To do that, we work with your providers and pharmacists to make sure we cover the most important and useful drugs for a variety of conditions.
Tufts Health One Care covers first-time prescriptions and refills. We also cover some over-the-counter (OTC) drugs with a doctor’s prescription. Covered drugs are free.
To quickly find out if we cover a specific drug, look it up in our List of Covered Drugs, also called the Drug List. We update the Drug List every month. The Drug List applies only to drugs you get at retail, Optum Rx Home Delivery and specialty pharmacies. If you are in the hospital, you may get drugs covered that are not on the Drug List.
Some drugs in our List of Covered Drugs require prior authorization and/or step therapy. For more information, please see:
In-network large-chain or independent pharmacies can fill your prescription. You can use our search tool to find a pharmacy near you.
Call us toll-free at 1-855-393-3154 (TTY: 711)
Tufts Health One Care is a health plan that contracts with both Medicare and MassHealth to provide benefits of both programs to enrollees. It is for people with both Medicare and MassHealth ages 21 through 64 at the time of enrollment.
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 (2025).
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. 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.
H7419_4520_CMS Approved
Page modified on: 3/16/2022 5:35 PM