Alyssa Lane
Tufts Medical Center accepts a variety of insurance plans, including MassHealth and Rhode Island Medicaid, which cover all Medicaid benefits and more. Tufts also offers Medicare-Medicaid plans and works closely with doctors, hospitals, and community organizations to provide high-quality healthcare services for all patients. It is important to note that Tufts Medical Center only provides specialty care and not primary care. Additionally, the specific coverage and costs may vary depending on the insurance plan and the type of care received. Patients are advised to verify their insurance coverage and understand their financial responsibilities, as some plans may require additional referrals or authorizations for certain procedures.
| Characteristics | Values |
|---|---|
| Insurance accepted | Tufts Health Plan |
| MassHealth | |
| Rhode Island Medicaid | |
| Medicare | |
| Medicaid | |
| UnitedHealthcare | |
| Kaiser Permanente Insurance | |
| Out-of-state Medicaid programs | |
| Children's Medical Security Program | |
| Health Safety Net | |
| Notes | Tufts Medical Center: specialty care only, no primary care |
| Emergency department doctors may not be in-network with all insurance payors or plans |
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What You'll Learn
Tufts Health Plan Medicare Preferred
Tufts Health Plan offers a variety of Medicare plans to its customers. These include the Tufts Medicare Preferred Access PPO plan, which allows members to choose from a wider network of doctors nationwide, without the need for referrals to see a specialist. The costs for services are generally lower when seeing doctors inside the network, but the PPO plan gives members the flexibility to choose doctors outside the network as well.
Tufts Health Plan also offers Medicare Advantage Plans (Medicare Part C) through their Tufts Health Plan Medicare Preferred HMO plans. These plans offer medical and prescription drug coverage (Medicare Part D) beyond Original Medicare (Medicare Parts A & B). Tufts Health Plan Medicare Preferred Group Plans are offered through employer groups and include HMO Medicare Advantage Plans, Supplemental Plans, and Prescription Drug Plans.
Tufts Health Plan Medicare Supplement plans offer more benefits than Original Medicare and MassHealth Standard at no cost for those who qualify. Additionally, Tufts Health One Care is a Medicare-Medicaid One Care plan for individuals aged 21 to 64, providing access to a network of providers and a dedicated care manager.
Tufts Health Plan makes transitioning to Medicare simple and stress-free. Their Medicare plans provide excellent care, service, and value, which is why 97% of their Medicare plan members remain loyal to Tufts Health Plan year after year.
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MassHealth and Rhode Island Medicaid plans
Tufts Health Plan offers a range of MassHealth and Rhode Island Medicaid plans that cover all Medicaid benefits and more. These plans are designed to provide excellent care, service, and value to their members. Here is some detailed information about these plans:
Tufts Health Together (MassHealth)
This plan provides members with comprehensive benefits, including visits to doctors and specialists, prescription drugs for children, eye exams, and eyeglasses. MassHealth also covers other services such as hospital stays, lab tests, and more, depending on the specific plan.
Tufts Health RITogether (Rhode Island Medicaid)
The Tufts Health RITogether plan offers all the benefits of RIte Care, Rhody Health Partners, and Rhody Health Partners Expansion. Additionally, members can avail of benefits such as visits to doctors and specialists, emergency services, and eye care. This plan ensures that individuals in Rhode Island have access to the care they need within the Rhode Island Medicaid program.
Tufts Health One Care (Medicare-Medicaid Plan)
This Medicare-Medicaid One Care plan is designed for individuals aged 21 to 64. It combines the benefits of both MassHealth and Medicare, providing members with a comprehensive range of services. This includes access to a care manager, a personalized care plan, a 24/7 NurseLine, and long-term services and supports.
Tufts Health Plan Senior Care Options (65+ Medicare-Medicaid Plan)
The Senior Care Options plan is tailored for individuals aged 65 and older who have or are eligible for Medicare and MassHealth Standard (Medicaid) or just MassHealth Standard (Medicaid). This plan offers a seamless transition to Medicare, ensuring that members receive the care and support they need as they age.
It is important to note that specific benefits and coverage may vary depending on the individual's plan and location. Members are encouraged to review their plan details and contact their insurance provider for a comprehensive understanding of their benefits. Additionally, Tufts Medicine also offers financial assistance and support in exploring insurance options to ensure accessibility to high-quality healthcare services.
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Medicare Supplement plans
Tufts Health Plan offers Medicare Advantage and Medicare Supplement plans (also known as Medigap plans) in many areas across Massachusetts. Tufts Medicare Supplement plans offer coverage for some of the costs that are typically incurred when using Medicare. These costs usually include Part A coinsurance costs for hospital and hospice care.
Tufts offers three Medigap plans: Plan 1, Plan 1a, and the Core Plan. Plan 1 is only available to people who were eligible for Medicare before January 1, 2020, and includes coverage for the Medicare Part B deductible and most other out-of-pocket costs. Plan 1a offers coverage for most Medicare costs, except the Part B deductible, and is a good option for those who want comprehensive coverage but are not eligible for Plan 1. The Core Plan provides coverage for some of the everyday costs of Medicare, such as Part B coinsurance, but enrollees will still need to pay Part A and Part B deductibles. Tufts plans cost the same amount regardless of the enrollee's age or location in Massachusetts.
Tufts members can add dental coverage to any plan for an additional $35 per month in 2025. They can also receive extras such as a wellness allowance. Tufts Health Plan Medicare Preferred Group Plans are offered through employer groups in the form of HMO Medicare Advantage Plans, Supplemental Plans, and Prescription Drug Plans. The Tufts Medicare Preferred Access PPO plan provides the flexibility to choose from a wider network of doctors nationwide, while the Tufts Health Plan Medicare Preferred HMO plans offer medical and prescription drug coverage beyond Original Medicare.
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Senior Care Options
Tufts Medical Center accepts specialty care but does not cover primary care. It is recommended that you get in touch with your insurance provider to understand what your medical plan covers and what you may need to pay out of pocket.
Tufts Health Plan offers a Senior Care Options plan for those aged 65 and above, which is a Medicare-Medicaid plan. This plan provides more benefits than MassHealth Standard and Original Medicare, with no additional costs. It offers complete healthcare coverage, with a dedicated Care Manager who works with you, your doctors, and your caregivers to ensure that you get the care and services you need. The plan also includes wellness benefits, Preferred Extras, in-network doctors and pharmacies, forms and plan documents, and a secure online portal.
Tufts Health Plan representatives are available to take your application over the phone or to schedule a consultation to learn more about the Senior Care Options plan. You can also enrol online.
Tufts Medicare Preferred is another option, which includes Medicare Advantage Plans, Medicare Supplement plans, and Senior Care Options. The Medicare Advantage Plans fill the gaps in Original Medicare, allowing you to continue seeing any doctor that accepts it. The Medicare Supplement plans offer more benefits than Original Medicare and MassHealth Standard at no cost for those who qualify.
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Emergency services coverage
Tufts Medical Center accepts a variety of insurance plans, but it is important to note that the specific coverage and costs can vary depending on the insurance provider and the individual's plan.
Regarding emergency services coverage, it is crucial to contact your insurance company directly to confirm coverage for emergency services provided at Tufts Medical Center. The reason for this is that emergency department doctors may not be in-network with all insurance payors or plans. By contacting your insurance company, you can verify whether Tufts Medical Center is considered an in-network provider for emergency services under your specific plan.
Additionally, Tufts Medical Center offers financial assistance and counselling services to help patients understand their insurance coverage and explore options for managing their healthcare expenses. Their financial counselors can guide patients in applying for financial assistance and finding suitable insurance options.
It is always recommended to review the details of your insurance plan, including any copayments, deductibles, or coinsurance requirements, to fully understand your coverage and any potential out-of-pocket expenses. Tufts Health Plan offers a range of options, including MassHealth, Rhode Island Medicaid, and Medicare-Medicaid plans, each with its own set of benefits and coverage.
For Tufts University students, there are specific insurance considerations. The university offers a comprehensive mandatory Health and Wellness Fee for all full-time and half-time undergraduate and graduate students. Additionally, students can seek assistance from the FIRST Resource Center and the International Center for financial support related to medical costs.
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Frequently asked questions
Tufts Medical Center accepts a wide range of insurance plans, including MassHealth and Rhode Island Medicaid plans. They also offer Medicare Advantage Plans and Medicare Supplement plans. It is always a good idea to discuss the type of coverage you have and how your insurance company covers your healthcare services.
You can log in to your member portal to find doctors, hospitals, and providers that accept your health plan. Alternatively, you can contact your insurance company directly to understand your coverage and confirm if Tufts Medical Center is in-network.
Tufts Medical Center has financial counselors who can help you with the financial assistance application process and guide you in finding insurance. They can be reached at 617.636.6013, Monday to Friday, from 7:30 am to midnight.
You can update your personal information by contacting Tufts Medical Center. They will assist you in making the necessary changes to your account.
Yes, all undergraduate and graduate students enrolled full-time or at least half-time are required to pay a comprehensive mandatory Health and Wellness Fee. Students can also opt for an affordable insurance plan offered through UnitedHealthcare.
