Explanation of Benefits (EOB)

Part D is a program that helps pay for prescription drugs for people with Medicare who join a plan that includes Medicare prescription drug coverage. Every month, if you use the prescription drug benefit, we will send you a summary report, called the Explanation of Benefits. This report tells you the total amount we have paid for each of your Part D drugs during the month. The Tufts Health One Care Member Handbook (2026) gives more information about the Explanation of Benefits and how it can help you keep track of your drug coverage.

Questions?

Call us toll-free at 1-855-393-3154 (TTY: 711)

Disclaimers

Tufts Health One Care is a Dual Special Needs Plan (D-SNP) health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook (2026).

If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. (Please note: Our hours shift to Monday through Friday, from April 1 through September 30). The call is free.

Si habla español, tiene disponible los servicios de asistencia de idioma gratis. Llame al 1-855-393-3154 (TTY: 711), siete días de la semana, de 8 a.m. a 8 p.m. (Ten en cuenta lo siguiente: Del 1 de abril al 30 de septiembre, nuestro horario pasa a ser de lunes a viernes). La llamada es gratuita.

You can get this document for free in other formats, such as large print, formats that work with screen reader technology, braille, or audio. Call 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. (Please note: Our hours shift to Monday through Friday, from April 1 through September 30). The call is free.

The List of Covered Drugs and/or pharmacy and provider networks may change from time to time throughout the year. We will send you a notice before we make a change that affects you.

Benefits may change on January 1 of each year.

H5314_7960_C