-rays, bone density tests, mammography, and ultrasounds. Low-tech imaging is sometimes performed in your doctor’s office or during an emergency room visit. It is covered as part of your visit and does not require a separate copayment. If your plan has a deductible, low-tech imaging services will apply toward the deductible.
What is High-tech Imaging?
High-tech Imaging includes CT/CTA, MRI/MRA, PET Scans, and Nuclear Cardiology. These procedures require prior authorization. This means your doctor needs to submit a request for approval before they will be covered. Many members are on a plan that has a high-tech imaging copayment. If this applies to you, this means you are responsible to pay a copayment for the procedure that is separate from your office visit or hospital copayment. Important Note: Members are exempt from paying the high-tech imaging copayment when the imaging is required as part of an active treatment plan for a cancer diagnosis. If you aren’t sure whether your plan has a high-tech imaging copayment, please check your Benefit Document or contact a Member Services Representative.