Support and Assistance from Tufts Health Plan

For members impacted by substance use disorder

Tufts Health Direct benefits

Your health plan covers a broad range of treatment options for addiction, including:

  • Inpatient detoxification and residential treatment
  • Partial hospital programs and intensive outpatient programs
  • Structured addiction outpatient programs (SOAP)
  • Outpatient therapy and medication management
  • Medication-assisted treatment, including methadone maintenance and use of Suboxone
  • Medications used to treat addiction
  • Naloxone (Narcan) needs no prescription and has no copayment. This medication can reverse an opioid overdose.

Tufts Health Direct network

Tufts Health Direct has a contracted network that includes facilities, programs and practitioners located throughout our service areas.

If you need help getting the right care, call member services at 888-257-1985 (TTY: 711). Our staff will help you find the programs and services you need. We are available Monday to Friday, from 8 a.m. to 5 p.m.

Care Management

We’re committed to providing the support you need to address alcohol, opioid and other substance use disorders. We can connect you with providers, programs and other resources.

Addictions Recovery Care Management (ACRM) Program

Tufts Health Plan has an ARCM program to support members who are in early recovery from the use of opiates, alcohol or other substances. Care managers coordinate care for members who recently needed medical care for a substance use-related illness. This includes members who:

  • Were hospitalized on a medical unit for detoxification
  • Were identified as having substance use problems while hospitalized for a medical condition
  • Have medical problems caused or worsened by substance use

Care managers support members as they follow through with their aftercare plans and begin to take charge of their recovery. They coordinate care across the different programs, providers and facilities involved with the member’s treatment. They also help the member set goals and a plan to move forward. 

The program has a peer recovery specialist who supports members during periods of transition from 24-hour levels of care. The recovery specialist serves as a role model, mentor and advocate. The specialist encourages members to regain their independence, develop self-advocacy skills and participate in treatment and recovery-oriented activities as needed. The recovery specialist supports members with their transition back into the community, helping to prevent relapse and promote long-term recovery.

For more information about these programs, call member services at 888-257-1985 (TTY: 711). We are available Monday through Friday from 8 a.m. to 5 p.m.