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 Member Handbook (2023) gives more information about the Explanation of Benefits and how it can help you keep track of your drug coverage.

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Disclaimers

Tufts Health Unify 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 (2023).

ATTENTION: If you speak English, 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. 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. 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. 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: 4/7/2016 6:58:40 PM