Tufts Deductible HMO Plan

This is a comprehensive plan in which you choose a primary care provider (PCP) who will coordinate your medical care within the HMO's network and provide referrals as needed. There are no benefits for health care outside of the New England network except for emergency and urgent care.

During personal travel outside of the New England network, you may need to pay for emergency or urgent care, and then apply for reimbursement from the plan.

For information about health care while traveling for business outside of the New England network, contact us at benefits@berklee.edu.

In-Network (Using Tufts Health Care Providers) 
There is no coverage outside of the network except for urgent care or emergencies.

Deductible $500 individual
$1,000 family
Preventive care Covered in full
Annual physical Covered in full
Office visit $25 copay applies (copay does not apply toward deductible)
Routine vision exam $25 copay applies; one visit every 12 months (copay does not apply toward deducible)
Emergency room $150 copay applies (copay does not apply toward deductible)
Outpatient surgery Deductible, then $250 copay applies
Inpatient hospital Deductible, then $500 copay applies
Copayment maximum Individual $2,500; family $5,000
Prescription Drugs

Tier 1 

Low Cost Generic

Tier 2

High Cost Generic

Tier 3

Preferred Brand

Tier 4

Non-Preferred Brand

Retail (30-day supply) $5 $20 $30 $50
Mail order (90-day supply) $10 $40 $60 $150
Specialty drugs Special pricing may apply.  

Deductible HMO Cost Summary 2022

Tip: Consider enrolling in a health care FSA to pay for copays and other services not covered by the plan.