Benefits & Costs
Tufts Health Unify members get the medical, behavioral health (mental health and/or substance use), pharmacy, vision and dental benefits of MassHealth (Medicaid) and Medicare, plus much more.
You get access to:
- A care team and care manager who will work with you to meet your health needs. They will help you get the right services and organize your care
- An Individualized Care Plan (ICP) specially designed to meet your physical and behavioral health care needs
- Health support any time with our 24/7 NurseLine at 855.393.3154 (TTY:711)
- A primary care provider (PCP). This is the doctor or other provider you see first for most health problems. Your PCP makes sure you get the care you need to stay healthy. He or she also may talk with other doctors and health care providers about your care and refer you to them and specialists near you
- A member services team who speaks your language
- A long-term services and supports (LTSS) and community-based supports if you need help with everyday tasks like taking a bath, getting dressed, grocery shopping and making food
- Medication therapy management, if you're eligible
What's the cost?
There are no premiums* or copayments (2021) for medical and behavioral health (mental health and/or substance use) care. You pay nothing for your covered services as long as you follow the plan’s rules. We will pay for the services listed in the medical, behavioral health, pharmacy, dental and LTSS sections** of the Tufts Health Unify Summary of Benefits when:
- Your services (including medical care, services, supplies and equipment) are medically necessary
Medically necessary: Medically necessary services, supplies, or drugs are those that; prevent, diagnose, stop the worsening of, improve, correct, cure or treat a medical condition that endangers your life, causes suffering or pain, causes physical deformity or malfunction, may cause or worsen a disability or could result in making you very sick.
- You get your care from a network provider
Network provider: In most cases, this plan will not pay for care you get from an out-of-network provider. However, there are some exceptions:
1. The plan covers emergency care or urgent care that you get from an out-of-network provider; if you need medical care that our plan covers and the providers in our network cannot provide this care, you can get this care from an out-of-network provider with prior authorization (permission).
2. Also, the plan covers kidney dialysis services at a Medicare-certified dialysis facility when you are outside the plan's service area for a short period of time.
For more information about your benefits and costs, see your Tufts Health Unify Member Handbook (2021) or call us toll-free at 855.393.3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m.
* Note: If you pay a premium to MassHealth for CommonHealth, you must continue to pay the premium to MassHealth to keep your coverage.
** Exceptions may apply; see your Member Handbook for details.
Page modified on: 4/25/2018 1:33:12 PM