Tufts Health Plan

I am a provider and this health insurance company has been one of the most difficult ones to deal with. Very unorganized and poor customer service. Stay away from them.

they do not keep their network provider list up to date. I chose one of their providers on their list then about a month later I was charged out of network. when I asked they said well they are no longer on the list. I went back and the provider wasnt on there anymore. I told them it was on there before and I dont purposely go out of my way to pay out of network when I can pay in network and the place was 5 minutes from my house. I only heard of the place because of their website. They told me to produce a screenshot of the provider on their list. Wait what?!!
Ok so I am supposed to be a psychic and know that in one month you will no longer have this provider so i better get a screenshot of them. What kind of BS is that???
If you can avoid Tufts, then please avoid tufts.

Tufts Health plan has to be one of the worst in covering services and customer service.
I hope my employer changes next time it comes up. Fallon Health was great, Blue Cross was good, but Tufts is the bottom of the barrel.

i have had tufts for many years and find the insurance is a good plan considering what i was offered when i worked at Aetna or BX. The policy has a lot of benefits to help you stay in shape get in shape etc… I am offered a rebate of 150.00 each year for going to a gym that’s awesome! the people are great to talk with and always seem to be happy. Good Job Tufts

Tufts is one of the worst plans I’ve had. I’d do almost anything to get back Aetna or Blue Cross Blue Shield.
Unfortunately, my job is only offering Tufts at the moment. Tufts makes you pick a primary care physician before they will pay any of your medical bills. While I can technically understand why they want you to have a pcp — what I HATE is thay you are forced to pick just anyone. In my case, my current Pcp was not on the Tufts list. I wanted to choose someone affiliated with the same Hospital — but NONE were accepting new patients. I called Tufts to see if I had time to chose, and the basic answer was NO. They also then told me any other doctor I have seen previously without my new Pcp’s referral would be declined payment. Thus being said, I will be in medical debt thanks to their dumb rules AND I will have to chose a Pcp that is affiliated with a hospital that I will refuse to go to if ever needed.
Too many rules. Very unfair. Forcing people to go to their doctors. Just ridiculous.

Tufts is the worst health plan I have ever had. I pay out of pocket and they should be ashamed the hoops they make people go through to get basic care. God forbid something really terrible were to happen. If you’re considering Tufts — don’t! If there was a way for me to give these guys minus starts I would.

i have many nightmare stories about my deductibe, but what i found absurd was
when i canceled my policy recently, a rep called which i returned. i owed tufts
1.50 $. think about the time the rep and i spent. way more than 1.50.
b

Most incompetent, stingiest, greediest bastards in insurance that I ever did have the displeasure and misfortune of dealing with! Tufts Health Plan will not cover you even if you have surgery for a life threatening condition!
I had surgery 6 weeks ago and need physical therapy to get back on my feet, guess what, I’ve been fighting with Tufts for 6 weeks now over why it’s necessary that they cover for this. They are not budging and this whole thing has made my recovery much slower than if I had a good insurance company that would cover me like they should in the first place. I’m having to do therapy only once a week now as opposed to the recommended 3 times a week by my doctor because i’m paying out of pocket. I thought having insurance was all about having someone to have your back when hard times like this hit? Tufts is a scam, not a real insurance company. Stay away! I wold give 0 stars if I could!

I’ve been a victim of Tufts Health Plan for a year now. I’m self-​employed, so I’m paying a fortune and have no advocate such as an HR rep to help me fight my battles with my insurance company. I recognize that what is a fortune to me each month is a pittance to them. On to the story:
My daughter went for a well-​baby visit back in March. After two months the doctor sent us a bill for about $ 92 saying Tufts rejected the claim. After arguing with my Tufts rep on the phone they finally acknowledged that yes indeed they should cover a well-​baby visit. They said the codes were messed up but they would take care of it. Fine, mistakes happen.
A month later I get another bill from the doctor. Again I call Tufts and they tell me they’ll take care of it. This has now gone on for over six months. Each month I fax my rep the overdue bill and all of the previous correspondence. Each month they tell me it’s being taken care of and not to worry about it.
It’s been seven months. (My monthly fax to them is now up to 9 pages.) I asked to speak to a supervisor and was told he’d call me back (that was a month ago). Today I asked again and never got through.
I’m now filing a complaint with the state of Massachusetts and trying to get the media involved. I have no one to fight for me. I pay my huge bill each month on time and they’re not keeping up their end of the bargain. Soon I’m sure the doctor is going to turn me over to a collection agency which will affect my credit — all because my insurance company isn’t doing what they have said they’d do!
I’ve wasted huge amounts of time fighting this $ 92 bill. And this isn’t the only problem. I just got another bill from a hospital visit that was messed up in processing (again Tufts told me they’re taking care of it, but I don’t believe them).
As soon as I find any other option, I will run far away from this company that define incompetence and everything wrong with the health care system in the United States.

Medical Insurance can be a racket. I used to work at a hospital, trying to obtain authorizations for treatment. Nightmare. But Tufts was always easy. When a case was questionable, I’d speak with a nurse in their office (one specific nurse who was well-​versed in the issues involved in my specific specialty department) and we’d work it out. Having to deal with other insurance companies made me appreciate Tufts even more.
Now I’ve had Tufts Health Plan for about 5 years. I’m a relatively healthy person, so my doctor visits are pretty mundane. But they’ve never hit me with any surprises. I can go to the doc for a sore throat, I can get my prescriptions for a decent price and I know I can get specialists if I need them. And they don’t have some evil mental health carveout that nickels and dimes patients. Which is important because if you’re going through a bunch of stress with your insurance company, and then they won’t let you get a therapist for it, that’s just insult to injury.

In the two months that I had insurance from Tufts Health Plan, I never went to a doctor or filed a claim, so I can’t speak to those aspects. But their billing system is somewhere between a pain in the ass and a scam. When you sign up, they tell you that you have to mail them a check at least seven days before the end of each month in order to be insured for the following month. I needed insurance from September 1 to October 31, so I sent in checks in August and September. Then I get a call saying that I’m overdue for my November payment and I need to pay up. I explain that I no longer need the insurance and want to cancel, and they say they can’t cancel me retroactively, so I’ll have to pay for the first week of November.
Okay, fine, I made a mistake. I should have called and cancelled in October. I didn’t realize that was necessary since they said I’d be cancelled if I didn’t pay seven days ahead of time, but I shouldn’t have assumed and should have double-​checked. I’m willing to pay for a week because I was dumb.
Then they tell me that they need payment in full by the 4^th in order to cancel my insurance effective the 7^th. Well, it’s the 3^rd, so I ask if I can pay over the phone. Nope, they don’t do that. Can I pay in person? Sure, but they’re in Worcester. Finally they tell me I can overnight them a check. Okay, that costs $ 13 but I’ll do it. The last straw is that they tell me I should «make the check out for a few dollars over» the balance they say I owe, «just in case» the payoff amount changes overnight. They will mail me a check for the overage… when they get around to it.
What kind of company says THEY can cancel YOU if you don’t pay in advance, but YOU can’t cancel THEM on the same terms? And they don’t take any kind of credit card payments or bank drafts? I thought this was totally ridiculous. I’m glad to be insured by someone else.