• Medicare Advantage plans are private insurance plans that combine all the coverage of original Medicare plus additional services.
  • Costs and coverage for Medicare Advantage plans vary by plan and where you live
  • Tufts Health Plan offers Medicare Advantage plans to residents of Massachusetts.

Many private insurers offer Medicare Advantage plans that provide flexible healthcare choices for people who are age 65 and older. These programs combine original Medicare coverage with additional programs for added benefits. Plans vary in different states – and even different counties in the same state.

In this article, we’ll review the Medicare Advantage plan options offered by Tufts Health Plan this year.

Tufts Medicare Advantage is a Medicare Part C plan offered by the nonprofit Tufts Health Plan organization.

Tufts offers employer-sponsored and private health insurance plans in Massachusetts, Connecticut, New Hampshire, and Rhode Island. It also offers Medicaid plans in Massachusetts and Rhode Island.

Tufts Medicare Advantage plans are open to Massachusetts residents in many counties throughout the state. Search your ZIP code on Medicare’s plan finder tool to see if Tufts offers plans in your county and how much they will cost.

Tufts offers a few options for those who are eligible for Medicare. These offerings include traditional Medicare Advantage plans, as well as Special Needs Plans for those who are dual eligible for Medicare and Medicaid.

Tufts Medicare Advantage plans are all Health Maintenance Organization (HMO) plans. HMO plans require members to choose from a certain network of providers to ensure more affordable healthcare coverage.

You may still have the option to see providers who are outside of the HMO’s network, but you may have higher costs for these visits.

Tufts Medicare Advantage plans are set up like most Medicare Advantage plans. They cover all the services offered by original Medicare, like hospital and outpatient medical care, plus additional services like prescription drug coverage.

Each plan will include basic Medicare services, including:

Depending on the Tufts Medicare Advantage plan you choose, you may also receive:

The services covered in a particular plan depend on the options you choose. There are lower-premium options for people who don’t use healthcare services very often and higher-premium options with lower copayments for more frequent users.

Tufts Medicare Advantage plans vary in cost based on how much you want to pay in premiums versus copayments and other out-of-pocket costs. Plan availability varies by county, but none of these plans have a medical deductible.

Here are examples of what three plan options offer and what they cost in two different locations:

Costs for Tufts Medicare Advantage plans in Boston (Suffolk County)

PlanMonthly premiumDrug deductiblePrimary doctor copay, specialist copayIn-network out-of-pocket max
Tufts Medicare Preferred HMO Saver Rx (HMO)$0$250$10, $45$7,550
Tufts Medicare Preferred HMO Value No Rx (HMO)$123$10, $25$3,450
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)$235$0$10, $15$3,450

Costs for Tufts Advantage plans in Chatham (Barnstable County)

PlanMonthly premiumDrug deductiblePrimary doctor copay, specialist copayIn-network out-of-pocket max
Tufts Medicare Preferred HMO Saver Rx (HMO)$0$250$10, $45$7,550
Tufts Medicare Preferred HMO Value No Rx (HMO)$103
$10, $25
$3,450
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)$214$0
$10, $15
$3,450

Medicare Advantage (Part C) is a healthcare plan that’s offered through private insurance providers. Part C plans combine original Medicare plans – inpatient care through Medicare Part A and outpatient care through Medicare Part B – to offer at least as much coverage as Medicare. Many of these plans also typically cover prescription drugs (Medicare Part D), dental, vision, and more.

Coverage availability is based on your location and the plans and services you choose to include. Additional coverage and services will cost more, and there may be limitations set by your plan on which providers, services, and products you can choose.

If you’re thinking about signing up for a Medicare Advantage plan, you can compare each plan’s costs and services with Medicare’s online plan comparison tool.

Like other parts of Medicare, there are certain enrollment periods when you can sign up for a Medicare Advantage plan. You first need to enroll in Medicare parts A and B. Then, you will be eligible to enroll in Medicare Advantage during open enrollment periods.

Medicare’s main open enrollment period is from October 15 through December 7. Medicare Advantage open enrollment is from January 1 through March 31.

  • There are many Medicare Advantage plans available that combine original Medicare coverage with additional products and services.
  • Some plans are specific to certain states or even certain counties.
  • Tufts Health Plan offers several Medicare Advantage HMO plans for Massachusetts residents.
  • To choose the right plan for you, weigh the amount of coverage you’ll need against how much you are willing to pay.

This article was updated on November 13, 2020, to reflect 2021 Medicare information.

Healthline

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