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Tufts Medicare Preferred HMO Prime No Rx (HMO) Medicare Advantage Plan H2256-016-1 • 2027

CMS Rating: Not yet rated by CMS.
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
See List
Total Enrollment
185 beneficiaries
Last update:

Tufts Medicare Preferred HMO Prime No Rx (HMO) Introduction

This Medicare Advantage HMO plan, Tufts Medicare Preferred HMO Prime No Rx, is offered by Tufts Health Plan and uses a Health Maintenance Organization (HMO) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $3850.00. The plan is identified by CMS Plan ID H2256-016-1.

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 H2256-016-1.

Compare 2027 plan benefits with 2026.

Office Visits

Office visit costs by plan year.
Covered Service 2027 2026
Primary care In-network: $10 copay In-network: $10 copay
Specialist In-network: $20 copay In-network: $15 copay

Preventive and Wellness Services

Preventive and wellness service costs and benefits by plan year.
Covered Service 2027 2026
Annual wellness exam In-network: $0 copay In-network: $0 copay
Telehealth benefit In-network: $0-$200 copay In-network: $0-$100 copay
Routine chiropractic Not covered Not covered
Fitness benefits Coming soon In-network: $0 copay
Health education In-network: $0 copay In-network: $0 copay
Counseling services Not covered Not covered
Over-the-counter drug benefits Not covered Not covered
Health transportation (non-emergency) Coming soon In-network: $0 copay

Diagnostic, Lab, and Imaging Services

Diagnostic, laboratory, and imaging service costs by plan year.
Covered Service 2027 2026
Diagnostic radiology services In-network: 20% coinsurance In-network: 20% coinsurance
Lab services In-network: $0-$30 copay In-network: $0-$30 copay
Outpatient x-rays In-network: $0-$30 copay In-network: $0-$30 copay
Diagnostic tests and procedures In-network: $0-$30 copay In-network: $0-$30 copay

Emergency and Urgent Care Services

Emergency, urgent care, hospital, ambulance, and skilled nursing costs by plan year.
Covered Service 2027 2026
Emergency room care $130 copay $110 copay
Worldwide emergency care Coming soon $110 copay
Urgent care $30 copay $30 copay
Inpatient hospital care Tier 1
$300 per stay		 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		 Tier 1
$20 per day for days 1-20
$80 per day for days 21-44
$0 per day for days 45-100
Ground ambulance In-network: $175 copay In-network: $175 copay

Mental Health Services

Mental health therapy and inpatient psychiatric care costs by plan year.
Covered Service 2027 2026
Outpatient individual therapy In-network: $0-$10 copay In-network: $0-$10 copay
Outpatient group therapy In-network: $0-$10 copay In-network: $0-$10 copay
Inpatient psychiatric hospital care Tier 1
$300 per stay		 Tier 1
$300 per stay

Rehabilitation Services

Physical, speech, and occupational therapy costs by plan year.
Covered Service 2027 2026
Physical therapy and speech and language therapy In-network: $15 copay In-network: $15 copay
Occupational therapy In-network: $15 copay In-network: $15 copay

Medical Equipment and Supplies

Diabetes supplies, durable medical equipment, and prosthetic costs by plan year.
Covered Service 2027 2026
Diabetes supplies In-network: $0 copay In-network: $0 copay
Durable medical equipment In-network: 10% coinsurance In-network: 10% coinsurance
Prosthetics In-network: 10% coinsurance In-network: 10% coinsurance

Medicare Part B Drugs

Chemotherapy and other Medicare Part B-covered drug costs by plan year.
Covered Service 2027 2026
Chemotherapy In-network: $0 copay In-network: $0 copay
Other Part B drugs (Medicare-covered) In-network: $0 copay In-network: $0 copay

Dental Services

Preventive and comprehensive dental service costs by plan year.
Covered Service 2027 2026
Oral exam Not covered Not covered
Dental x-rays Not covered Not covered
Cleaning Not covered Not covered
Periodontics Not covered Not covered
Endodontics Not covered Not covered
Restorative services Not covered Not covered
Implant services Not covered Not covered
Orthodontics Not covered Not covered
Oral/Maxillofacial surgery Not covered Not covered

Vision Services

Routine eye exams, contact lenses, and eyewear costs by plan year.
Covered Service 2027 2026
Routine eye exam In-network: $15 copay In-network: $15 copay
Contact lenses In-network: $0 copay In-network: $0 copay
Eyeglass frames only In-network: $0 copay In-network: $0 copay
Eyeglass lenses only In-network: $0 copay In-network: $0 copay
Eyeglasses (frames & lenses) In-network: $0 copay In-network: $0 copay
Upgrades In-network: $0 copay In-network: $0 copay

Hearing Services

Hearing exams, fittings, and hearing aid costs by plan year.
Covered Service 2027 2026
Hearing exam In-network: $0 copay In-network: $0 copay
Fitting/evaluation In-network: $0 copay In-network: $0 copay
Prescription hearing aids In-network: $250-$1150 copay In-network: $250-$1150 copay
OTC hearing aids Not covered Not covered

Additional and Special Needs Services

Additional and special needs service costs and benefits by plan year.
Covered Service 2027 2026
Adult day health services Not covered Not covered
Home-based palliative care Not covered Not covered
Personal emergency response system Coming soon Not covered
Weight management programs In-network: $0 copay In-network: $0 copay
Wigs for chemotherapy-related hair loss Coming soon In-network: $0 copay
Alternative therapies In-network: $0 copay In-network: $0 copay
Massage therapy In-network: $0 copay In-network: $0 copay
Home/bathroom safety devices In-network: 10% coinsurance 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)

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, 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 ☆☆☆☆☆

Plan Availability

Tufts Medicare Preferred HMO Prime No Rx (H2256-016-1) is available in the following locations:

Massachusetts Counties Served

Frequently Asked Questions

Here are some of the most frequently asked questions about this plan (click to open).

Frequently Asked Questions About Tufts Medicare Preferred HMO Prime No Rx (HMO)

What is the monthly premium for Tufts Medicare Preferred HMO Prime No Rx (HMO)?

The 2027 monthly premium is $0.00. The Medicare Part B premium is paid separately.

What is the in-network MOOP for plan H2256-016-1?

For 2027, the in-network maximum out-of-pocket is $3850.00. The plan pays 100% of covered in-network services beyond this amount.

What is the total enrollment for plan H2256-016-1?

Total enrollment is 185 beneficiaries based on the latest CMS data.

What is the Part D deductible for plan H2256-016-1?

The plan’s Part D deductible is $0.00, applied to covered prescription drug costs.

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 October 5, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services October 5, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services October 5, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services October 5, 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
CMS.gov Medicare Advantage Plan Fact Sheet 25 May, 2025
AARP.org The Big Choice: Original Medicare vs. Medicare Advantage 25 May, 2025
Medicare.gov Your coverage options 25 May, 2025

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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.