Tufts Medicare Preferred HMO Basic Rx (HMO) Medicare Advantage Plan H2256-026-2 • 2027
- Monthly Premium
- $82.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $4500.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $200.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 15,640 beneficiaries
Tufts Medicare Preferred HMO Basic Rx (HMO) Introduction
This Medicare Advantage HMO plan, Tufts Medicare Preferred HMO Basic Rx, is offered by Tufts Health Plan and uses a Health Maintenance Organization (HMO) provider network. It comes with prescription drug coverage. For the 2027 plan year, the monthly premium is $82.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $4500.00. The plan is identified by CMS Plan ID H2256-026-2. The 2027 Part D prescription drug deductible is $200.00.
Plan Benefits
Tufts Medicare Preferred HMO Basic Rx includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H2256-026-2.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $10 copay | In-network: $10 copay |
| Specialist | In-network: $45 copay | In-network: $40 copay |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay | In-network: $0 copay |
| Telehealth benefit | In-network: $0-$300 copay | In-network: $0-$270 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
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $100-$350 copay | In-network: $100-$250 copay |
| Lab services | In-network: $0-$45 copay | In-network: $0-$45 copay |
| Outpatient x-rays | In-network: $10-$45 copay | In-network: $10-$45 copay |
| Diagnostic tests and procedures | In-network: $10-$45 copay | In-network: $10-$45 copay |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $130 copay | $125 copay |
| Worldwide emergency care | Coming soon | $125 copay |
| Urgent care | $45 copay | $45 copay |
| Inpatient hospital care | Tier 1 $350 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
Tier 1 $275 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
| Skilled Nursing Facility | Tier 1 $0 per day for days 1-20 $170 per day for days 21-44 $0 per day for days 45-100 |
Tier 1 $20 per day for days 1-20 $160 per day for days 21-44 $0 per day for days 45-100 |
| Ground ambulance | In-network: $325 copay | In-network: $325 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $0-$25 copay | In-network: $0-$25 copay |
| Outpatient group therapy | In-network: $0-$25 copay | In-network: $0-$25 copay |
| Inpatient psychiatric hospital care | Tier 1 $350 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
Tier 1 $275 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $30 copay | In-network: $30 copay |
| Occupational therapy | In-network: $30 copay | In-network: $30 copay |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: $0 copay | In-network: $0 copay |
| Durable medical equipment | In-network: 20% coinsurance | In-network: 20% coinsurance |
| Prosthetics | In-network: 20% coinsurance | In-network: 20% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: 0%-50% coinsurance | In-network: 0%-50% coinsurance |
| Dental x-rays | In-network: 0%-50% coinsurance | In-network: 0%-50% coinsurance |
| Cleaning | In-network: $0 copay | In-network: $0 copay |
| Periodontics | In-network: 50% coinsurance | In-network: 50% coinsurance |
| Endodontics | Not covered | Not covered |
| Restorative services | In-network: 50% coinsurance | In-network: 50% coinsurance |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | In-network: 50% coinsurance | In-network: 50% coinsurance |
Vision Services
| 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
| 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
| 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 | Not covered | In-network: 20% coinsurance |
Certain preventive services are covered 100% by Tufts Medicare Preferred HMO Basic Rx as a Part B benefit.
Prescription Drug Coverage
Tufts Medicare Preferred HMO Basic Rx includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $26.50 |
| Supplemental Part D Premium: | $$15.40 |
| Total Part D Premium: | $41.90 |
| Low-Income Premium Subsidy: | $33.82 |
| Low-Income Premium Subsidy Paid by CMS: | $26.50 |
| Low-Income Subsidy Premium: | $15.40 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $200.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Tufts Health Plan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Tufts Medicare Preferred HMO Basic Rx may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $4.00 copay | Coming soon |
| Preferred Brand | 20% coinsurance | Coming soon |
| Non-Preferred Drug | 40% coinsurance | Coming soon |
| Specialty Tier | 30% coinsurance | Coming soon |
| Vaccines | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
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.
| 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 |
Contact Information for Tufts Health Plan
- Website
- Tufts Health Plan Plan Page
- Providers
- Tufts Health Plan Providers Page
- Formulary
- Tufts Health Plan Formulary Page
- Pharmacy
- Tufts Health Plan Pharmacy Page
- New Member Health Plan Help
- (877)218-4835
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (877)218-4835
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Plan Availability
Tufts Medicare Preferred HMO Basic Rx (H2256-026-2) 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 Basic Rx (HMO)
What is the monthly premium for Tufts Medicare Preferred HMO Basic Rx (HMO)?
The 2027 monthly premium is $82.00. The Medicare Part B premium is paid separately.
What is the in-network MOOP for plan H2256-026-2?
For 2027, the in-network maximum out-of-pocket is $4500.00. The plan pays 100% of covered in-network services beyond this amount.
What is the star rating for plan H2256-026-2 in 2027?
For 2027, plan H2256-026-2 has a CMS star rating of ★0.0 out of 5 stars.
What is the total enrollment for plan H2256-026-2?
Total enrollment is 15,640 beneficiaries based on the latest CMS data.
Is there a Part D deductible for this plan?
The Part D deductible is $200.00.
Medicare Plan Data Sources and Methodology
| 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.
| 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 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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