Terms and Conditions of Use
SEARCH INSTRUCTIONS, DEFINITIONS & DISCLAIMERSTufts Health Plan Medicare Preferred contracts with local private and group practice physicians located in your community. Each primary care physician is either in general practice, family practice or internal medicine. All Tufts Medicare Preferred HMO contracting physicians and specialists have been selected based on their records of delivering quality medical care, convenient locations, and experience treating people with Medicare.
Instructions
Tufts Medicare Preferred HMO
Provider Validation and Limitations
Hospital Validation and Limitations
Definitions
Provider Availability and Coverage Disclaimer
Disclaimer
INSTRUCTIONS
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The provider search function allows you to customize your search based on the information most relevant to you.
1) Ways to quickly search for a provider:
- To search for a specific Primary Care Physician(PCP), enter the doctors's last name under Quick Search and click Search.
- To search for doctors meeting certain criteria, feel free to search by Primary Care Physician, Specialist/Specialty, Location, or More Search Options.
2) Search by Location
- To search by Location select either a PCP or a Specialist, enter a location by specifying a city and state/or zip code. If you do not find the provider in your desired city, or do not have a specific requirement for a city or zip, select the desired proximity miles from the drop-down choices. To expand your search, click More Search Options.
If you would like, you can also select optional criteria to further refine your search:
- doctors by gender
- doctors who speak or who have staff who speak a language other than English
- doctors who are accepting new patients or current patients only
- doctors by board certification
- doctors by medical group
3) Search by Hospital - To Search by Hospital select the Search by Hospital Tab. Select a Hospital or search by specifying city and state/or zip code. If you do not find the hospital in your desired city or zip, or do not have a specific requirement for a city or zip, select the desired proximity miles from the drop-down choices.
4) After conducting your specific search, a list of doctors or hospitals meeting your requirements will be displayed, with address, phone number, and for PCP's, links to their referral circle or for specialists, links to their affiliated PCPs. Doctor listings will include hospital affiliation, medical group, and for PCP's only, whether or not they are accepting new patients.
- Additional details about each doctor in the list can be found by clicking on the Profile link. Detailed information includes specialties, board certification, languages spoken and more.
- Maps of doctor office locations are available by clicking the Maps link on the search results pages.
To perform another search, click Start New Search in the upper left corner of the tool.
TUFTS MEDICARE PREFERRED HMO
If you've elected to join a Tufts Medicare Preferred HMO plan, you will have to choose one of our plan providers that are listed in this site to be your Primary Care Physician (PCP). Generally, you must get your health care coverage from your PCP.
The "plan providers" listed in this site have agreed to provide you with your health care coverage. You will get your routine or basic care from your Primary Care Physician (PCP). The PCP you choose works with certain plan specialists he/she uses for referrals, called a "referral circle", to provide the medical care you need. This means in most cases, you will not have access to the entire Tufts Medicare Preferred HMO network, except in an emergency or urgent care situations, or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Tufts Health Plan Medicare Preferred will be responsible for the costs.
Occasionally, PCP's may limit the number of new patients in their practice. These doctors are identified with one of the following statuses:
1. Accepting New Patients: PCP's who are willing and able to accept new patients.
2. Accepting Current Patients Only: PCP's who are currently accepting members who have been receiving medical care from him or her prior to joining Tufts Medicare Preferred HMO.
3. Closed: PCP's who are not accepting new Tufts Medicare Preferred HMO members.
What is the service area for Tufts Medicare Preferred HMO?
The counties and parts of counties in our service area are listed below.
Barnstable, Bristol*, Essex, Hampden, Middlesex, Norfolk, Plymouth*, Suffolk, and Worcester Counties, Massachusetts. Asterisk (*) indicates partial county. If you live in one of the following zip codes, you live outside the service area and are not eligible to be a member: Bristol County: 02715, 02718, 02764, 02779, 02780, 02783. Plymouth County: 02344, 02346, 02347, 02348, 02349
How do you find Tufts Medicare Preferred HMO providers in your area?
The site provides several search options to allow you the flexibility to search for information in the way that best suits your needs. You can search by provider name, location (zip radius), or hospital affiliation. To find Tufts Medicare Preferred HMO PCP's near your home, just reference the City and State or Zip and the distance you are willing to travel from your home.
If you have questions about Tufts Medicare Preferred HMO, please call Customer Relations at 1-800-701-9000, Monday - Friday 8:00 a.m. - 8:00 p.m. (From Oct. 15- Feb. 14 representatives are available 7 days a week, 8:00 a.m. - 8:00 p.m.) After hours and on holidays, please leave a message and a representative will return your call on the next business day. TTY users should call 1-800-208-9562.
PROVIDER VALIDATION AND LIMITATIONS
The information reported on this website is based on the information provided to Tufts Health Plan Medicare Preferred from the participating provider or hospital and/or verified by licensing and accrediting entities. This information on providers or hospitals is subject to change without notice. Tufts Health Plan Medicare Preferred updates this information on a monthly basis as changes are reported by providers, medical groups and/or hospitals. Information on provider's name, gender, medical group affiliation, hospital affiliation, address, and acceptance of new patients is dependent on the accuracy and timeliness of changes to the information being reported to Tufts Health Plan Medicare Preferred by the providers. Information on board certification is verified at the time of collection and re-verified at least every two years.
HOSPITAL VALIDATION AND LIMITATIONS
The information reported on this website is based on the information provided to Tufts Health Plan Medicare Preferred from the participating provider or hospital and/or verified by licensing and accrediting entities. This information on hospitals is subject to change without notice. Tufts Health Plan Medicare Preferred updates this information on a monthly basis as changes are reported by hospitals. Information on hospital's name, address, city, state, zip, phone and JCAHO accreditation is dependent on the accuracy and timeliness of changes to the information being reported to Tufts Health Plan Medicare Preferred by the hospitals. Information on JCAHO accreditation is verified at the time of collection and re-verified at least every three years.
Definitions
Accepting New Patients: PCP's who are willing and able to accept new patients
Accepting Current Patients Only: PCP's who are currently accepting members who have been receiving medical care from him or her prior to joining Tufts Medicare Preferred HMO.
Closed: PCP's who are not accepting new Tufts Medicare Preferred HMO members.
Additional Languages: A list of languages, in addition to English, that a provider or their staff speaks.
Board Certification: Board certification refers to a practitioner satisfying the requirements of a nationally recognized specialty board and receiving a certificate from the specialty board. Tufts Health Plan recognizes board certification by the American Board of Medical Specialties (ABMS). To access the most current information about a provider's board certification, please visit the American Board of Medical Specialties (ABMS) at www.abms.org. Information on board certification is verified at the time of collection and re-verified at least every two years.
Hospital Affiliation: Hospital affiliation means that the physician can make referrals to the hospital and may have admitting privileges.
JCAHO Accreditation: Tufts Health Plan requires contracting hospitals to be accredited by the Joint Commission. Joint Commission accreditation is a nationally recognized symbol of quality reflecting an organization's commitment to meeting and maintaining certain performance standards. To obtain and retain Joint Commission accreditation, an organization must undergo an on-site survey conducted by the Joint Commission survey team at least every three (3) years. To access the most current information about a hospital's Joint Commission accreditation, please visit the Joint Commission's website at www.jointcommission.org/qualitycheck.
Location: You can search for providers in a particular city and state or enter information by proximity to locate a provider near a particular address.
Medical Group: Tufts Medicare Preferred HMO network of Primary Care Physicians (PCP's) and Specialists are associated with a specific Medical Group. A Medical Group is a group of doctors and other health care providers who practice together in the same community and who admit patients to the same hospital in order to provide their patients with a full range of care.
Referral Circle: The PCP you choose works with certain plan specialists he/she uses for referrals, called a "referral circle", to provide the medical care you need. This means in most cases, you will not have access to the entire Tufts Medicare Preferred HMO network, except in an emergency or urgent care situations, or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Tufts Health Plan Medicare Preferred will be responsible for the costs.
Revise Search: In some cases your search for a provider will return a large number of results. You can select More Search Options to further refine your search.
Specialist: A doctor who specializes in a particular branch of medicine, such as cardiology, dermatology, orthopedics, or surgery.
PROVIDER AVAILABILITY AND COVERAGE DISCLAIMER
The availability of hospitals and providers may change during the year. Please call Customer Relations if you have questions about a specific provider at 1-800-701-9000, Monday - Friday 8:00 a.m. - 8:00 p.m. (From Oct. 15 - Feb. 14 representatives are available 7 days a week, 8:00 a.m. - 8:00 p.m.) After hours and on holidays, please leave a message and a representative will return your call on the next business day. TTY users should call 1-800-208-9562. Be sure that the provider you choose is affiliated with Tufts Medicare Preferred HMO, and check that he or she is able to take you as a new patient. Some network providers may not be able to take new patients. While Tufts Health Plan Medicare Preferred seeks to ensure the continued availability of network providers, providers sometimes may leave the network, or close or open their panels. There may be many reasons for these changes, including provider retirement, a move out of the area, failure to reach an agreement regarding a contractual relationship with Tufts Health Plan Medicare Preferred, or failure to meet Tufts Health Plan Medicare Preferred's credentialing standards. We regret any inconvenience these changes may cause.
Disclaimer:
Tufts Health Plan Medicare Preferred is a Medicare Advantage organization with a Medicare contract. Medicare beneficiaries eligible on the basis of age or disability may apply. Members must be entitled to Medicare Part A and enrolled in Part B. All members must continue to pay their Part B Medicare premiums and use contracting providers for routine care. Plan benefits are subject to co-payments and limitations. Plan premiums vary by county. You must live in the Tufts Medicare Preferred HMO service area to be a member.
The Medicare Advantage contract between Tufts Health Plan Medicare Preferred and the Centers for Medicare & Medicaid Services (CMS) is renewed annually. The availability of coverage beyond the end of the current contract year is not guaranteed. The benefits, premiums, co-payments and service area offered by Tufts Health Plan are subject to change on an annual basis. Please contact Tufts Health Plan Medicare Preferred for details at 1-800-701-9000, Monday-Friday 8:00 a.m. - 8:00 p.m. (From Oct. 15 - Feb. 14 representatives are available 7 days a week, 8:00 a.m. - 8:00 p.m.) After hours and on holidays, please leave a message and a representative will return your call on the next business day. (TTY 1-800-208-9652).