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Tufts Medicare Preferred HMO Saver Rx (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Tufts Medicare Preferred HMO Saver 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 Saver Rx (HMO) in 2025, please refer to our full plan details page.
Tufts Medicare Preferred HMO Saver 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 2025.
It's important to know that Tufts Medicare Preferred HMO Saver Rx (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Tufts Medicare Preferred HMO Saver 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 Saver 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.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7550.00 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
The Tufts Medicare Preferred HMO Saver Rx (HMO) plan has an enhanced alternative drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay a $6 copay for preferred generic drugs at preferred pharmacies, and 23% coinsurance for standard generic drugs. For preferred brand drugs you will pay 50% coinsurance. Specialty tier drugs have no copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Tufts Medicare Preferred HMO Saver Rx (HMO) plan offers comprehensive coverage with varying costs for different services. Inpatient hospital stays have a $350 copay for the first five days, and then no copay for the rest of the stay, and outpatient services have copays ranging from $0 to $370. Emergency services have a $110 copay, and primary care visits have a $5 copay, with specialist visits at $40. Preventive services are covered with no copay, and the plan also includes coverage for hearing, vision, and dental services, with copays and coinsurance varying by service. Additional benefits include coverage for ambulance, transportation, and home health services. Other covered services include acupuncture, over-the-counter items, and medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $350 for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital Psychiatric are not covered, and Non-Medicare-covered stay and Upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $370, observation services with a $370 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $25 copay for both individual and group sessions, and outpatient blood services. Prior authorization and a doctor referral are required for some services.
Partial Hospitalization See details
Partial Hospitalization benefits are covered under the Tufts Medicare Preferred HMO Saver Rx (HMO) plan. There is no copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $350 copay for both ground and air ambulance services, and no coinsurance. Transportation services to a plan-approved health-related location are covered, while transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, Urgently Needed Services have a $45 copay, and Worldwide Emergency Services have a copay that varies depending on the service.
Primary Care See details
Under the Tufts Medicare Preferred HMO Saver Rx (HMO) plan, primary care physician services have a $5 copay, and chiropractic services have a $15 copay, but routine chiropractic care is not covered. Occupational therapy services have a $30 copay, physician specialist services have a $40 copay, and physical therapy and speech-language pathology services have a $30 copay. Mental health and psychiatric services have a $0-$25 copay for individual and group sessions, and other health care professional services have a $5-$40 copay. Additional telehealth benefits have a $0-$370 copay, and opioid treatment program services have a $25 copay.
Preventive Services See details
The Tufts Medicare Preferred HMO Saver Rx (HMO) plan covers a variety of preventive services, including no copay for Medicare-covered services, annual physical exams, health education, and more. The plan does not cover Personal Emergency Response Systems (PERS), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Counseling Services, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, and Support for Caregivers of Enrollees.
Hearing Services See details
The Tufts Medicare Preferred HMO Saver Rx (HMO) plan covers hearing exams with a $40 copay, routine hearing exams, and fitting/evaluation for hearing aids. Prescription hearing aids are covered with a copay between $250 and $1150, while inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are also covered.
Vision Services See details
Vision services include eye exams and eyewear benefits. Eye exams have a copay of $15 to $40, and routine eye exams have a copay of $15. Eyewear has a combined maximum benefit of $250 per year.
Dental Services See details
Dental services include coverage for Medicare dental services with a $40 copay, oral exams with a 0-50% coinsurance, dental x-rays with a 0-50% coinsurance, and prophylaxis (cleaning), with other services like fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics not covered. Restorative services, adjunctive general services, periodontics, and oral and maxillofacial surgery are covered with 50% coinsurance, and endodontics, prosthodontics (removable and fixed) are available as optional, supplemental benefits. There is a $1,000 maximum benefit per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Tufts Medicare Preferred HMO Saver Rx (HMO) plan. You will pay a 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance, but Durable Medical Equipment for use outside the home is not covered; there is no copay for these services. Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $5 and $45, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at least $100, and Therapeutic Radiological Services have a copay of $60, while Outpatient X-Ray Services have a $5 copay.
Home Health Services See details
Home Health Services are covered by the Tufts Medicare Preferred HMO Saver Rx (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Tufts Medicare Preferred HMO Saver Rx (HMO) plan, but require prior authorization. For days 1-20, there is no copay, for days 21-44, there is a $180 copay, and for days 45-100, there is no copay. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Tufts Medicare Preferred HMO Saver Rx (HMO) plan covers acupuncture with no copay, and covers over-the-counter (OTC) items up to $160 every three months, including nicotine replacement therapy and naloxone. The plan also offers a meal benefit for a chronic illness, and covers medical stockings and sleeves with 20% coinsurance. This plan does not cover Dual Eligible SNPs with Highly Integrated Services, and many other services like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), and others.
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