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:

What's the cost?

There are no premiums* or co-payments (PDF) 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 or approved by your care team
  • You get your care from a network provider

For more information about your benefits and costs, see your Tufts Health Unify Member Handbook (PDF) or call us 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. 

+Primary Care Providers: Your primary care provider is the doctor or other provider you see first for most health problems. They make sure you get the care you need to stay healthy. They also may talk with other doctors and health care providers about your care and refer you to them.
++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.
+++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:

  • 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).
  • 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.

H7419_5559A_CMS Approved
Page modified on: 4/25/2018 1:33:12 PM

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