Tufts Health One Care
Plan overview for providers
Through the One Care initiative, MassHealth and the Centers for Medicare & Medicaid Services (CMS) seek to integrate care for people who are eligible for both Medicare and Medicaid.
Tufts Health One Care simplifies care by providing MassHealth and Medicare benefits through one plan and one ID card for eligible individuals. Individuals are eligible for Tufts Health One Care if they are Massachusetts Medicaid beneficiaries between the ages of 21 and 64 who are also eligible for Medicare due to a disability; CMS and MassHealth jointly determine eligibility.
Benefits
Tufts Health One Care combines Medicare and Medicaid benefits into one expanded benefit package, including community-based long-term services and supports (LTSS), to maximize enrollees’ independence and well-being. Tufts Health One Care includes free coverage for services, such as:
- Community health workers
- Community support services (CSS)
- Day habilitation
- Group adult foster care
- Home care/Homemaker services
- Home health care services
- Home modifications
- Nurse midwife services
- Peer support/Counseling/Navigation
- Personal care assistants
- Program of assertive community treatments (PACT)
- Respite care
Training
CMS and MassHealth require that all providers contracted to serve One Care enrollees receive training on certain elements of the program, covering topics such as an introduction to the program, cultural competence, and contemporary models of disability. Learn about the required provider trainings for Tufts Health One Care or see our frequently asked questions for more information.
Additional resources
- Tufts Health Public Plans Provider Manual
- Provider Resource Guide
- Policies, including Payment, Medical Necessity Guidelines, pharmacy information and more
- Doing business with us
- Community resource directory
For more information about how we can partner with you to serve individuals who are eligible for Tufts Health One Care, call us at 888-257-1985 and ask to speak with a provider services team member.