Helping Tufts Health Unify Members During the Coronavirus (COVID-19) Pandemic
We want to make it as safe and easy as possible for you to access your health care during the pandemic.
For that reason, we are making coverage changes to our Tufts Health Unify plan.
Until further notice:
- Tufts Health Unify 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. However, we strongly encourage members to continue receiving services from their current providers and stay within our network if possible.
- Please note: Members do not need a referral or prior authorization to get testing or treatment related to COVID-19 in-network or out-of-network. A referral or prior authorization is required for any out-of-network service that is not related to COVID-19.
- Testing for COVID-19 is only covered for reasons that are medically necessary. Tufts Health Unify will not cover testing for COVID-19 for reasons solely related to travel, work or school.
- Tufts Health Unify 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.
- Tufts Health Unify 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.
- Call member services at 855.393.3154 (TTY: 711) if you have questions about out-of-network coverage.
- Members should continue to see providers in their network whenever possible. Referrals or prior authorization is required for any out-of-network service that is not related to COVID-19.
If you have questions about your coverage, call the Member Services number on your member ID card.
Members can get an early refill of their prescriptions prior to the expiration date so they have a supply of their maintenance medications should they need it.
We will waive the refill limitation for maintenance medications to permit refills of up to a 90-day supply. Early refills are not allowed for controlled substance drugs.
When and How to Get Care
Here are some steps you can take based on your situation:
- If you have questions about COVID-19 or any health issue, call your care manager directly. For calls after business hours, call us at 855.393.3154.
- If you have mild, flu-like symptoms, call your health care provider. Call before going to a health care facility. This will prevent you from exposing others to COVID-19.
- Your provider may offer check-ins by phone or video chat. Contact your provider to see if this option is available. Virtual check-ins are covered in full under Tufts Health Unify. 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.
- Virtual check-ins and telehealth enable members to make inquiries regarding symptoms or treatment for COVID-19 in order to reduce the need for members to go to medical offices where the risk of coming in contact with COVID-19 may be higher.
- If you believe you have COVID-19 or another flu-like illness, stay home. 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 list is not a full list. Follow the CDC’s guidance for separating yourself from others. Your close contacts should stay home too. But if your symptoms get worse, call your health care provider before you visit them or go to urgent care. Follow any rules that a health care facility has in place.
- In an emergency, call 911. Or go to an emergency room right away.
Where to Get 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 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.
For more information, visit the CDC and the Massachusetts Department of Health websites.
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.