Tufts Medicare Preferred HMO Prime Rx (HMO)
H2256 - 015 - 1
(4 / 5)
Tufts Medicare Preferred HMO Prime Rx (HMO) is a Medicare Advantage Plan by Tufts Health Plan.
This page features plan details for 2025 Tufts Medicare Preferred HMO Prime Rx (HMO) H2256 – 015 – 1 available in Most of Massachusetts.
Locations
Tufts Medicare Preferred HMO Prime Rx (HMO) is offered in the following locations.
Plan Overview
Tufts Medicare Preferred HMO Prime Rx (HMO) offers the following coverage and cost-sharing.
| Insurer: | Tufts Health Plan |
| Health Plan Deductible: | $0 |
| MOOP: | $3,650 In-network |
| Drugs Covered: | Yes |
Ready to sign up for Tufts Medicare Preferred HMO Prime Rx (HMO) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST
Premium Breakdown
Tufts Medicare Preferred HMO Prime Rx (HMO) has a monthly premium of $213.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.| Part B | Part C | Part D | Part B Give Back | Total |
|---|---|---|---|---|
| $185.00 | $172.10 | $40.90 | $ | $ |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
- You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.
Drug Info
Tufts Medicare Preferred HMO Prime Rx (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $0.00 |
| Drug Out-Of-Pocket maximum: | $2,000.00 |
| Drug Benefit Type: | Enhanced Alternative |
Part D Premium Reduction
The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.
The table below shows how the LIS impacts the Part D premium of this plan.
| Part D | LIS Full |
|---|---|
| $40.90 | $23.20 |
Initial Coverage Phase
After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.
30 Day
60 Day
90 Day
30 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1) Preferred Generic | $4.00 Copay | $4.00 Copay | ||
| 2) Generic | $8.00 Copay | $8.00 Copay | ||
| 3) Preferred Brand |
60 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1) Preferred Generic | $8.00 Copay | $8.00 Copay | ||
| 2) Generic | $16.00 Copay | $16.00 Copay | ||
| 3) Preferred Brand |
90 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1) Preferred Generic | $12.00 Copay | $8.00 Copay | ||
| 2) Generic | $24.00 Copay | $16.00 Copay | ||
| 3) Preferred Brand |
Catastrophic Coverage Phase
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.
Additional Benefits
Tufts Medicare Preferred HMO Prime Rx (HMO) also provides the following benefits.
Ready to sign up for Tufts Medicare Preferred HMO Prime Rx (HMO) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST
Need more information on Tufts Medicare Preferred HMO Prime Rx (HMO)? See 2025 Tufts Medicare Preferred HMO Prime Rx (HMO) at MedicareAdvantageRX.com.