Tufts Health Plan - Canton, Massachusetts

Bill S.

Tufts Medicare Preferred: I have never had an issue with this advantage plan. They have paid for everything minus my small co-pays.Prescriptions are very low cost on my plan. Recently, they approved a Tier adjustment for a medication for me. I am VERY grateful. So, my experience has been very positive.

Birgit S.

Terrible - they denied insurance coverage the day before my scheduled knee surgery which was booked four months in advance by one of the leading knee surgeon in the U.S. The reason for last minute denial was that the insurance company's authorization middleman company, EviCore, decided upon last minute review of the MRI, that they felt the reconstructive ACL surgery (due to a severed ACL) was not really necessary. If anyone has ever had a torn ACL they will know how painful this is and how it impairs walking. Everyone, including the surgeon, was stunned by this last minute decision. Ironically, the insurance company had approved the week before, a 2 week in-home rental for CPM motion machine (post operative knee recovery) and in home nurse care for PT after my surgery, but then deemed that the actual surgery was not necessary the day before the procedure.

The surgery center is appealing the decision hoping to reschedule somewhen in February. They warned me that this has happened to other patients who also needed knee surgery, and that numerous appeals and delays may occur. I spent many hours planning for this procedure - now I have to spend all day cancelling all the home care & post operative & other services that took me weeks to schedule. Whats worse, is that I now have to continue limping through each day in pain, making my knee worse- and even the other knee now is showing signs of deterioration because of the extra strain caused by my uneven walking.

I am so shocked and saddened by our broken healthcare system. It has gotten much worse since COVID. If insurance companies are unable to cover medical costs, then we as a nation must support Universal Health Coverage that ensures everyone has access to quality health care services without financial hardship!

Stephen C.

Customer service is awful. Hard to understand. Called Tufts Health Plan to find out how to get proof of coverage
Which I have a Medicare replacement plan
With Tufts. I attempted to log in to the web site first before I bothered anyone.
I was locked out. I called and stated I am locked out of the website and needed information for my taxes. I was told to call Medicare and that they don’t have any tax information that I have had coverage. I posted this screen shot that states the information is on the web site ?

Jim J.

I just signed up for Tuft's PPO MA plan this year. I was excited, it sounded great. Two visits, two problems already. I went to my primary care doctor's office for bad congestion. He was unavailable, I saw another doctor in his office. She is a Tuft's preferred provider. They did covid and bacterial infection tests in the office. I got a bill for $67. They claim lab fees are $0 copay. She sent me to Beth Israel Lahey Family Care for an x-ray, $45, supposed to be $30 in-network. I was told they are not in-network. Next, my doctor sent me to Lahey Hospital and Medical Center for blood work for a physical, another $14 copay. Once again labs advertised as $0. Lahey is an in-network hospital under Tuft's. I was was told Lahey Hospital is 41 Mall Rd, I went to Lahey at 31 Mall Rd. On Lahey's website, it states they offer additional services at 31 Mall Rd. Nope, they're not in-network. Apparently, nobody is in their network. Two weeks with Tuft's, I've already run up $125 in copays, thinking I was getting in-network care. I am just glad there is a three month window to get out of this health plan. I've already made some calls to other providers. I would hate to deal with this for the next 11-1/2 months.

bill E.

Terrible Company. They sell you a PPO plan. Suddenly the doctor drops off their list. They won’t cover the doctor effective October 1. They say if I had a HMO they would cover a surgical procedure. Since I have a PPO they say I have to pay 40% of the surgical bill.
Do not buy anything from Tufts Medicare Preferred.
All of the other 1 star reviews on Google are correct. TUFTS is the worst.
Eileen Auden, CEO, will find out how badly managed her Company is on January 1, 2025 when members leave the Company for another Company. MEDICARE should investigate TUFTS HEALTH PLAN.
William Earley

Gene D.

I wanted to tell people & help and prevent them from getting involved with Tufts Health Plan. At 65 years old, I just retired and picked it up. It is the worst health plan I've ever had. Throughout my jobs, I've had plenty of health plans. I am paying good money for bad service in return. They don't cover much at all. I've been denied the medicines I need. People, please do your research. Tufts is the worst. I didn't do mine, I guess. Open enrollment can't come quick enough.

Meredith M.

I am reviewing a customer service call only. I was unable to complete the process of selecting a PCP online and dreaded having to call the customer service number. The automated process to get to an agent was almost painless, however when I was connected to an agent, she was a lovely, patient, knowledgeable young woman with a great attitude and impeccable manners. I wish I could call her directly going forward with any questions.
Thank you for an easy resolution, Miss Jennifer!

Gabriel E.

Great health plan, but the voice system is just terrible. Why don't just use keypad instead voice recognition?