Plan Benefit Changes Effective January 1, 2010

The following benefit changes will be effective January 1, 2010, and will be rolled out as employer groups renew or join Tufts Health Plan during the year.

Some groups may choose to opt out of these changes. Always check the member’s eligibility and benefits, available on Tufts Health Plan’s secure Web site, NEHEN, NEHENNet, and our Interactive Voice Response (IVR) system.

• High-tech imaging (MRI/MRA, CT/CTA Scan, PET Scan, Nuclear Cardiology) will require a $25 copayment per visit for all HMO Premium plans. Members will be exempt from paying the copayment when high-tech imaging is required as part of an active treatment plan for a cancer diagnosis.
• Physical and Occupational Therapy will be limited to 30 visits per plan year for physical therapy and 30 visits per plan year for occupational therapy for all fully insured plans. (Members of RI-based employer groups currently have this benefit limit.)
• Hearing Aids for children (members under age 19) will no longer be a covered benefit for Select Network plans. Select Network Plans are currently offered to Massachusetts residents only.
• Pediatric Dental Benefit will be eliminated for HMO Select 10.

Refer your Tufts Health Plan patients to their current Tufts Health Plan member benefit document if they have questions about their coverage.

November 1, 2009
Note: The information in this article was correct as of the date of posting and may not reflect subsequent policy changes.