New Member Care Form

Welcome, we are glad to have you as a new member

To assist with your switch to Tufts Health Plan, please complete this form within one month prior to effective date if you or your family member(s):

  • Have a scheduled surgery or hospitalization
  • Have a serious condition such as heart disease, cancer, or multiple sclerosis
  • Are currently being supported by a case manager or disease management program
  • Are currently receiving home health care services
  • Are pregnant and considered “high risk”