Tufts Health Plan is a nonprofit organization established in 1979 that continues to provide Massachusetts, Rhode Island, and Connecticut residents with comprehensive health insurance plans.
Tufts also allows Massachusetts children and adults to participate in Medicaid and Medicare subsidized markets. Tufts Health Plan specializes in affordability, prevention, and wellness, and making it as easy as possible to have healthcare coverage for addiction treatment.
How To Determine Tufts Health Plan Benefits For Substance Abuse Treatment
If Tufts Health Plan is your insurance company, you can find out if your plan covers substance abuse treatment by:
- calling the phone number on the back of your insurance card
- contacting an insurance provider representative via email
- talking to a staff member at the rehab center you’re interested in for treatment
Insurance availability for substance use disorder treatment options generally depends on what kind of policy you have and in what state you reside.
Does Tufts Health Plan Cover Detoxification Programs?
Completing a medical detoxification program may be necessary before beginning the actual treatment program.
Medical detox involves patients spending several days in a hospital-like setting to “get clean” while receiving medications for reducing withdrawal symptoms and cravings.
Tufts Health Plan covers “medically necessary inpatient substance abuse services,” but only if coverage is included in your particular plan.
Does Tufts Health Plan Cover Inpatient Drug Or Alcohol Rehab?
If you have Tufts Health Plan and want to find out if your plan covers inpatient treatment, call them at the number printed on the back of your ID card, or reach out to a recovery center directly.
Also, be aware that some HMO members must receive treatment at a designated inpatient healthcare provider that contracts with Tufts. However, PPO, POS and EPO members do not need to go to a specific treatment center.
Does Tufts Health Plan Cover Intensive Outpatient Treatment?
While intensive outpatient (IOP) treatment allows participating individuals to continue living at home or working, it includes more hours of counseling, behavioral therapy, medication management, and group sessions than standard outpatient treatment.
Tufts Health Plan does cover IOP treatment and urges you or someone you know with an addiction to contact member services or a treatment provider directly.
Does Tufts Health Plan Cover Partial Hospitalization Programs?
Partial hospitalization programs (PHPs) involve patients receiving additional medical services while staying in a hospital for two or three days.
Individuals who need to enter a PHP program typically have physical and/or mental health issues underlying their substance use disorder that require monitoring and treatment.
In addition to inpatient medical detox and intensive outpatient programs, Tufts Health Plan likely offers insurance coverage for PHPs.
Does Tufts Health Plans Cover Methadone or Suboxone Treatment?
Suboxone is a medication approved for individuals in recovery from opioid addiction. A combination of naloxone and buprenorphine, Suboxone reduces severity of withdrawal symptoms, cravings, and the risk of relapse.
Tufts Health Plan pays for Suboxone treatment because it is considered a medication-assisted treatment (MAT).
Methadone is an older medication approved for opioid withdrawal and long-term recovery. A schedule II drug that has a high potential for abuse, Methadone is typically prescribed for patients who do not respond well to Suboxone.
Tufts Health Plan also pays for medication-assisted treatment involving methadone.
Where Is Tufts Health Plan Available?
- Individuals enrolled in Tufts employer-sponsored Medicare Complement or Medicare Preferred have access to hundreds of doctors in New Hampshire, Rhode Island, and Massachusetts.
- Tufts Health Plan offers Medicaid benefits to Rhode Island and Massachusetts residents.
- Tufts Health Plan includes senior care options to those over 65 and living in Massachusetts who are eligible for Medicare.
What Are The Different Types Of Tufts Health Plans?
Commercial plans include but are not limited to the following:
- Health Maintenance Organization (HMO)
- Lifespan Premier Choice (HMO, PPO)
- PHCS Healthy Directions (Multiplan)
- Preferred Provider Organization (PPO)
- Tufts Health Premier
- Your Choice (HMO, EPO, PPO, POS)
Tufts Health Public Plans
- Tufts Health Unify
- Tufts Health RITogether
- Tufts Health Direct
- Tufts Health Together
Tufts Medicare Plans
- Tufts Medicare Complement (TMC)
- Tufts Medicare Preferred HMO
Verify Your Insurance Coverage
The easiest way to verify if you have coverage for substance abuse treatment is to contact an addiction treatment provider to do the verification process for you.
At Ark Behavioral Health, we’ll help you understand deductibles, copays, prior authorization, and more. To learn more about insurance coverage for yourself or a loved one, please connect with us today.