2006 V.1

AVAILABLE IN MASSACHUSETTS HMO (Health Maintenance Organization) Members of the Tufts Health Plan HMO (health maintenance organization) receive coverage for routine and preventive care services with little or no paperwork such as bills or claim forms. Care is typically covered in full after a small co-payment. The HMO plans are available to the self-employed and small business owner. Tufts Health plan utilizes a network of over 18,000 Massachusetts physicians with access to more than 80 hospitals. PPO (Preferred Provider Organization) As part of providing a wide range of plan options Tufts now offers Advantage PPO option to employer groups. PPOs offer coverage with the added advantage of gaining services without a gatekeeper. Premium savings are available due to in and out of network deductibles and co-payments. RETIREE HEALTH PLANS Three plans are available to group retirees and working employees that have attained age 65. TUFTS HEALTH PLAN MEDICARE PREFERRED HMO This is a Medicare Advantage Plan for people who are entitled to Medicare or are already enrolled in Medicare. Members of THP Medicare Preferred HMO have access to over 3,500 physicians including 600 Primary Care. The plan includes unlimited prescription drug coverage with only small-tiered co-payments. TUFTS HEALTH PLAN MEDICARE PREFERRED PPO This is a Medicare Advantage Plan for people who are entitled to Medicare or are already enrolled in Medicare. Members of THP Medicare Preferred PPO have access to over 5,000 physicians including 1,000 Primary Care. The plan includes unlimited prescription drug coverage with only small-tiered co-payments. It also allows access to any Medicare participating doctor in the United States. Higher co-payments are charged for non-contracted providers. TUFTS MEDICARE COMPLEMENT(TMC) TMC is not a Medicare Advantage Plan. Members may be retirees of an employer group, or still actively working, provided the employer has less than 20 employees. Members have access to over 20,000 physicians including 8500 Primary Care. Members may choose unlimited prescription drug coverage or no prescription drug coverage. EMERGENCY CARE Members are always covered for care in a serious medical emergency. Members should receive treatment at the nearest emergency facility, call 911 or another local emergency number. WORLDWIDE COVERAGE If traveling and in need of immediate care, members go to the nearest medical facility. Tufts Health Plan covers any unexpected or unforeseen care needed when traveling outside of the service area. Click here to go to the Tufts Health Plan Web Site