Frequently Asked Questions

Here are some frequently asked questions about Tufts Health RITogether, our RIte Care and Rhody Health Partners plan:

How can I update my information?

You can update your contact information, such as your address, phone number or email, through Tufts Health Member Connect, our self-service tool, 24/7. All you need to create an account is your Tufts Health RITogether member ID number and date of birth. If you do not know your member ID number, check your member ID card.

As a RIte Care, Rhody Health Partners or Rhody Health Partners Expansion member, you need to notify the state of Rhode Island when your mailing address changes or you may lose your RIte Care, Rhody Health Partners, Rhody Health Partners Expansion and Tufts Health RITogether benefits. Contact HealthSource RI or the Rhode Island Department of Human Services (DHS) at 855.MY.RIDHS (855.697.4347) to update your information. You can call HealthSource RI at 855.840.4774 (TTY: 888.657.3173) or visit HealthSourceRI.com. If you are the parent or guardian of a child with special needs, you should contact your local DHS office with any changes to your child’s information.

Is my doctor or specialist in your network?

If you are looking for a doctor or specialist in your area, use our Find a Doctor, Hospital or Pharmacy tool to find primary care providers (PCPs), behavioral health (mental health and/or substance use disorder) providers, specialists and other health care providers near you. You can also call member services.

To choose or change your PCP, or to check if your doctor needs to get prior authorization (approval) for you to get a service, sign up for Tufts Health Member Connect, our self-service tool, or log in if you already have an account. All you need to create an account is your Tufts Health RITogether member ID number and date of birth. Your member ID number is on your Tufts Health RITogether member ID card.

How do I order a new member ID card?

To order a new member ID card 24/7, sign up for Tufts Health Member Connect, our self-service tool, or log on if you already have an account. All you need to create an account is your Tufts Health RITogether member ID number and date of birth. You can also call us to request a new member ID card at 866.738.4116 (TTY: 711), Monday through Friday, from 8 a.m. to 6 p.m.

Once you order your member ID card, you should receive it in the mail within 15 business days.

How can I check the status of an authorization?

To check the status of an authorization 24/7, simply sign up for Tufts Health Member Connect, our self-service tool, or log on if you already have an account. All you need to create an account is your Tufts Health RITogether member ID number and date of birth. If you do not know your member ID number, check your member ID card.

Am I member of RIte Care, Rhody Health Partners or Tufts Health Plan?

As a RIte Care, Rhody Health Partners or Rhody Health Partners Expansion member, you can verify your eligibility and enrollment status by calling HealthSource RI Customer Service at 855.574.2846 (TTY: 888.657.3173), Monday through Friday, from 8 a.m. to 7 p.m. Or you can visit HealthSourceRI.com. You should have your social security number and date of birth ready when you call.

Do I need to renew my RIte Care, Rhody Health Partners, Rhody Health Partners Expansion or Tufts Health RITogether benefits?

Yes. Each year RIte Care, Rhody Health Partners or Rhody Health Partners Expansion members, including Tufts Health RITogether members, must renew their RIte Care, Rhody Health Partners or Rhody Health Partners Expansion benefits. There are two ways to renew: by automatic renewal or through a pre-populated renewal form.

For details, see the renewal section of this website. Or you can call HealthSource RI Customer Service at 855.840.4774 (TTY: 888.657.3173), Monday through Friday, from 8 a.m. to 7 p.m.

Do I have dental coverage?

Most RIte Care, Rhody Health Partners or Rhody Health Partners Expansion members may be eligible for dental benefits through RIte Smiles or Rhode Island Medicaid.

Unsure of your Rhode Island Medicaid plan type? Look on the front of your Tufts Health RITogether member ID card. Your RI Medicaid plan type is written next to “Plan Type.”
Members who were born on or after May 1, 2000, are covered by RIte Smiles. Members born before May 1, 2000, are covered under RI Medicaid for dental services.

If you have questions about your eligibility, or want more information about dental coverage, call our member services team at 866.738.4116 (TTY: 711), Monday through Friday, from 8 a.m. to 6 p.m.

What pharmacy benefits do I have? Is my prescription covered?

Rhode Island has a Generic First Program and requires that all members use generic drugs first. For example, brand-name and generic drugs have the same active ingredients. Both are safe and work the same way to make you well, but generic drugs cost less. When generic drugs are available, we won’t cover the brand-name drug without giving prior authorization. There are a limited number of brand-name drugs that are covered, and the state updates this list on a regular basis. Most brand-name drugs require prior referrals. Some generic drugs may also require prior referrals.

Covered drugs and some over-the-counter prescribed drugs are available for all members with a provider’s prescription. We aim to provide high-quality, cost-effective options for drug therapy. We work with your providers and pharmacists to make sure we cover the most important and useful drugs for a variety of conditions and diseases.

Tufts Health RITogether uses a Preferred Drug List (PDL) as our list of covered drugs. To quickly find out if we cover a specific drug, look it up in our PDL. We update the PDL every three months. The PDL applies only to drugs you get at retail and specialty pharmacies. The PDL does not apply to drugs you get if you are in the hospital.

We also cover some over-the-counter drugs with a provider’s written prescription.

Do I have any benefits?

As a Tufts Health RITogether member, you get all of your RIte Care, Rhody Health Partners and Rhody Health Partners Expansion covered benefits.

We also have an EXTRAS program that offers incentives to Tufts Health RITogether members for completing healthy behaviors and meeting other health-related goals. You can find more information about the EXTRAS program in your Member Handbook or by calling member services.

Member ID Cards: Tufts Health RITogether and Rhode Island Medicaid ID card

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More questions?

Call us at 866.738.4116 (TTY: 711), Monday through Friday, from 8 a.m. to 6 p.m. We're happy to help.

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