Tufts Medicare Preferred HMO

For more information about Tufts Medicare Preferred HMO, please click on the links below:

Tufts Medicare Preferred HMO Prior Authorization List and Inpatient Notification List PDF: This list includes the procedures, services and items that require prior authorization from Tufts Health Plan Medicare Preferred HMO.

Medicare-Approved Facilities List PDF: This list includes the procedures that must be performed at a Medicare-Approved Facility, along with links to the CMS website to determine whether a facility is Medicare approved. This document also includes a list of Medicare approved facility that are also contracted with Tufts Medicare Preferred HMO.

Pharmacy Prior Authorization and Step Therapy Guidelines: Medical Necessity Guidelines Clinical criteria for drugs with prior authorization or coverage limitation requirements

Medical Management Toolbox: Tools and materials to support a Tufts Medicare Preferred HMO provider in caring for members in the community.

Tufts Health Plan Medicare Preferred Medical Director Meeting Resources: Past meeting presentations, meeting minutes and the upcoming meeting schedule are available here. This section is password protected and available to select individuals.

Resources PDF: Links to Medicare coverage resources