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GIC Medicare Health Plan Options
Tufts Health Plan Medicare Complement
Eligibility
Plan Contact Information
Plan Service Area
Plan Overview
Tufts Medicare Complement is a supplemental Medicare HMO plan that requires members to select a Primary Care Physician (PCP) to manage their care. With an HMO, you receive care through the Plan’s network of doctors, hospitals, and other providers. There are no out-of-network benefits, with the exception of emergency and urgent care. Contact the plan to see if your provider is in the network.
Benefits
Physician Office Visit and Preventive Care
100% after $10 per visit
Outpatient Mental Health and Substance Abuse Care
100% after $10 per visit
Inpatient Hospital Care
100%
Inpatient and Outpatient Surgery
100%
:
Emergency Room
100% after $50 co-pay per visit (waived if admitted)
Prescription Drug Co-payments
Retail up to 30-day supply: Mail Order up to 90-day supply:
Tier 1: $8 Tier 1: $16
Tier 2: $20 Tier 2: $40
Tier 3: $35 Tier 3: $70
Eligibility
Retirees, Retired Municipal Teachers (RMTs), Elderly Governmental Retirees (EGRs), survivors, and their eligible dependents with Medicare Part A and Part B are eligible. Members must live in the plan’s service area.
Service Area
Tufts Health Plan Medicare Complement is available in the following Massachusetts counties:
Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire,
Middlesex, Norfolk, Plymouth, Suffolk, Worcester
Tufts Medicare Complement is also available in the following other states:
Connecticut, New Hampshire, New York, Rhode Island, Vermont
Coverage may not be available in every city and town in these states, so contact the plan for more specific
coverage information.
Monthly Rates as of July 1, 2008
Plan Contact Information
Contact the plan for additional information on participating providers and benefits.
Tufts Health Plan Medicare Complement
1.800.333.0880
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