Tufts Health Plan
Do you live in the Boston area and want a health plan that
is nationally rated in the top five? Tufts Health Plan is
considered one of the best in your region and offers multiple
types of plans for individuals and families. Tufts also has
programs that are intended to keep you healthy (preventive
reminders, home visits, discounts for wellness benefits) and
give you easy access to all types of health information and
assistance.
Request a free health insurance quote >>
Tufts Health Plan Provides Affordable Health Care Solutions
With the cost of health care so high these days,
Tufts Health Plan works to provide you with the type of plan
you can afford, without forgetting any of your health needs.
The premium of an insurance plan generally varies according
to four major issues: accessibility of your doctors, annual
deductible, services covered, and out-of-pocket costs. Because
Tufts understands you want choices related to these variables,
yet have unique requirements and health care needs, there
is a wide range of plan options from which to choose.
Insurance Coverage offered by Tufts Health Plan
For Massachusetts residents, THP offers the
following personal and family plans
(All of these are group plans, except the Medicare Preferred
Plan):
HMO or Health Maintenance Organization
Includes one of the largest networks of health providers in
the area. From the network, you choose your primary care physician
who guides your health care, providing network referrals when
needed. For each service, you will pay a pre-determined co-payment.
(This is a group plan from an employer.)
POS or Point of Service
Offers
more flexibility, in terms of accessing health providers.
You choose a primary care physician (PCP) from the network
who directs your health services. If you need more specialized
care, your PCP can either refer you to another network specialist
or refer you to an out-of-network doctor. If you seek care
from a non-network doctor without the PCP referral, you will
pay an annual deductible and following coinsurance levels
for covered services. (Group Plan)
EPO or Exclusive Provider Option
Provides services much like an HMO. You choose your primary
care physician from the network and he/she manages your health
services, providing referrals to other network specialists
or non-network specialists when needed. You pay a copayment
for covered services. (Group Plan)
Choice Payment Options
Provides
comprehensive coverages under the HMO, POS, or EPO plans,
and also includes more freedom in emergency situations. You
choose a primary care physician within the Tufts network of
doctors and obtain referrals according to the guidelines of
your HMO, POS, or EPO plan. You also have 24/7 coverage outside
of the THP service area. (Group Plan)
PPO or Preferred Provider Organization
Offers a larger range of choices for doctors. You do not choose
a primary care physician and can seek services from doctors
in the Tufts network and outside of the network also. For
network providers, you pay a copayment for covered services
with a preset limit. For out-of-network, you will be subject
to an annual deductible and then coinsurance payments up to
a maximum limit, all of which is pre-determined by your employer.
(Group Plan)
Advantage PPO
Gives you the
choice of seeking health services from any licensed provider,
although the services you receive from a network provider
have higher benefits. You are responsible for an annual deductible
and then for coinsurance amounts. Out-of-network services
have a lower coinsurance, thus requiring higher out-of-pocket
amounts, up to a maximum amount, followed by 100% coverages.
Liberty by Tufts Health Plan
Powered by Destiny Health features the Personal Medical Fund
(PMF) where your employer deposits a fixed annual amount,
subject to your deductible. You decide which services you
pay for with the PMF. Any money left in the account stays
there gaining interest and can be used for future medical
expenses. You have a preset maximum for out-of-pocket expenses,
after which the plan will pay 100% of covered expenses. You
are also rewarded for healthy lifestyles through Destiny Health
with the Vitality program which includes discounts and financial
bonuses.
Navigator by Tufts Health Plan
Is a PPO designed plan whereby you can choose the outpatient
provider you want, whether network or non-network. For in-hospital
services, Navigator groups the network Massachusetts hospitals
into several groups, depending on their quality and costs.
The members can access this information and then choose any
of the hospitals, but will pay lower copayments at hospitals
with higher quality and lower costs for services.
Tufts Health Plan Medicare Preferred
or Medicare + Choice Plan
Includes the Medicare coverages
for eligible Medicare beneficiaries. If you are eligible for
Part A and enrolled in Part B, you receive your routine care
from the contracting providers of the Tufts HMO. There are
additional services and value-added items included also. This
plan is available in only some counties of MA.
Tufts Health Plan Office Location
705 Mt. Auburn Street
Watertown, MA 02471
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