Tufs Insurance Detox & Rehab Benefits Guide

Tufs Insurance Detox & Rehab Benefits Guide

Tufts Insurance is a private, non-profit health plan that was founded in 1979  (1) and is prominent in the New England area. Tufts services members in Massachusetts, New Hampshire, Connecticut, and Rhode Island. It has an extensive network of providers to serve you and your needs. Tufts Health Plan has over 51,000 providers and 110 hospitals in their network; they also have over 1,170,000 members as of May 2019. (1)

If you are a member of Tufts and you are wondering about insurance coverage for rehab, you are not alone. Does Tufts cover therapy? Does health insurance cover detox? Is there even such a thing as drug rehab insurance coverage?

The purpose of this page is to demystify the world of health insurance, particularly as it relates to substance abuse treatment, and clarify Tufts rehab insurance benefits. If you are a member of Tufts Health Care, considering a Tufts plan, or looking for more information about substance abuse and addiction treatment, this page may help you.

Does Tufts Insurance Cover Detox?

Detoxification (detox) is the first step toward recovery for most people struggling with addiction. Withdrawal symptoms from drug and alcohol use can be intense, severe, and uncomfortable. Many people choose to receive specialized services that can help make the process as comfortable and safe as possible. A medically supervised detox can help mitigate your withdrawal symptoms and ensure a safe detox.

Unfortunately, many people don’t consider detox under a doctor’s care as an option for their recovery journey due to unanswered questions they may have about the process and cost of treatment. Is detox covered by insurance? Can I get into detox without insurance? Fortunately, Tufts drug rehab coverage may include detox as well as many other services, including different types of interventions, if required.

Tufts understands that no two substance abuse treatments look alike. Your treatment plan will involve a variety of services based on your unique needs. Variables include the type of substance(s) used, how long and how much you used, your age, your physical health status, and your mental health status.

Tufts Health Care can cover the following substance abuse and mental health services: 7

  • Evaluations
  • Medications
  • Emergency services
  • Inpatient care
  • Partial hospitalization
  • Outpatient treatment
  • Intensive outpatient programs

Your plan may even cover dependents and family members. However, you must always remember to verify with your insurance provider regarding your specific benefits. An insurance representative can verify the specifics of your substance abuse and addiction coverage.

How to Check Your Tufts Insurance Benefits

The process of entering a substance abuse treatment facility and confirming coverage can feel overwhelming. Tufts makes it easy to verify your coverage and review the specifics of your insurance plan online here. You can also call the number on your insurance card and speak to a Tufts Insurance representative.

You will also want to be sure that the facility you choose will accept Tufts healthcare insurance. American Addiction Centers (AAC) has a simple tool to verify your insurance online. You can also contact AAC’s toll-free hotline at 1-888-935-1318 and speak directly with an admissions navigator who understands the addiction treatment process from start to finish, including your insurance options.

 

Types of Tufts Insurance Plans

It is important to understand your benefits and the specifics of your plan when looking to enter a substance abuse treatment facility and receive addiction services. The world of health insurance can feel overwhelming and even frustrating. If you have Tufts Health Care, there is a high likelihood that you are covered. Tufts Insurance offers a variety of plans to suit your needs. They offer 2 types of plans: Employer-Sponsored and Massachusetts Health Connector.

Employee-Sponsored Plans

Under the category of Employer-Sponsored Plans, Tufts offers several Health Management Organization options and Preferred Provider Organization plans (better known as HMOs and PPOs). You should be aware of some key differences between these types of plans and the various options that are available under each.

  • With an HMO, your medical care is coordinated by your primary care physician and any specialized services will most likely require a referral. 3 You’ll receive care from an approved in-network provider, which helps keep premiums down for you and your employer.
  • With a PPO, your monthly premiums may be higher, but you do not have to stay in-network and will most likely not need a referral for specialized services. 3
  • Advantage PPO and Advantage HMO plans generally have lower premiums and higher deductibles, with cost-sharing through co-pays, deductibles, and coinsurance. 3
  • Tiered Plans refer to a structure of different levels of cost and quality of service available from different providers within Tufts’ network.
  • The Select Network HMO requires you to stay in-network, which keeps costs as low as possible. The network includes 55 hospitals and 21,000 doctors around Massachusetts, New Hampshire, and Rhode Island. 3

Massachusetts Health Connector Plans

Targeting small groups and individuals, Massachusetts Health Connector plans include Tufts Health Direct and Tufts Premier, which can be further explored here. These plans are designed to be low-cost and may require you to stay in-network. You can contact Tufts Insurance to see if you qualify for either of these products.4

Out-of-State Coverage

You may be wondering what out-of-state coverage is available through Tufts. The company offers 2 options. Employers with employees living outside of Rhode Island, Massachusetts, and New Hampshire may want to consider the CareLink plan. With this plan, anyone can enroll, regardless of where they live (Tufts, 2020).3 The Cigna-out-of-area PPO is a second option for members who live outside of the Tufts Health Plan area. 3

Medicare

Tufts offers Medicare products as well. A government-funded insurance program for people 65 years old and older or those with certain disabilities, Medicare is offered in parts, each part covering a different type of service. You may have heard of Medicare Part A, B, C, and D.5 To learn more about Medicare and the different parts, click here.

Medicare members are eligible for a variety of supplemental products to elevate their coverage. Tufts Medicare products include a Medicare Preferred HMO, Senior Care Options, Medicare Preferred Supplement, Health Unify, and group plans. 6 The differences in the Medicare plans are a bit beyond the scope of this article. However, you can go here to learn more.

Tufts Insurance at American Addiction Centers

American Addiction Centers (AAC) has facilities nationwide providing comprehensive, evidence-based substance abuse treatment. AAC works hard to develop and maintain relationships with many different insurance providers, including Tufts, to make the process as easy and seamless for you as possible. They know that the cost of treatment can be a discouraging factor, and they will work directly with your insurance provider to verify coverage and reduce your out-of-pocket costs as much as possible.

AAC’s detox and rehabilitation facilities hold high medical standards so you can be sure the treatment you receive is safe and effective. Admissions navigators are available 24/7 to answer any questions and help you feel more comfortable as you begin your recovery journey. You can rest assured that your call will remain confidential and you will be treated with the utmost respect. Most of our admissions navigators have personal experience with addiction themselves, so they understand the uncertainty and fear you may be feeling.

It’s never too late to reach out for help. Call 1-888-935-1318 today and connect with a compassionate admissions navigator now.

  1. Tufts Health Plan. (2020). About Tufts health plan.
  2. Tufts Health Plan. (2020). Explore our plans.
  3. Tufts Health Plan. (2020). Employer-sponsored plans.
  4. Tufts Health Plan. (2020). Massachusetts health connector plans.
  5. Centers for Medicare & Medicaid Services. (n.d.). What’s Medicare?
  6.  Tufts Health Care. (2020). Medicare plans.
  7. Tufts Health Care. (2020). Behavioral health services.