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Tufts Medicare Preferred HMO Value No Rx (HMO)

Massachusetts Medicare Advantage Plan (2026 Plan)

Monthly Premium

Your Cost
$143
by Tufts Health Plan

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.0
out of 5 stars

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Plan Overview

Plan Name
Tufts Medicare Preferred HMO Value No Rx (HMO)
Insurance Carrier
Tufts Health Plan
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
HMO

Tufts Medicare Preferred HMO Value No Rx (HMO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Massachusetts and offered by the health insurance company Tufts Health Plan. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$143
Annual Deductible
$0
Max Out-of-Pocket
$3,850
Primary doctor visit
$10 copay
Specialist visit
$25 copay
ER visit
$125 copay
Ambulance
$225 copay

Tufts Medicare Preferred HMO Value No Rx (HMO) has a monthly premium cost of $143 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $3,850 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Tufts Medicare Preferred HMO Value No Rx (HMO) are defined below.

Additional Benefits and Coverage

No
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Tufts Medicare Preferred HMO Value No Rx (HMO) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Tufts Medicare Preferred HMO Value No Rx (HMO) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Tufts Medicare Preferred HMO Value No Rx (HMO) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Not covered
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Comparing the Quality Score of Tufts Medicare Preferred HMO Value No Rx (HMO) to Other Plans in Massachusetts

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2026, Tufts Medicare Preferred HMO Value No Rx (HMO) received an overall government quality rating of 4.0 stars out of 5 stars.

Tufts Medicare Preferred HMO Value No Rx (HMO) performed the same as Massachusetts’s State average overall quality score of 4.0 stars.

This Plan’s 5-star Gov’t Quality Score
Massachusetts State Average Score
Overall Government 5 Star Quality Rating
 4.0
 4.0
Summary rating of health plan quality
 4
 4.0
Staying healthy: screenings, tests, & vaccines
 4
 4.1
Managing chronic (long term) conditions
 3
 3.5
Member experience with health plan
 4
 3.7
Member complaints & changes in the health plan's performance
 5
 4.4
Health plan customer service
 4
 4.0

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Tufts Medicare Preferred HMO Value No Rx (HMO) received 4 stars for its health plan quality score which is the same as the Massachusetts State average health plan quality score of 4.0 stars.

Plan Benefits and Coverage Details

Monthly Premium
$143
Health Portion of Premium
$143
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$3,850 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
http://www.tuftsmedicarepreferred.org/doctor-search
Plan Link
http://www.tuftsmedicarepreferred.org

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $10 copay
Out-of-network: $10 copay
Specialist visit
In-network: $25 copay
Out-of-network: $25 copay

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $10-$30 copay
Out-of-network: $10-$30 copay
Lab services
In-network: $0-$30 copay
Out-of-network: $0-$30 copay
Diagnostic radiology services (like MRI)
In-network: $100 copay
Out-of-network: $100 copay
Outpatient x-rays
In-network: $10-$30 copay
Out-of-network: $10-$30 copay
Emergency care
$125 copay
Urgent care
$30 copay

Hospital Services

Inpatient hospital coverage
Tier 1
$200 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Outpatient hospital coverage
In-network: $0-$150 copay
Out-of-network: $0-$150 copay

Skilled nursing facility

Skilled nursing facility
Tier 1
$20 per day for days 1-20
$120 per day for days 21-44
$0 per day for days 45-100

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance
In-network: $225 copay
Out-of-network: $225 copay

Therapy services

Occupational therapy visit
In-network: $20 copay
Out-of-network: $20 copay
Physical therapy & speech & language therapy visit
In-network: $20 copay
Out-of-network: $20 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $0-$20 copay
Out-of-network: $0-$20 copay
Outpatient individual therapy with a psychiatrist
In-network: $0-$20 copay
Out-of-network: $0-$20 copay
Outpatient group therapy visit
In-network: $0-$20 copay
Out-of-network: $0-$20 copay
Outpatient individual therapy visit
In-network: $0-$20 copay
Out-of-network: $0-$20 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 10% coinsurance
Out-of-network: 10% coinsurance
Prosthetics (like braces, artificial limbs)
In-network: 10% coinsurance
Out-of-network: 10% coinsurance
Diabetes supplies
In-network: $0 copay
Out-of-network: $0 copay

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Chemotherapy drugs
In-network: $0 copay
Out-of-network: $0 copay
Other Part B drugs
In-network: $0 copay
Out-of-network: $0 copay

Extra Benefits

Hearing

Hearing exam
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription
In-network: $250-$1150 copay
Out-of-network: $250-$1150 copay
Hearing aids - over the counter
Not covered

Preventive Dental

Oral exam
In-network: 0%-50% coinsurance
Out-of-network: 0%-50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
Not covered
Dental x-rays
In-network: 0%-50% coinsurance
Out-of-network: 0%-50% coinsurance

Comprehensive dental

Restorative services
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Endodontics
Not covered
Periodontics
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, removable
Not covered
Prosthodontics, fixed
Not covered
Maxillofacial prosthetics
Not covered
Implant services
Not covered
Oral and maxillofacial surgery
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Orthodontics
Not covered
Adjunctive general services
In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Vision

Routine eye exam
In-network: $15 copay
Out-of-network: $15 copay
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: $0 copay
Upgrades
In-network: $0 copay
Out-of-network: $0 copay

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