Tufts Health Plan offers Tufts Medicare Preferred's Preferred Provider Organization (PPO), an option for individuals with Medicare coverage looking for both provider choice and comprehensive healthcare coverage.

With Tufts Medicare Preferred PPO you don't need to choose a primary care physician (PCP), and you don't need to obtain any referrals. Tufts Medicare Preferred PPO has a network of plan providers. These providers include doctors, other healthcare professionals, hospitals and healthcare facilities that are licensed by the State to provide healthcare services, and participate with Medicare. Your out-of-pocket costs will be less if you receive care from a plan provider, rather than a non-plan provider. You may still obtain services from a non-plan provider who accepts Medicare. However, with the exception of Emergency and Urgent Care, your co-payments and other out-of-pocket costs will be higher.

• Medical Coverage
• Prescription Drug Coverage
• Doctor and Hospital Choice
• Extra Members-Only Discounts and Services
• Who is eligible for Tufts Health Plan Medicare Preferred PPO?
• Plan Service Area

Medical Coverage
In addition to freedom of provider choice, Tufts Medicare Preferred PPO can offer you even more comprehensive medical coverage than Original Medicare alone. With Tufts Medicare Preferred PPO, you get*:

Annual physical exams
Routine eye and hearing exams
Vision care and eyeglasses allowance
Unlimited medically necessary hospitalization
Emergency care anywhere in the world
Medicare prescription drug options

*Co-payments, deductibles, and limitations apply.

Prescription Drug Coverage
With Tufts Medicare Preferred PPO, you have the option to receive medical coverage only, or you can add Medicare Part D prescription drug coverage. You may choose from two prescription drug options, Rx and Rx Plus. With Tufts Medicare Preferred PPO, you can choose to have both medical and prescription drug coverage in one plan.

Extra Members-Only Discounts and Services
You'll also have access to a number of discount programs and services that go beyond basic healthcare coverage. We call them Preferred Extras, because they are offered to you over and above the benefits under our contract with the Federal government. These services are intended to help save you money, improve your health and enhance your quality of life, including:

New for 2008, FastStart; order your prescriptions over the phone, no paper work, next day shipping and additional savings
New for 2008, special discount on Lasik Surgery.
Discount on health and wellness programs such as wellness seminars and nutritional counseling
Savings on Weight Watchers (12 week program).
Savings on health and fitness club membership.
Discount on acupuncture and massage therapy from participating providers.

The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Tufts Medicare Preferred grievance process.

Who is eligible for Tufts Health Plan Medicare Preferred PPO?
To join this plan, you must:

Be eligible for Medicare on the basis of age or disability.
Be entitled to Medicare benefits under Part A and enrolled in Part B.
Continue to pay Medicare Part B premiums, if not otherwise paid for under Medicaid or by another third party.
Live in the Tufts Medicare Preferred PPO Service Area.
Not currently have End-Stage Renal Disease (ESRD).

NOTE: If you do not need regular dialysis, or have had a successful kidney transplant, you are eligible by supplying a doctor's note or record with your enrollment form.

Plan Service Area
To join Tufts Medicare Preferred PPO, you must live in Barnstable, Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, or Worcester county.

H2229-2008-44R1 9-28-07