Tufts Health Plan offers Tufts Medicare Preferred's Preferred Provider Organization (PPO), an option for individuals with Medicare coverage looking for both provider choice and comprehensive healthcare coverage.
With Tufts Medicare Preferred PPO you don't need to choose a primary care physician (PCP), and you don't need to obtain any referrals. Tufts Medicare Preferred PPO has a network of plan providers. These providers include doctors, other healthcare professionals, hospitals and healthcare facilities that are licensed by the State to provide healthcare services, and participate with Medicare. Your out-of-pocket costs will be less if you receive care from a plan provider, rather than a non-plan provider. You may still obtain services from a non-plan provider who accepts Medicare. However, with the exception of Emergency and Urgent Care, your co-payments and other out-of-pocket costs will be higher.
Click on Step 1 to Select Your Medical Plan.
• Medical Coverage
• Prescription Drug Coverage Available
• Doctor and Hospital Network
• Who is eligible for Tufts Health Plan Medicare Preferred PPO?
• Plan Service Area
Medical Coverage
In addition to freedom of provider choice, Tufts Medicare Preferred PPO can offer you even more comprehensive medical coverage than Original Medicare alone. With Tufts Medicare Preferred PPO, you get*:
- Annual physical exams
- Routine eye and hearing exams
- Vision care and eyeglasses allowance
- Unlimited medically necessary hospitalization
- Emergency care anywhere in the world
- Medicare prescription drug options
*Co-payments, deductibles, and limitations apply.
Prescription Drug Coverage Available
With Tufts Medicare Preferred PPO, you have the option to receive medical coverage only, or you can add Medicare Part D prescription drug coverage. You may choose from two prescription drug options, Rx and Rx Plus. With Tufts Medicare Preferred PPO, you can choose to have both medical and prescription drug coverage in one plan.
Doctor and Hospital Network
A PPO plan also includes a network of doctors, specialists and hospitals. Members in a PPO plan are not required to see doctors within our network. Seeing doctors within the network will generally cost less than seeing doctors outside of the network.
If you use doctors, specialists and hospitals that are not on the PPO list, you will pay higher copayments and deductibles. The choice is yours.
Who is eligible for Tufts Health Plan Medicare Preferred PPO?
To join this plan, you must:
- Be eligible for Medicare on the basis of age or disability.
- Be entitled to Medicare benefits under Part A and enrolled in Part B.
- Continue to pay Medicare Part B premiums, if not otherwise paid for under Medicaid or by another third party.
- Live in the Tufts Medicare Preferred PPO Service Area.
- Not currently have End-Stage Renal Disease (ESRD).
NOTE: If you do not need regular dialysis, or have had a successful kidney transplant, you are eligible by supplying a doctor's note or record with your enrollment form.
Plan Service Area
To join Tufts Medicare Preferred PPO, you must live in Barnstable, Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, or Worcester county.
H2229-2009-15 9/30/08
