Tufts Medicare Preferred PPO RX (PPO)

TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION · 2027 plan year

Plan ID H9907-003-000

Local PPO★ 3.5 CMS StarsNew for 2027
MOOP (in-network)
$7,150
MOOP (combined)
$10,750
Monthly premium
$220/mo
Part C $134.50 + Part D $85.50, before Extra Help
Prescription drugs
Included

Plan information

Contract / Plan / Segment
H9907-003-000
Medical deductible
$0 — no deductible
Part D premium
$85.50/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION plans in MA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$550/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$550/day for days 1–4, $0 after
Worldwide Urgent Care Coverage$50

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-$40
Mental Health — Group Sessions$0-$40
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$20
Intensive Cardiac Rehabilitation — Additional Sessions$20
Supervised Exercise Therapy (SET)$15
Emergency Services$130
Urgently Needed Services$50
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$130
Worldwide Emergency Transportation$375
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Chiropractic — Other Services$15
Occupational Therapy Services$30
Physician Specialist Services$75
Podiatry Services$65
Other Health Care Professional Services$0-$75
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$0-$40
Psychiatric Services — Group Sessions$0-$40
Physical Therapy & Speech-Language Pathology$30
Additional Telehealth Services (Part B)$0-$450
Opioid Treatment Program Services$25
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$75
Laboratory Services$0-$75
Radiological ServicesSee plan details
Diagnostic Radiology$100-$300
Therapeutic Radiology$60
X-Ray Services$0-$75
Outpatient Hospital Services$0-$450
Hospital Observation Services$450 per stay
Ambulatory Surgical Center (ASC)$0-$350
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$40
Substance Abuse — Group Sessions$40
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$375
Air Ambulance$375
Digital Rectal ExamsNo charge
Durable Medical Equipment (DME)0%-50% coinsurance
Prosthetic Devices20% coinsurance
Medical Supplies0%-20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies0%-20% coinsurance
Diabetic Therapeutic Shoes & Inserts50% coinsurance
Diabetic Monitors0%-20% coinsurance
Dialysis Services20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Home & Bathroom Safety Devices20% coinsurance
In-Home Safety AssessmentNo charge
Medical Nutrition TherapyNo charge
Wigs for Chemotherapy Hair LossNo charge
Weight Management ProgramNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Welcome to Medicare EKG$30
Insulin (Part B)$35
Dental — Medicare-Covered Services$65
Vision — Eye Exams$0-$65
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Hearing — Exams$65
Chiropractic ServicesSee plan details
Hearing — ExamsSee plan details
Pulmonary Rehabilitation — Additional SessionsNo charge
Prosthetics & OrthoticsSee plan details
Hearing — Routine ExamsNo charge

Service area

  • MA: 9 counties

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