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Read more →Tufts Health Plan Senior Care Options (HMO D-SNP)
by Tufts Health Plan
2026 Medicare-Medicaid Dual Eligible D-SNP plan available in Massachusetts
Plan ID H8330-001-0
Additional coverage:
RxHearingVisionDental
Medicare-Medicaid Dual Eligible D-SNP HMO $0 premium 3.5 Overall
Monthly plan premium $0 / mo
Annual deductible $0 / yr
Max out-of-pocket · in-network $9,250 / yr
Drug deductible $615 / yr
3.5 Overall Government Star Rating 2026 · out of 5 stars
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Plan Overview
Tufts Health Plan Senior Care Options (HMO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Massachusetts and offered by the health insurance company Tufts Health Plan. This plan's network type is HMO, which determines the in-network doctors who accept the plan and whether a referral is needed.
Plan Name Tufts Health Plan Senior Care Options (HMO D-SNP)
Insurance Carrier Tufts Health Plan
Plan Type Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)
Network Type HMO
Cost Summary
Tufts Health Plan Senior Care Options (HMO D-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $9,250. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.
Monthly Premium $0 / mo
Health portion of premium $0
Drug portion of premium $0
Annual Deductible $0 / yr
Max Out-of-Pocket · in-network $9,250 / yr
Primary doctor visit $0 copay
Specialist visit $0 copay
ER visit $0 copay
Ambulance $0 copay
Additional Benefits and Coverage
Tufts Health Plan Senior Care Options (HMO D-SNP) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Tufts Health Plan Senior Care Options (HMO D-SNP) includes coverage for hearing, vision, dental.
Part D Prescription Drug Coverage Yes
Dental Yes
Vision Yes
Hearing Yes
Nationwide Coverage No
Other benefits
Fitness benefit Limited coverage
Over-the-counter drug benefits Limited coverage
In-home support services Limited coverage
Home & bathroom safety devices Limited coverage
Meals for short duration Limited coverage
Annual physical exams Limited coverage
Telehealth Limited coverage
Medical Benefits
Doctor Services
Primary doctor visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Specialist visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Tests, labs & imaging
Diagnostic tests & procedures In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Lab services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient x-rays In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Emergency care $0 copay
Urgent care $0 copay
Hospital Services
Inpatient hospital coverage Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
Outpatient hospital coverage In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Skilled nursing facility
Skilled nursing facility Tier 1
$0 per day for days 1-20
$217 per day for days 21-100
$0 per day for days 1-20
$217 per day for days 21-100
Preventive services
Preventive services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Therapy services
Occupational therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Physical therapy & speech & language therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Mental health services
Outpatient group therapy with a psychiatrist In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy with a psychiatrist In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient group therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Opioid treatment services
Opioid treatment services Covered
Other services
Durable medical equipment (like wheelchairs & oxygen) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prosthetics (like braces, artificial limbs) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Diabetes supplies In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prescription drugs (Part D benefits)
Drug tier standard retail · 1-month supply Initial coverage Catastrophic
Generic Drugs 25% coinsurance 0% coinsurance
Brand Name Drugs 25% coinsurance 0% coinsurance
Part B drugs
Chemotherapy drugs In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Other Part B drugs In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Medicare star rating
Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, Tufts Health Plan Senior Care Options (HMO D-SNP) earned an overall rating of 3.5 stars — worse than Massachusetts's state average of 4.0 stars.
Rating category This plan State average
Overall star rating ★ 3.5 4.0
Health plan quality
Summary rating of health plan quality ★ 3.5 3.8
Staying healthy: screenings, tests & vaccines ★ 4.0 4.3
Managing chronic (long-term) conditions ★ 4.0 4.0
Member experience with health plan ★ 2.0 3.0
Member complaints & changes in performance ★ 4.0 4.6
Health plan customer service ★ 4.0 3.8
Drug plan quality
Summary rating of drug plan quality ★ 3.5 4.0
Drug plan customer service ★ 4.0 4.3
Member complaints & changes in performance ★ 4.0 4.4
Member experience with the drug plan ★ 2.0 3.5
Drug safety & accuracy of drug pricing ★ 4.0 4.0
Extra Benefits
Hearing
Hearing exam Not covered
Fitting/evaluation Not covered
Hearing aids - prescription Not covered
Hearing aids - over the counter In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive dental
Oral exam In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Cleaning In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Dental x-rays In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Restorative services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Endodontics In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Periodontics In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics Not covered
Implant services Not covered
Oral and maxillofacial surgery In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Orthodontics Not covered
Adjunctive general services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
Routine eye exam Not covered
Contact lenses Not covered
Eyeglasses (frames & lenses) Not covered
Eyeglass frames (only) Not covered
Eyeglass lenses (only) Not covered
Upgrades Not covered
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