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Sunday, March 29, 2015  
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Tufts Health Plan

Are you over 65?
Yes   No

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.

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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

Are you over 65?
Yes   No is not associated with Medicare or the Center for Medicare and Medicaid Services. The Center for Medicare and Medicaid Services has neither reviewed nor endorses this information. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult

A Medicare Advantage plan is a health plan provided through a private insurer and delivering Medicare Part A and Part B benefits. A Part D Drug plan is a prescription drug plan provided through a private insurer and delivering Medicare Part D benefits. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the “gaps” in original Medicare coverage. The sales agent that will be discussing plan options with you is either employed or contracted by an agency that sells Medicare plans, a Medicare health plan, or a Medicare prescription drug plan that is not the Federal government. Submitting our form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement plan or other Medicare plans.

Individual-Health-Plans is not a licensed insurer or agency. We provide free information about insurance companies, products and services; we make no representation, express or implied, of any sponsorship by or any other relationship with any company on this site. Products and services may not be available in all states and no guarantees regarding same are made herein. Quotes are provided through insurance brokers, agents, or other representatives who may or may not be able to obtain quotes from any particular company. We make no representation, express or implied, that a user will be able to obtain an insurance quote from any particular insurance company profiled on this site.

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