Frequently Asked Questions

Here are questions members ask about our plan

How can I update my information?

You can change your name, address, phone number and more online. Visit Tufts Health Member Connect 24/7. You can also call us at 866.738.4116 (TTY: 711).

Let the state know when you change your home address. You can lose your coverage if you do not tell the state. To do so: 

  • Call HealthSource RI 855.840.4774 (TTY: 888.657.3173). Or visit healthsourceri.com
  • Call the Rhode Island Department of Human Services (RIDHS). The number is 855.MY.RIDHS (855.697.4347). If your child has special needs, call your local DHS office to let them know about any change in your child’s information.
Is my provider or specialist in your network?

You can use our Find a Doctor, Hospital or Pharmacy tool to find out. You can also call member services at 866.738.4116 (TTY: 711).

If you want to choose or change your primary care provider, use Tufts Health Member Connect, our self-service tool. Sign up is easy. Follow the steps on the sign up page.

How do I get a new member ID card?

Visit Tufts Health Member Connect to order a new ID card. Or call us at 866.738.4116 (TTY: 711) to ask for a new card. We’re open Monday through Friday, from 8 a.m. to 6 p.m.

Your ID card should come in the mail within 15 business days.

Can I check the status of an authorization?

Yes. You can check the status online anytime. Visit Tufts Health Member Connect.

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

Call HealthSource RI at 855.574.2846 (TTY: 888.657.3173) to ask. They’re open Monday through Friday, from 8 a.m. to 7 p.m. You can also visit healthsourceri.com

Do I need to renew my benefits?

Yes. You must renew your Medicaid eligibility each year with the state. See the renewal section for more info. You also can call HealthSource RI at 855.840.4774 (TTY: 888.657.3173). They’re open Monday through Friday, from 8 a.m. to 7 p.m.

Do I have dental coverage?

Many members have dental benefits through RIte Smiles or Rhode Island Medicaid.

Look on the front of your Tufts Health Plan member ID card. You can see your RI Medicaid plan type next to “Plan Type.”

RIte Smiles covers those born on or after May 1, 2000. Members born before May 1, 2000, are covered under RI Medicaid.

To learn more, call us at 866.738.4116 (TTY: 711). We’re open 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. This means that members use generic drugs first. Brand-name and generic drugs have the same active ingredients. Both are safe. They work the same way to make you well. Yet generic drugs cost less. 

Your plan covers some brand-name drugs. The state updates this list often. Most brand-name drugs need referrals. Some generic drugs also need referrals. When generic drugs are available, we do not cover the brand-name drug without prior authorization.

Our plan covers drugs and some over-the-counter (OTC) drugs with a provider’s prescription. We aim to provide high-quality, cost-effective options for our members. We work with providers and pharmacists to cover the most useful drugs for many conditions.

We have a Preferred Drug List (PDL). To find out if we cover a drug, look it up in our PDL. We update the PDL every three months. The PDL applies only to drugs you get at pharmacies. The PDL does not apply to drugs you may get in the hospital.

What is Doula By My Side?

We have a doula program that can help you have a healthy pregnancy. A doula can visit you at home. He or she can talk with you about what to expect while you’re pregnant. Your doula also can teach you how to breastfeed and take care of your baby. 

Working with a doula can help cut the risk of having health issues while you’re pregnant. It can also help you feel more at ease and ready to be a new mom.

Want to work with a doula? Ask your provider to refer you to the Doula by My Side program. You can also call member services at 866.738.4116 (TTY: 711).

What is Good Measures?

It’s a program that makes eating healthy fun. The program includes nutrition coaching. You can also use an app and website to find recipes and track your progress.

You get the tools you need to lose weight, improve your health and feel your best.

You can call 844.398.9510 or visit ritogether.goodmeasures.com to learn more.

What benefits do I have?

With our plan, you get all Rhode Island Medicaid benefits, and more.

We also have an EXTRAS program that rewards you for making health choices. You can find more about the EXTRAS program in your Member Handbook.


 

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

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More questions?

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