Tufts Medicare Preferred HMO Value Rx (HMO)

TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION · 2027 plan year

Plan ID H2256-018-008

HMO★ 4 CMS Stars
MOOP (in-network)
$4,200
MOOP (combined)
—
Monthly premium
$108/mo
Part C $45 + Part D $63, before Extra Help
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H2256-018-008
Medical deductible
$0 — no deductible
Part D premium
$63/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$200/yr
Also owed
Your Medicare Part B premium, paid separately

Other segments for this plan:

More TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION plans in MA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$300/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$200/day for days 1–5, $0 after
Worldwide Urgent Care Coverage$30

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$0-$20
Mental Health — Group Sessions$0-$20
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Primary Care Physician Services$10
Skilled Nursing Facility (SNF)$0/day for days 1–20, $150/day for days 21–44, $0 after
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Emergency Services$130
Urgently Needed Services$30
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$130
Worldwide Emergency Transportation$225
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Chiropractic Services$15
Chiropractic ServicesSee plan details
Chiropractic — Other Services$15
Occupational Therapy Services$20
Physician Specialist Services$35
Podiatry Services$25
Other Health Care Professional Services$10-$35
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$0-$20
Psychiatric Services — Group Sessions$0-$20
Physical Therapy & Speech-Language Pathology$20
Additional Telehealth Services (Part B)$0-$250
Opioid Treatment Program Services$25
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$10-$35
Laboratory Services$0-$35
Radiological ServicesSee plan details
Diagnostic Radiology$100
Therapeutic RadiologyNo charge
X-Ray Services$10-$35
Outpatient Hospital Services$0-$250
Hospital Observation Services$250 per stay
Ambulatory Surgical Center (ASC)$0-$150
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$20
Substance Abuse — Group Sessions$20
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$225
Air Ambulance$225
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)10% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices10% coinsurance
Medical Supplies0%-10% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & InsertsNo charge
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
AcupunctureNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Health EducationNo charge
Nutritional & Dietary BenefitNo charge
Vision — Contact LensesNo charge
Fitness BenefitNo charge
In-Home Safety AssessmentNo charge
Weight Management ProgramNo charge
Alternative TherapiesNo charge
Therapeutic MassageNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKG$10
Insulin (Part B)$35
Dental — Medicare-Covered Services$25
Dental — PreventiveSee plan details
Dental — Oral Exams0%-50% coinsurance
Dental — X-Rays0%-50% coinsurance
Dental — Prophylaxis (Cleaning)No charge
Dental — ComprehensiveSee plan details
Dental — Restorative Services50% coinsurance
Dental — Periodontics (Gum Care)50% coinsurance
Dental — Oral & Maxillofacial Surgery50% coinsurance
Dental — Adjunctive General Services50% coinsurance
Vision — Eye Exams$0-$15
Vision — Eye ExamsSee plan details
Vision — Routine Eye Exams$15
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — Exams$25
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$250-$1,150

Service area

  • MA: 2 counties

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