A non-government entity
Tufts Health Plan
Plan ID: H2256-16-1
Plan Summary PageTufts Medicare Preferred HMO Prime No Rx (HMO)
2027 Tufts Medicare Preferred HMO Prime No Rx (HMO) H2256 — 016 — 1 is a Medicare Advantage plan . It has received a 4-out-of-5 star rating from CMS for 2027.
Learn more about Tufts Medicare Preferred HMO Prime No Rx (HMO) H2256 - 016 - 1, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.
4 / 5 stars for 2027
$0.00 /mo
Monthly premium
$3850.00
Out-of-pocket maximum (In-Network)
Enroll online
Call to enroll
OR
Get personalized help from a licensed insurance agent
1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Plan Overview
2027 Tufts Medicare Preferred HMO Prime No Rx (HMO) H2256 — 016 — 1 is a HMO offered in Most of Massachusetts by Tufts Associated Health Maintenance Organization. It has a monthly premium of $186.00.
Premium Breakdown
Monthly plan premium
$186.00
Standard Part B premium (estimated)
$209.50
Note:
CMS has not yet announced the official 2027 standard Medicare Part B premium. The estimated 2027 premium is $209.50, per the 2026 Medicare Trustees Report; we'll update this page when CMS publishes the final amount. Your actual Part B premium may differ based on income (IRMAA), late enrollment penalties, Medicaid assistance, disability status, or other factors. Most people enrolled in Medicare Part B are required to pay this premium.
Special needs plan type
No
Out-of-pocket maximum (In-Network)
$3850.00
Plan Organization:
Tufts Associated Health Maintenance Organization
Parent Company:
Point32Health, Inc.
Plan Type:
HMO
Location:
Most of Massachusetts
Drugs Covered:
No
Drug Formulary:
Pharmacies:
Doctors Link:
Deductibles
The amount you must pay each year before your plan starts to pay for covered services.
Sign up for Tufts Medicare Preferred HMO Prime No Rx (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
Tufts Medicare Preferred HMO Prime No Rx (HMO) does not provide drug coverage. If drug coverage is something you need, you should consider shopping for other plans that do provide cost sharing on drugs.
Additional Benefits
Tufts Medicare Preferred HMO Prime No Rx (HMO) also provides the following benefits.
Inpatient Hospital
Inpatient Hospital benefits are covered.
Inpatient Hospital-Acute
Inpatient Hospital-Acute benefits are covered.
Cost Sharing:
More Details:
Copayment for Medicare-covered stay
300.00
Additional Days for Inpatient Hospital-Acute
Not covered.
Non-Medicare-covered Stay for Inpatient Hospital-Acute
Not covered.
Upgrades for Inpatient Hospital-Acute
Not covered.
Inpatient Hospital Psychiatric
Inpatient Hospital Psychiatric benefits are covered.
Cost Sharing:
More Details:
Copayment for Medicare-covered stay
300.00
Additional Days for Inpatient Hospital Psychiatric
Not covered.
Non-Medicare-covered Stay for Inpatient Hospital Psychiatric
Not covered.
Outpatient Services
Outpatient Services benefits are covered.
All Outpatient Hospital Services
All Outpatient Hospital Services benefits are covered.
Outpatient Hospital Services
Outpatient Hospital Services benefits are covered.
Cost Sharing:
Observation Services
Observation Services benefits are covered.
Cost Sharing:
Ambulatory Surgical Center (ASC) Services
Ambulatory Surgical Center (ASC) Services benefits are covered.
Cost Sharing:
Outpatient Substance Abuse Services
Not covered.
Individual Sessions for Outpatient Substance Abuse
Individual Sessions for Outpatient Substance Abuse benefits are covered.
More Details:
Minimum copayment
10.00
Maximum copayment
10.00
Group Sessions for Outpatient Substance Abuse
Group Sessions for Outpatient Substance Abuse benefits are covered.
More Details:
Minimum copayment
10.00
Maximum copayment
10.00
Outpatient Blood Services
Not covered.
Partial Hospitalization
Partial Hospitalization benefits are covered.
Partial Hospitalization
Partial Hospitalization benefits are covered.
Cost Sharing:
Partial Hospitalization
Partial Hospitalization benefits are covered.
Cost Sharing:
Ambulance and Transportation Services
Ambulance and Transportation Services benefits are covered.
All Ambulance Services
All Ambulance Services benefits are covered.
Ground Ambulance Services
Ground Ambulance Services benefits are covered.
Cost Sharing:
Air Ambulance Services
Air Ambulance Services benefits are covered.
Cost Sharing:
Transportation Services
Not covered.
Transportation Services - Plan Approved Health-related Location
Not covered.
Transportation Services - Any Health-related Location
Not covered.
Emergency Services
Emergency Services benefits are covered.
Emergency Services
Emergency Services benefits are covered.
Cost Sharing:
More Details:
Enter number of days or hours
1
Urgently Needed Services
Urgently Needed Services benefits are covered.
Cost Sharing:
Worldwide Emergency Services
Not covered.
Worldwide Emergency Coverage
Worldwide Emergency Coverage benefits are covered.
Cost Sharing:
Worldwide Urgent Coverage
Worldwide Urgent Coverage benefits are covered.
Cost Sharing:
Worldwide Emergency Transportation
Worldwide Emergency Transportation benefits are covered.
Cost Sharing:
Primary Care
Primary Care benefits are covered.
Primary Care Physician Services
Primary Care Physician Services benefits are covered.
Cost Sharing:
Chiropractic Services
Chiropractic Services benefits are covered.
Cost Sharing:
Routine Chiropractic Care
Not covered.
Other Chiropractic Services
Other Chiropractic Services benefits are covered.
Cost Sharing:
More Details:
Visits
1
Service Name
Initial Chiropractic Evaluation
Occupational Therapy Services
Occupational Therapy Services benefits are covered.
Cost Sharing:
Physician Specialist Services
Physician Specialist Services benefits are covered.
Cost Sharing:
Mental Health Specialty Services
Not covered.
Individual Sessions for Mental Health Specialty Services
Individual Sessions for Mental Health Specialty Services benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
10.00
Group Sessions for Mental Health Specialty Services
Group Sessions for Mental Health Specialty Services benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
10.00
Podiatry Services
Podiatry Services benefits are covered.
More Details:
Minimum copayment
15.00
Maximum copayment
15.00
Other Health Care Professional
Other Health Care Professional benefits are covered.
More Details:
Minimum copayment
10.00
Maximum copayment
20.00
Psychiatric Services
Not covered.
Individual Sessions for Psychiatric Services
Individual Sessions for Psychiatric Services benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
10.00
Group Sessions for Psychiatric Services
Group Sessions for Psychiatric Services benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
10.00
Physical Therapy and Speech-Language Pathology Services
Physical Therapy and Speech-Language Pathology Services benefits are covered.
Cost Sharing:
Additional Telehealth Benefits
Additional Telehealth Benefits benefits are covered.
Cost Sharing:
Opioid Treatment Program Services
Opioid Treatment Program Services benefits are covered.
More Details:
Minimum copayment
15.00
Maximum copayment
15.00
Preventive Services
Preventive Services benefits are covered.
Medicare-covered Zero Dollar Preventive Services
Medicare-covered Zero Dollar Preventive Services benefits are covered.
Annual Physical Exam
Not covered.
Additional Preventive Services
Not covered.
Health Education
Not covered.
In-Home Safety Assessment
Not covered.
Personal Emergency Response System (PERS)
Not covered.
Medical Nutrition Therapy (MNT)
Medical Nutrition Therapy (MNT) benefits are covered.
More Details:
Numerical limit
3
Post discharge In-Home Medication Reconciliation
Not covered.
Re-admission Prevention
Not covered.
Wigs for Hair Loss Related to Chemotherapy
Wigs for Hair Loss Related to Chemotherapy benefits are covered.
More Details:
Maximum plan benefit coverage amount
500.00
Weight Management Programs
Weight Management Programs benefits are covered.
More Details:
Maximum plan benefit coverage amount
150.00
Alternative Therapies
Not covered.
Therapeutic Massage
Not covered.
Adult Day Health Services
Not covered.
Nutritional/Dietary Benefit
Not covered.
Home-Based Palliative Care
Not covered.
In-Home Support Services
Not covered.
Support for Caregivers of Enrollees
Not covered.
Additional Sessions of Smoking and Tobacco Cessation Counseling
Not covered.
Fitness Benefit
Not covered.
Enhanced Disease Management
Not covered.
Telemonitoring Services
Not covered.
Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline)
Not covered.
Home and Bathroom Safety Devices and Modifications
Home and Bathroom Safety Devices and Modifications benefits are covered.
More Details:
Minimum coinsurance
10
Maximum coinsurance
10
Counseling Services
Not covered.
Kidney Disease Education Services
Not covered.
Other Preventive Services
Other Preventive Services benefits are covered.
Glaucoma Screening
Not covered.
Diabetes Self-Management Training
Not covered.
Digital Rectal Exams
Not covered.
EKG following Welcome Visit
Not covered.
Hearing Services
Hearing Services benefits are covered.
Hearing Exams
Hearing Exams benefits are covered.
Cost Sharing:
Routine Hearing Exams
Routine Hearing Exams benefits are covered.
More Details:
Number of visits
1
Fitting/Evaluation for Hearing Aid
Fitting/Evaluation for Hearing Aid benefits are covered.
More Details:
Number of visits
1
Prescription Hearing Aids
Not covered.
Prescription Hearing Aids (all types)
Prescription Hearing Aids (all types) benefits are covered.
More Details:
Quantity for Hearing Aids
2
Minimum copayment
250.00
Maximum copayment
1150.00
Prescription Hearing Aids - Inner Ear
Not covered.
Prescription Hearing Aids - Outer Ear
Not covered.
Prescription Hearing Aids - Over the Ear
Not covered.
OTC Hearing Aids
Not covered.
Vision Services
Vision Services benefits are covered.
Eye Exams
Eye Exams benefits are covered.
Cost Sharing:
Routine Eye Exams
Routine Eye Exams benefits are covered.
Cost Sharing:
More Details:
Number of visits
1
Eyewear
Eyewear benefits are covered.
More Details:
Combined maximum amount
150.00
Contact Lenses
Not covered.
Eyeglasses (lenses and frames)
Not covered.
Eyeglass lenses
Not covered.
Eyeglass frames
Not covered.
Upgrades
Not covered.
Dental Services
Dental Services benefits are covered.
Medicare Dental Services
Medicare Dental Services benefits are covered.
Cost Sharing:
Orthodontic Services
Not covered.
Restorative Services
Not covered.
Adjunctive General Services
Not covered.
Endodontics
Not covered.
Periodontics
Not covered.
Prosthodontics, removable
Not covered.
Maxillofacial Prosthetics
Not covered.
Implant Services
Not covered.
Prosthodontics, fixed
Not covered.
Oral and Maxillofacial Surgery
Not covered.
Orthodontics
Not covered.
Home Infusion bundled Services
Not covered.
Dialysis Services
Dialysis Services benefits are covered.
More Details:
Minimum coinsurance
20
Maximum coinsurance
20
Medical Equipment
Medical Equipment benefits are covered.
Durable Medical Equipment (DME)
Durable Medical Equipment (DME) benefits are covered.
More Details:
Minimum coinsurance
10
Maximum coinsurance
10
Prosthetics/Medical Supplies - Non-Medicare benefit
Not covered.
Prosthetic Devices
Prosthetic Devices benefits are covered.
More Details:
Minimum coinsurance
10
Maximum coinsurance
10
Medical Supplies
Medical Supplies benefits are covered.
Cost Sharing:
Diabetic Equipment
Not covered.
Diabetic Supplies
Not covered.
Diabetic Therapeutic Shoes/Inserts
Not covered.
Diabetic Equipment
Not covered.
Diagnostic and Radiological Services
Diagnostic and Radiological Services benefits are covered.
All Diagnostic services
Not covered.
Diagnostic Procedures/Tests
Diagnostic Procedures/Tests benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
30.00
Lab Services
Lab Services benefits are covered.
Cost Sharing:
All Radiological Services
All Radiological Services benefits are covered.
Cost Sharing:
More Details:
Description
Per Day
Diagnostic Radiological Services
Diagnostic Radiological Services benefits are covered.
Cost Sharing:
More Details:
Minimum coinsurance
20
Therapeutic Radiological Services
Not covered.
Outpatient X-Ray Services
Outpatient X-Ray Services benefits are covered.
Cost Sharing:
Home Health Services
Not covered.
Cardiac Rehabilitation Services
Not covered.
Skilled Nursing Facility (SNF)
Skilled Nursing Facility (SNF) benefits are covered.
| Days 1-20: | Days 21-44: | Days 45-100: | |
|---|---|---|---|
| Copayment | 0.00 | 110.00 | 0.00 |
Additional Days beyond Medicare-covered for Skilled Nursing Facility (SNF)
Not covered.
Other Services
Other Services benefits are covered.
Acupuncture
Not covered.
Over-the-Counter (OTC) Items
Not covered.
Meal Benefit
Not covered.
Dual Eligible SNPs with Highly Integrated Services
Not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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