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Tufts Medicare Preferred HMO Value No Rx (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Tufts Medicare Preferred HMO Value No Rx (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Tufts Medicare Preferred HMO Value No Rx (HMO) in 2026, please refer to our full plan details page.
Tufts Medicare Preferred HMO Value No Rx (HMO) is a HMO plan offered by Point32Health, Inc. available for enrollment in 2025 to people living in Most of Massachusetts. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Tufts Medicare Preferred HMO Value No Rx (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Tufts Medicare Preferred HMO Value No Rx (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Tufts Medicare Preferred HMO Value No Rx (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3850.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by Tufts Medicare Preferred HMO Value No Rx (HMO).
Additional Benefits
The Tufts Medicare Preferred HMO Value No Rx (HMO) plan offers affordable coverage with predictable copays and no coinsurance for many core services. Routine medical care is highly accessible, featuring a $10 copay for primary care visits, a $25 copay for specialists, and no copay for annual physicals. If you require hospital care, inpatient stays carry a $200 daily copay for days one through five with no copay for remaining days, while emergency room visits require a $125 copay. Supplemental benefits such as dental, vision, and hearing services are partially covered, offering low exam copays and a $150 annual eyewear benefit with no copay or coinsurance. While many services like home health care and lab tests have no copay and no coinsurance, some medical needs require coinsurance, such as 10% for durable medical equipment and 20% for dialysis. Additionally, the plan covers unlimited acupuncture and approved transportation services with no copay.
Inpatient Hospital See details
Tufts Medicare Preferred HMO Value No Rx (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $200 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Tufts Medicare Preferred HMO Value No Rx (HMO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Covered outpatient hospital services require a copay of $0 to $150, while outpatient substance abuse sessions have a $20 copay and observation services carry a $150 copay per stay.
Partial Hospitalization See details
Partial hospitalization is fully covered under the Tufts Medicare Preferred HMO Value No Rx (HMO) plan. Members will pay no copay and no coinsurance for these covered services.
Ambulance and Transportation Services See details
Tufts Medicare Preferred HMO Value No Rx (HMO) covers ground and air ambulance services with a $225 copay and no coinsurance. Transportation services are partially covered with no copay and no coinsurance for unlimited rides to plan-approved health-related locations, while transportation to any health-related location is not covered.
Emergency Services See details
Tufts Medicare Preferred HMO Value No Rx (HMO) covers emergency services with a $125 copay and no coinsurance, with the copay waived if you are admitted to the hospital within one day. Urgently needed services have a $30 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $125, $30, and $225 respectively.
Primary Care See details
Tufts Medicare Preferred HMO Value No Rx (HMO) offers primary care physician visits for a $10 copay and specialist visits for a $25 copay, with no coinsurance for either service. Additional benefits like physical therapy, mental health, and telehealth are covered with no coinsurance and copays ranging from no copay up to $150, though chiropractic services are only partially covered and podiatry is not covered.
Preventive Services See details
Preventive services are partially covered under the Tufts Medicare Preferred HMO Value No Rx (HMO), featuring no copay and no coinsurance for annual physicals and kidney disease education, while home safety devices require a 10% coinsurance and post-welcome visit EKGs require a $10 copay with no coinsurance. Excluded sub-services that are not covered include personal emergency response systems, post-discharge medication reconciliation, readmission prevention, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by Tufts Medicare Preferred HMO Value No Rx (HMO), which features a $25 copay and no coinsurance for annual routine exams and fittings. Covered prescription hearing aids require a copay between $250 and $1,150 with no coinsurance, but OTC, inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Tufts Medicare Preferred HMO Value No Rx (HMO) partially covers vision services with no deductible, featuring a $15 to $25 copay and no coinsurance for covered eye exams, though other eye exam services are not covered. Eyewear is covered with no deductible, no copay, and no coinsurance, offering a $150 annual maximum benefit for contacts, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by Tufts Medicare Preferred HMO Value No Rx (HMO) up to a $1,000 annual maximum, with a $25 copay and no coinsurance for Medicare-covered dental. Other covered preventive and restorative services feature no copay and no coinsurance to 50% coinsurance, while fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled services are partially covered by Tufts Medicare Preferred HMO Value No Rx (HMO) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs are covered with no copay and no coinsurance, while Medicare Part B chemotherapy or radiation drugs and other Part B drugs are not covered.
Dialysis Services See details
Dialysis services are covered under the Tufts Medicare Preferred HMO Value No Rx (HMO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Tufts Medicare Preferred HMO Value No Rx (HMO) with no copays, featuring a 10% coinsurance for durable medical equipment and prosthetics, and 0% to 10% coinsurance for medical supplies. Diabetic equipment is covered with no coinsurance, but diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by the Tufts Medicare Preferred HMO Value No Rx (HMO) plan, featuring no coinsurance and requiring prior authorization for all covered services. Diagnostic procedures and tests carry a $10 to $30 copay, outpatient X-rays require a $10 copay, and diagnostic radiological services have a minimum $100 copay, whereas lab services have no copay and therapeutic radiological services are not covered.
Home Health Services See details
Tufts Medicare Preferred HMO Value No Rx (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Tufts Medicare Preferred HMO Value No Rx (HMO) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, subject to prior authorization and referral requirements. However, specific services including Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Tufts Medicare Preferred HMO Value No Rx (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copay for days 1-20, a $120 daily copay for days 21-44, and no copay for days 45-100. Prior authorization is required, a prior 3-day hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered under the Tufts Medicare Preferred HMO Value No Rx (HMO), which features unlimited acupuncture treatments with no copay and no coinsurance. Over-the-counter (OTC) items and meal benefits are not covered.
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