2018 Tufts Health Unify (Medicare-Medicaid Plan) H7419-1-0 in MA from Tufts Health Plan | HealthPocket

Tufts Health Unify (Medicare-Medicaid Plan)

$0/mo

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Zip Code02128
Applicant10/23/1983 Male
Coverage Start10/24/2018
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderTufts Health Plan
Plan IDH7419-1-0
Plan Year2018
CMS RatingNot Rated
Plan TypeMedicare-Medicaid Plan
Annual Deductible$0.00

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2019. see plan

Why We Like This Plan
  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium

Costs and Other Important Information

Plan Year2018
Optional Supplemental BenefitsNo
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)Not Applicable
Other health plan deductibles?No
Health Plan Deductible$0
Monthly Drug Plan Premium$0.00
Monthly Health Plan Premium$0.00

Benefits

SERVICECOST
Inpatient hospital coverage$0 copay
Outpatient hospital coverage$0 copay
Doctor visitsPrimary:
$0 copay
Specialist:
$0 copay
Preventive care$0 copay
Emergency care/Urgent careEmergency:
$0 copay
Urgent care:
$0 copay
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
$0 copay
Lab services:
$0 copay
Diagnostic radiology services (e.g., MRI):
$0 copay
Outpatient x-rays:
$0 copay
Mental health services$0 copay
Outpatient group therapy visit with a psychiatrist:
$0 copay
Outpatient individual therapy visit with a psychiatrist:
$0 copay
Outpatient group therapy visit:
$0 copay
Outpatient individual therapy visit:
$0 copay
Skilled Nursing Facility$0 copay
Rehabilitation servicesOccupational therapy visit:
$0 copay
Physical therapy and speech and language therapy visit:
$0 copay
Ambulance$0 copay
Transportation$0 copay
Foot care (podiatry services)Foot exams and treatment:
$0 copay
Routine foot care:
$0 copay
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):
$0 copay
Prosthetics (e.g., braces, artificial limbs):
$0 copay
Diabetes supplies:
$0 copay
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:
$0 copay
Other Part B drugs:
$0 copay

Coverage Area for Tufts Health Unify (Medicare-Medicaid )

StateMassachusetts
CountySuffolk

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offereds0% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered0% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered0% coinsuranceNot offered
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

60 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered0% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered0% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered0% coinsuranceNot offered
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered0% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered0% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered0% coinsuranceNot offered
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

Physicians that accept Tufts Health Unify (Medicare-Medicaid ) for Massachusetts

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Chou, Loretta
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Dohlman, Jan
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Manandhar, Monica
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Master, Michelle
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Ribeiro, Ricardo
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Trilianos, Panagiotis
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Braun, Leah
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Jirmanus, Lara
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Walsh, Carolyn
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Fernandez Bohorquez, Rafael
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Sharma, Kavita
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Huanuco Perez, Juan
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Shen, Daniel
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Gaskins, Elizabeth
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Lopez Morra, Hernan
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Cardenas, Lilia
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Chen, Dorothy
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Dabora, Sandra
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Brown, Allison
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Zarraga-forsyth, Ida
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Wigden, Beth
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Boreri, Susan
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Woodson, Jonathan
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Raney, Jennifer
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Schapiro, Jeffrey
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Loretta Chou, MD
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  • Phone Number
    (617) 568-4477
  • Office Locations
    10 Gove St
    East Boston, MA 02128
10 Gove St East Boston MA, 02128

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