Tufts Health Direct

Our focused-network plan for individuals and small groups

Tufts Health Direct is our focused-network plan for individuals and small groups that offers several plan levels, each with comprehensive health benefits and EXTRAS, and each with its own cost-sharing structure.

Working with us to care for your Tufts Health Direct patients is essentially the same as for your other Tufts Health Public Plans patients. It’s easy to access and submit forms, file claims, and get paid. You can verify a Tufts Health Direct patient’s enrollment status and get other patient information through Tufts Health Plan's secure Provider portal, our online self-service tool; NEHEN or NEHENnet; or our Interactive Voice Response system at 888-257-1985.

Member benefits

Our Tufts Health Direct members get:

• Doctors’ office visits and checkups
• Prescriptions
• Hospital stays, X-rays, and lab tests
• Vision services
• Family planning services
• Infertility services
• Fitness benefits

Additional resources

See answers to frequently asked questions for Tufts Health Direct. For information about benefits, prior authorization requirements, co-payments, co-insurance, deductibles, and annual maximum out-of-pocket amounts, please see our medical and behavioral health benefit summary grids.

See the following materials for more information about Tufts Health Direct:

• Tufts Health Public Plans Provider Manual
• Payment Policies
• Provider Resource Guide
• Insights and Updates for providers newsletter
• No Surprise Act Provider Payment Disputes