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Tufts Medicare Preferred HMO Prime No Rx (HMO) Medicare Advantage Plan H2256-039 • 2027 • Worcester County, MA

CMS Rating: ☆☆☆☆☆ (4.0 out of 5 stars*)
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$3850.00In-network
Part B Giveback
Not offered
Prescription Coverage
Not Included
Additional Benefits
Dental, Vision, Hearing
Service Area
Worcester County, MA
Local Enrollment
15 beneficiaries in Worcester County
Last update:

Tufts Medicare Preferred HMO Prime No Rx (HMO) Introduction

Tufts Medicare Preferred HMO Prime No Rx is a Medicare Advantage HMO plan offered by Tufts Health Plan. It uses a Health Maintenance Organization (HMO) provider network and comes without prescription drug coverage. For the 2027 plan year it has a $0.00 monthly premium, $0.00 medical deductible, and $3850.00 in-network maximum out-of-pocket. CMS Plan ID H2256-039 identifies this plan.

You must live in Worcester County, Massachusetts to enroll in this plan. CMS reports 15 beneficiaries enrolled in this plan in Worcester County. For assistance with this plan, new members can call (877)218-4835 (TTY 711).

Compare Similar Plans in Worcester County

Compare this plan with the two most-enrolled HMO plans available in Worcester County, Massachusetts. Enrollment is based on CMS local enrollment data.

HMO plan comparison for Worcester County, Massachusetts
Plan Detail Tufts Medicare Preferred HMO Prime No Rx Tufts Medicare Preferred HMO Basic Rx Tufts Medicare Preferred HMO Prime Rx
CMS Plan ID H2256-039-0 H2256-036-0 H2256-033-0
Local Enrollment 15 2,975 1,492
Monthly Premium $0.00 $85.00 $224.00
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $3,850.00 $4,500.00 $3,850.00
Part B Giveback Not offered Not offered Not offered
Primary Care $10 copay $10 copay $10 copay
Specialist $20 copay $45 copay $30 copay
Part D Deductible Not Applicable $200.00 $0.00
CMS Star Rating 4.0 4.0 4.0
Dental Not covered 0%-50% coinsurance Not covered
Vision $15 copay $15 copay $15 copay
Hearing $0 copay $0 copay $0 copay

Want to explore more options? Browse all Medicare Advantage plans in Worcester County, or compare Medicare Advantage plans across Massachusetts, including premiums, out-of-pocket costs, CMS ratings, and enrollment.

Plan Benefits

Cost-sharing for Tufts Medicare Preferred HMO Prime No Rx includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H2256-039.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H2256-039-0 Cost Compare.

Office Visits

Primary care
In-network: $10 copay
Specialist
In-network: $20 copay

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Telehealth benefit
In-network: $0-$200 copay
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
In-network: $0 copay
Counseling services
Not covered
Over-the-counter drug benefits
Not covered
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: 20% coinsurance
Lab services
In-network: $0-$30 copay
Outpatient x-rays
In-network: $0-$30 copay
Diagnostic tests and procedures
In-network: $0-$30 copay

Emergency and Urgent Care Services

Emergency room care
$130 copay
Worldwide emergency care
Coming soon
Urgent care
$30 copay
Inpatient hospital care
Tier 1
$300 per stay
Skilled Nursing Facility
Tier 1
$0 per day for days 1-20
$110 per day for days 21-44
$0 per day for days 45-100
Ground ambulance
In-network: $175 copay

Mental Health Services

Outpatient individual therapy
In-network: $0-$10 copay
Outpatient group therapy
In-network: $0-$10 copay
Inpatient psychiatric hospital care
Tier 1
$300 per stay

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: $15 copay
Occupational therapy
In-network: $15 copay

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
Durable medical equipment
In-network: 10% coinsurance
Prosthetics
In-network: 10% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: $0 copay
Other Part B drugs (Medicare-covered)
In-network: $0 copay

Dental Services

Oral exam
Not covered
Dental x-rays
Not covered
Cleaning
Not covered
Periodontics
Not covered
Endodontics
Not covered
Restorative services
Not covered
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
Not covered

Vision Services

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

Hearing Services

Hearing exam
In-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Prescription hearing aids
In-network: $250-$1150 copay
OTC hearing aids
Not covered

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
In-network: $0 copay
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
In-network: $0 copay
Massage therapy
In-network: $0 copay
Home/bathroom safety devices
In-network: 10% coinsurance

Certain preventive services are covered 100% by Tufts Medicare Preferred HMO Prime No Rx as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Performance Ratings (Contract ID: H2256)

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.

2027 Medicare Star Ratings for Contract H2256
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines ☆☆☆☆☆
Managing Chronic (Long Term) Conditions ☆☆☆☆☆
Member Experience with Health Plan ☆☆☆☆☆
Complaints and Changes in Plans Performance ☆☆☆☆☆
Health Plan Customer Service ☆☆☆☆☆
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan ☆☆☆☆☆
Member Experience with the Drug Plan ☆☆☆☆☆
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆
Medicare Advantage Plan Availability

Tufts Medicare Preferred HMO Prime No Rx is available to eligible Medicare beneficiaries residing in Worcester County, Massachusetts, including communities such as Barre, Oakham, Warren, Athol, Fitchburg, Ashburnham, Baldwinville, Gardner, Harvard, Hubbardston, Leominster, Lunenburg, Templeton, Westminster, Winchendon, Auburn, Berlin, Blackstone, Boylston, Brookfield, Charlton, Clinton, East Brookfield, Douglas, Fiskdale, Grafton, Holden, Jefferson, Lancaster, Leicester, Millbury, Millville, Northborough, Northbridge, North Brookfield, North Grafton, North Oxford, Oxford, Princeton, Rochdale, Rutland, Shrewsbury, Southbridge, South Grafton, Spencer, Sterling, Sturbridge, Upton, Uxbridge, Webster, Dudley, Westborough, West Boylston, West Brookfield, Whitinsville, Sutton, Worcester, Cherry Valley, Paxton, Bolton, Hopedale, Mendon, Milford, Southborough, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services November 10, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services November 10, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services November 10, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services November 10, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Tufts Health Plan (official source) http://www.tuftsmedicarepreferred.org October 4, 2026
Medicare.gov Understanding Medicare Advantage Plans 25 May, 2025
Medicare.gov Joining a plan 25 May, 2025
Medicare.gov Compare Original Medicare & Medicare Advantage 25 May, 2025

MedicarePlans.com operates as an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.

Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.