Information about access to health care services in response to the COVID-19 outbreak
Tufts Health Plan is committed to providing our Tufts Health Direct members with accurate, reliable information about access to health care services in response to the COVID-19 (“Coronavirus”) outbreak.
Please note, in accordance with local stay-at-home advisories, all Tufts Health Plan offices are closed until further notice. We encourage our members to call 888.257.1985 (TTY: 711) with any questions related to their health benefits.
Until further notice, the following is in place for all Tufts Health Direct members:
Waiving Member Costs:
- We are waiving member cost share (including copayments, coinsurance and deductibles) for medically necessary Coronavirus testing and treatment. This coverage applies with in-network providers or at in-network facilities, and at out of network providers or facilities in the event a member cannot easily find an in-network provider to provide timely services.
- There are no out-of-pocket costs for Telehealth Services. We are waiving all member cost share (copayments, coinsurance and deductible charges) for any in-network telehealth services and out-of-network telemedicine services when not readily available in-network.
We are making it easier for you to get increased access to the prescription drugs you will need during this period of emergency by:
- Allowing for early refill of prescription medication without waiting to finish your current fill
- Allowing refill for up to a 90-day supply to the extent consistent with clinical guidelines, except for controlled substances (subject to CMS rules)
24-Hour Nurse Lines
Tufts Health Direct also offers access to 24/7 Nurse Line. Call 888.697.6546 to speak to a registered nurse to receive medical advice on appropriate care.
You can also call your provider with questions. If it’s an emergency, call 911.
Contacting Member Services
If you have questions regarding your health plan coverage, please call Member Services at 888.257.1985 (TTY: 711).
Remember, Tufts Health Direct also offers access to 24/7 Nurse Line, where members can speak to a registered nurse to receive medical advice on appropriate care. To reach a nurse, call 888.697.6546.
Telehealth can help members avoid contact with the Coronavirus in medical offices
People with mild, flu-like symptoms or other health issues should call their health care provider before going to a health care facility.
- Many providers offer telehealth services. Ask your primary care provider if they do. All out-of-pocket costs for telehealth visits with in-network providers and out-of-network providers (when in-network providers are not readily available) will be waived until further notice. This also includes telephone consultations. Telehealth enables members to make inquiries regarding symptoms or treatment for the Coronavirus in order to reduce the need for members to go to medical offices where the risk of coming in contact with the Coronavirus may be higher.
What should individuals do if they think they have been exposed to the virus?
People with COVID-19 or with other flu-like symptoms should stay home and follow all quarantine procedures. Their close contacts should be advised to stay home. If someone has more significant symptoms, they should go to their health care provider, urgent care or the emergency room. But they are advised to call in advance and follow any protocols that the facility has in place. Older individuals should be especially cautious during this time.
Where can individuals find additional information and updates about Coronavirus?
They should visit the CDC website at www.cdc.gov and click on “Coronavirus Disease 2019.” Another excellent source of information is:
Our policy in case the company needs to close down due to a pandemic
Tufts Health Plan has an extensive policy in place to ensure the continued service of our members and clients if we are required to close our physical locations in any of our markets. Most of our employees are currently working remotely to ensure continued service to our members, providers and small groups. Please reference our corporate continuity plan (CCP) summary for our organization for more information. We will continue to keep you abreast of any changes to this policy as it develops. You can view the CCP Summary here.