• 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 location.
  • Tufts Health Plan offers its own Medicare Advantage products to residents of Massachusetts.

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

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

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

Tufts Health Plan 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.

The Tufts Health Plan Medicare Advantage plan is only open to Massachusetts residents living in the following counties:

  • Barnstable
  • Bristol
  • Essex
  • Hampden
  • Hampshire
  • Middlesex
  • Norfolk
  • Plymouth
  • Suffolk
  • Worcester

Tufts offers a few options for those who are eligible for Medicare. These plans include several Medicare Advantage options, Medicare supplement (Medigap) plans, Special Needs Plans, and dually eligible plans.

Tufts’ Medicare Advantage plans only include Health Maintenance Organization (HMO) plans. HMO plans restrict members to 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 offers a few options for Medicare Advantage coverage under its HMO plans. If you don’t expect frequent doctor visits, a plan with a low monthly premium and higher copays might be right for you. These plans include:

  • HMO Saver Rx
  • HMO Basic No Rx
  • HMO Basic Rx

However, if you expect to visit the doctor often, a plan with a higher premium and lower copay costs may be your best option. These plan options include:

  • HMO Value No Rx
  • HMO Value Rx
  • HMO Prime No Rx
  • HMO Prime Rx
  • HMO Prime Rx Plus

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.

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.

Each plan will include basic Medicare services, including:

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

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. Monthly premiums range from $0 to $220 per month, with out-of pocket maximums of $3,400 to $6,700 per year.

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)

PlanPremiumCopay for prescription drugsMax
out of pocket
Extra coverage offered
Preferred HMO Saver Rx Plan$0 per monthUp to $300 depending on tier$6,700$17 per month dental
Preferred HMO Value No Rx Plan$123 per monthNA
$3,400
$30 per month dental
Preferred HMO Prime Rx Plus Plan$220 per monthUp to $300 depending on tier
$3,400
$30 per month dental

Costs for Tufts Advantage plans in Chatham (Barnstable County)

PlanPremiumCopay for prescription drugsMax
out of pocket
Extra coverage offered
Preferred HMO Saver Rx Plan$0 per monthUp to $300 depending on tier$6,700$17 per month dental
Preferred HMO Value No Rx Plan$103 per monthNA
$3,400
$30 per month dental
Preferred HMO Prime Rx Plus Plan$199 per monthUp to $300 depending on tier
$3,400
$30 per month dental

Medicare Part C, or Medicare Advantage, 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, plus prescription coverage (Medicare Part D), dental coverage, 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 an online 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.
  • In order to choose the right plan for you, weigh the amount of coverage you’ll need against how much you are willing to pay.