GIC Medicare Health Plan Options

Tufts Health Plan Medicare Preferred
Eligibility
Plan Contact Information
Plan Service Area

Plan Overview
Tufts Health Plan Medicare Preferred is a Medicare Advantage 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 care.  Tufts Health Plan Medicare Preferred HMO is a Medicare Advantage plan under contract with the federal government that includes Medicare Part D prescription drug benefits.  Contact the plan for details and to see if your provider is in the network.  This Medicare plan’s benefits and rates are subject to change January 1, 2009.


Benefits Effective January 1, 2008

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: $10                                                Tier 1: $20
Tier 2: $20                                                Tier 2: $40
Tier 3: $40                                                Tier 3: $80

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 Preferred is available in the following Massachusetts counties:
Barnstable, Essex, Hampden, Hampshire, Middlesex, Norfolk, Suffolk, Worcester

Tufts Health Plan Medicare Preferred  is partially available in the following Massachusetts counties:    Bristol, Plymouth           
The plan may not be available in every city and town in these counties.  Contact the plan for details.
                    
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 Preferred
1.888.333.0880