Retiree Health Plans

Tufts Health Plan is pleased to offer Tufts Medicare Preferred Prime Supplement PDP+ Plan and Tufts Medicare Preferred HMO Prime RX+ Plan for January 2012.

The rate for Tufts Medicare Preferred HMO Prime RX+ Plan and Wrap plan effective January 1, 2012 is $232.00.  16% of this rate is allocated to the Wrap coverage, see below.

The rate for Tufts Medicare Preferred Prime Supplement PDP+ Plan effective January 1, 2012  is $302.00.  15% of this rate is allocated to the Wrap coverage, see below.  

Tufts Medicare Preferred HMO Prime:
All plan benefits and co-payments are unchanged with the following exceptions:

• Fitness Benefit will include Nutritional counseling. Member may apply the $150 fitness benefit when using any network registered nutritionist or dietician.  Member pays provider and submits receipt for reimbursement
• Eyewear Benefit – Member may apply $150 retail benefit to either eyewear (glasses) or contact lenses each year, not both.
• Falls Prevention Program - $0 co-payment for home-bound and non home-bound members
• Anti-coagulant Visit - $0 co-payment for anticoagulant visit to PCP, RN/NP or Anti-Coagulant Clinic for INR testing

Tufts Medicare Supplement PDP+:
All plan benefits and co-payments are unchanged.

New Wrap plan accompanying the Tufts Medicare Preferred HMO Prime and PDP plans:

In 2012, Tufts Health Plan will be implementing new Wrap coverage to accompany the Tufts Medicare Preferred HMO and PDP Employer Group Waiver Plan (EGWP) 800 series.  This will include Wrap coverage for the Part D brand name drugs while the member is in the coverage gap stage.  The Medicare Coverage Gap Discount Program will provide manufacturer's discounts on brand name drugs in the coverage gap.  Members will pay the full co-payment in the coverage gap.  The co-payment plus the cost of the mnufacturer's discount will go towards the member's true out of pocket costs (TrOOP).  Implementation of the Wrap plan has resulted ina premium decrease for 2012.  In 2011, members received a 50% manufacturer's discount on their co-payment for brand name drugs in the coverage gap.  This 50% discount has been eliminated in 2012.  

Current Tufts retiree medical renewal rates:

Tufts Medicare Preferred HMO Prime RX+ Plan:

• 2011 Rate - $249.00
• 2012 Rate - $232.00

Tufts Medicare Preferred Prime Supplement PDP+ Plan:

• 2011 Rate - $321.00
• 2012 Rate - $302.00

If you have any questions about your eligibility or about the plans, please contact the New Member Sales Queue at 1.800.246.2400.