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Insurances Accepted

There are many different types of health insurance and each insurance company may offer multiple different plans to hundreds of employers and their employees.  For this reason, it is very important that you understand the unique components of your plan and ask your health plan or employer what care and services they will cover and what they expect you to pay for directly. The best way to reach your insurer is typically the member services number on your insurance card.

Below, we’ve listed the health insurance plans and products that are accepted at Tufts Medical Center. If your health insurance company or plan is not listed, please contact your health insurance provider to better understand your benefit plan and provider network available to you.

Many insurance plans have different levels of costs for their members depending on where they receive care. The information below can be used as a reference but you should check with your plan to see what level of coverage you will receive for any care provided by Tufts Medical Center. It is also important to check with your insurance plan to see if you need additional referrals and/or authorizations before getting care at Tufts MC.

The level of coverage you receive is determined by your health insurance provider. Some health insurance companies may use other companies to cover certain services such as mental health or transplant-related services.  Some services may not be covered by your insurance plan. Again, it is very important that you ask your health insurance provider or employer what care and services they will cover and what they expect you to pay for directly. 

Insurance Payer

Plans Accepted

Aetna

  • All Commercial Plans
  • Medicare Advantage PPO
  • Medicare Supplemental (i.e. Medex) -- (if patient has Medicare as primary)

Blue Cross Blue Shield of Massachusetts

  • All Massachusetts Plans
  • Medicare Advantage

Blue Cross Blue Shield -- Out of State

 

  • PPO
  • BCBSMA has a reciprocal relationship with other states' BCBS PPO Plans.  Verify details of benefit plan for patients with out-of-state BCBS HMO/POS to determine if Tufts MC and PO are in network.

BMC HealthNet

  • Medicaid MCO
  • ConnectorCare/QHP Silver
  • Senior Care Option (SCO)

    ACO Plans:
  • Community Alliance (Health Centers and other providers)
  • Mercy Alliance (Springfield)
  • Signature Alliance (Brockton)
  • SouthCoast Alliance

Cigna

  • All Commercial Plans
  • Medicare Supplemental   (i.e. Medex) -- (patient has Medicare as primary)

Commonwealth Care Alliance

  • One Care Plan (specialty care only)

Fallon Health

  • Flex Care
  • Select
  • Direct
  • Senior Plans (specialty care only)
  • Preferred Care PPO

    ACO Plans:
  • Berkshire Fallon Health- Collaborative
  • Fallon 365 Care- Reliant Medical Group
  • Fallon 365 Care- Southboro Medical Group
  • Wellforce Care Plan

First Health/Coventry

  • PPO
  • See Aetna

Harvard Pilgrim Health Plan

  • HMO
  • POS
  • PPO
  • Medicare Supplemental
  • National Plans
  • Stride Medicare Advantage (specialty care only) effective 11/1/17.

Health New England
  • PPO plan accepted for out-of-network benefits for specialty care only.

MaineCare

  • Maine Medicaid when referred directly from MaineCare
 MassHealth
  • CarePlus
  • Partial

    Primary Care ACO Plans:
  • Community Care Collaborative (C3)- includes 15 federally qualified health centers across Mass.
  • Partners Healthcare Choice
  • Steward Healthcare Choice

Medicare

  • For specific Medicare plans accepted, refer under each Insurance Payer’s Plans Accepted.

MultiPlan, Inc./PHCS

  • PPO

Neighborhood Health Plan - MA

  • All Commercial Plans
  • Massachusetts Connector Products

    ACO Plans:
  • My Care Family - Lawrence Family Health Center, Lowell General Hospital, Neighborhood Health Plan

New Hampshire Healthy Families (NHHF)

  • NH Medicaid Product
Oxford Health Plans
  • Choice Plus

Senior Whole Health

  • Senior Whole Health

Tricare

  • Prime

Tufts Health Plan

Note:  While we work very closely with Tufts Health Plan and most other major insurers, we are not affiliated with Tufts Health Plan in any way. While we accept the majority of their plans, we do not accept Tufts Medicare Preferred for Primary Care services. 

  • Most Commercial Plans
  • Medicare Supplemental
  • Tufts Medicare Preferred (specialty care only)
  • Senior Care Option (SCO)
  • Lifespan Premier Choice ( HMO and PPO tiered products for RI employer groups)
  • CareLink Plan Design

Tufts Public Plans

  • Tufts Health Together
  • Tufts Unify

    ACO Plans:
  • Tufts Together with Atrius Health
  • Tufts Together with Beth Israel Deaconess Care Organization
  • Tufts Together with Boston Children's Hospital ACO
  • Tufts Together with Cambridge Health Alliance

Unicare

  • GIC

United Healthcare

  • Choice Plus
  • UnitedHealthcare Senior Care Options (SCO)
  • Passport Plan
  • PPO
  • Medicare Supplemental (Plan Core & Plan Supplement 1)
  • Erickson Advantage POS
  • Erickson Advantage Champion/Guardian HMO-POS-SNP

Veterans Health Administration (VHA) 
  •  Veterans Choice Program

 

  • Choice Plus
  • Evercare Senior Care Option
  • Passport Plan
  • PPO
  • Medicare Supplemental
  • Choice Plus
  • Evercare Senior Care Option
  • Passport Plan
  • PPO
  • Medicare Supplemental