Helping Tufts Health Together (MassHealth) Members During the Coronavirus (COVID-19) Outbreak

We want to make it as safe and easy as possible for you to access your health care.

2/9/21 updates:

  • As new treatments are approved for emergency use authorization, they will be subject to the same guidelines as our other COVID-19 treatments.
  • There are no costs to members for medically necessary COVID-19 testing, Food and Drug Administration (FDA) approved vaccines and in-person treatments. We encourage members to call our member services team at 888-257-1985 (TTY: 711) with any questions related to their health benefits.


Health care and plan information

Symptoms and possible exposure

People with COVID-19 have had a wide range of symptoms. This may include: a cough, shortness of breath, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. This is not a full list.

If you believe you have COVID-19 or another flu-like illness, stay home and follow the CDC’s guidance for separating yourself from others. Your close contacts should stay home too.

If your symptoms get worse, call your health care provider before you visit him or her or go to urgent care. Follow any rules that a health care facility has in place. This will reduce your changes of exposing others to COVID-19.

In an emergency, call 911. Or go to an emergency room right away.

Where to find testing for COVID-19

If you are experiencing COVID-19 symptoms or have been exposed to someone that has, you should call your health care provider. You do not need a referral or prior approval (authorization) to get medically necessary testing or treatment related to COVID-19. Based on where you live, you can find a location near you to get tested for COVID-19. Just click one of the links below to search for a location.

Please call ahead to check the rules for each location before you seek a test.

For help understanding any symptoms you may be having, you can also check your symptoms online.

Testing locations:

In addition to your provider’s office and locations listed above, the state has also set up testing sites around the state. Check Stop the Spread for locations and instructions.

Tufts Health Together members are covered for antibody testing when testing is determined by a primary care provider (PCP) or another provider to be medically necessary. Please contact your PCP or other provider to find out whether this testing is appropriate for you.

Testing for COVID-19 is only covered for reasons that are medically necessary. Tufts Health Together will not cover testing for COVID-19 for reasons solely related to travel, work or school.

Vaccinations

The U.S. Food and Drug Administration (FDA) has approved several COVID-19 vaccines. A vaccine will be available to all individuals free of charge.

  • Early supplies of the vaccine are limited.
  • We are hopeful that over the next few months, more groups will have had an opportunity to be vaccinated.

The first vaccines approved require two doses. You will need to take both doses for the vaccine to be fully effective.

COVID vaccine distribution for residents of the Commonwealth is being led at the state level in a phased in approach. Currently all people in Phase 1 and group 1 in Phase 2, which is people 75+, are eligible. You can learn more about the groups in each phase and groups currently eligible at https://www.mass.gov/info-details/massachusetts-covid-19-vaccination-phases.

The general public (those not falling into one of the higher risk categories) is not expected to be offered the vaccine until later in 2021. For more detailed information and the most up to date information on vaccine distribution, please visit https://www.mass.gov/covid-19-vaccine.

There is no cost for our members to get the vaccine.

Be aware of vaccine scams

As COVID-19 vaccine distribution begins, be aware that scams are starting to emerge. It’s important to know what signs to watch for, including:

  • You are asked to pay out-of-pocket to get the vaccine.
  • You are asked to pay to put your name on a vaccine waiting list or to get early access.
  • Marketers offer to sell or ship doses of the vaccine for payment.

Learn more about how to protect yourself and report potential COVID-19 fraud here

Costs and coverage—COVID-19 related

Until further notice:

  • As new treatments are approved for emergency use authorization, they will be subject to the same guidelines as our other COVID-19 treatments.
  • COVID-19 vaccines that are FDA-approved and available are covered in full. There will be no cost to members.
  • Tufts Health Together plan members are fully covered to receive medically necessary testing and in-person treatment for COVID-19 from any health care provider within our provider network and with out-of-network providers if a member has trouble accessing such services in-network.
    • If you have received a bill for a service that you believe was related to seeking care for COVID-19 but was considered not related to COVID-19, please contact us at 888-257-1985 (TTY: 711)
  • Tufts Health Together members are covered for antibody testing when testing is determined by a primary care provider (PCP) or another provider to be medically necessary. Please contact your PCP or other provider to find out whether this testing is appropriate for you.
  • Testing for COVID-19 is only covered for reasons that are medically necessary. Tufts Health Together will not cover testing for COVID-19 for reasons solely related to travel, work or school.
  • Tufts Health Together members are fully covered to receive telehealth services from network providers. Telehealth is the term for checking in or receiving health care from a provider by phone or another technology virtually. Contact your provider to see if this option is available.
If you have questions about your coverage, call member services at 888-257-1985 (TTY: 711).
Referrals During the State of Emergency
  • Members do not need a referral or prior authorization to get medically necessary testing or treatment related to COVID-19 in-network or out-of-network.
  • Tufts Health Together members should continue to see providers in their network whenever possible. Members do not need a referral from their primary care provider to see in-network specialists.
  • A referral or prior authorization is required for most out-of-network services that are not related to COVID-19. Members do not need a referral to see out-of-network providers for certain covered services, such as emergency and urgent care, outpatient behavioral health and primary care.

These changes apply to our managed care organization (MCO) and accountable care organization (ACO) MassHealth plans.

Children’s vaccines and wellness visits

During the COVID-19 pandemic, it’s still important for children to get their immunizations. Make sure you protect your kids from preventable diseases. Measles, mumps and whooping cough are some of the illnesses we can prevent through vaccines. They are serious risks for young children even now. Providers’ offices are taking steps to see kids in a safe and controlled way when they need an in-office visit.

Call your child’s primary care provider. Make a plan to keep your child on schedule for his or her immunizations safely. Well visits and immunizations are covered at no cost to members. Members who get their immunizations by their second birthday may qualify for a $25 gift card reward!

Prescriptions and medications

We will waive the refill limitation for medications to permit refills of up to a 90-day supply.

Please note: Most members ages 21 and older still have to pay a small copayment for covered prescription drugs.


 

Virtual health care

Telehealth

Your provider may offer check-ins by phone or video chat. Contact your provider to see if this option is available. Virtual check-ins and telehealth enable members to make inquiries regarding symptoms or treatment for COVID-19 or other health issues without going to medical offices where the risk of coming in contact with COVID-19 may be higher. Virtual check-ins with network providers are covered in full.

If you don’t have reliable phone or internet service or you’re having trouble paying for the services you have, you may qualify for help through the federal Lifeline program. Learn more. 

24-Hour NurseLine

If you have questions about coronavirus or any health issue, call our free 24/7 NurseLine at 888-697-6546 to speak to a registered nurse.


 

More Information