Plan Overview

Tufts Medicare Complement is a supplemental Medicare HMO plan that provides coverage through the Plan’s network of doctors, hospitals, and other providers.  Members must select a Primary Care Physician (PCP) to manage their care, and obtain referrals to specialists. 

Contact the plan to see if your doctors and hospitals are in  the network.   There are no out-of-network benefits, with the exception of emergency care. 

Effective July 1, 2017, members will be automatically enrolled in Medicare Part D as the prescription drug benefit of this plan transitions to an Employer Group Waiver Plan (EGWP) under contract with the federal government along with extra coverage from the GIC.  The program will be administered by SilverScript.  See the benefit change section for details.

Your Responsibility

Do your doctors and hospitals participate in Tufts Medicare Complement?

Contact the plan.

Plan Contact Information

Medical Benefits

Tufts Health Plan Medicare Complement 1.888.333.0880

Prescription Drug Benefits
SilverScript

1.877.876.7214 TDD: 1-800-238-0756

Copays Effective July 1, 2017

Preventive Services

Covered at 100% - no copay

Physician Office Visit 
$15 per visit

Retail Clinic

$15 per visit

Outpatient Behavioral Health and Substance Use Disorder Care

$15 per visit

Inpatient Hospital Care

Covered at 100% - no copay

Inpatient and Outpatient Surgery
Covered at 100% - no copay

Emergency Room
$50 per visit (waived if admitted)

Prescription Drug

Retail up to 30-day supply:                   Mail Order up to 90 day supply:
Tier 1:   $10                                         Tier 1:   $25
Tier 2:   $30                                         Tier 2:   $75
Tier 3:   $65                                         Tier 3:   $165

Who is Eligible?

Retirees, GIC Retired Municipal Teachers (RMTs), Elderly Governmental Retirees (EGRs), Survivors, and their eligible dependents with Medicare Part A and Part B are eligible.

Where You Live Determines Which Plan You May Enroll In:

Tufts Health Plan Medicare Complement is available throughout Massachusetts.

The plan is also available in the following other state:

Rhode Island

Tufts Health Plan Medicare Complement is available only in certain parts of the following states; contact the plan to find out if you live in the service area:

Connecticut, New Hampshire, New York, Vermont

FY17 Tufts Medicare Complement Evidence of Coverage  doc format of FY17 Tufts Medicare Complement Evidence of Coverage 
file size 2MB

FY17 Tufts Medicare Complement Evidence of Coverage  pdf format of FY17 Tufts Medicare Complement Evidence of Coverage 
file size 1MB


This information provided by the Group Insurance Commission .