Tufts Health Direct Network Changes for Health Connector Members
November 4, 2024
Tufts Health Direct has made two changes to its provider network for plans available through MAhealthconnector.org. Starting on January 1, 2025, hospitals and providers in the UMass Medical Center network and Boston Children’s Hospital network will no longer be available to Health Connector members enrolled in Tufts Health Direct.
Members have the option of staying in Tufts Health Direct and finding new providers as necessary, or they can consider moving to a new health plan that includes the UMass and/or Boston Children’s networks in their plans.
Health Connector Open Enrollment runs from November 1, 2024, through January 23, 2025, and current members have the ability during this time to switch to a new plan. For members who want to change plans in time for January 1 coverage, the deadline is December 23, 2024.
Note for MassHealth members: UMass Medical Center network and Boston Children’s Hospital will continue to be in network for the Tufts Health Public Plans offered to MassHealth members.
The talking points below help explain what has happened and what needs to be done when assisting Tufts Health Direct members that have questions.
For Health Connector members considering different providers through Tufts:
- Hospitals and doctors affiliated with UMass Medical Center and Boston Children’s Hospital will no longer be available to Tufts Health Direct members starting January 1.
- You can keep your Tufts Direct plan in 2025, but you will need to look for a new provider(s) if your current doctor is no longer covered.
- Your best option is to call Tufts Health Direct and check to see if your provider(s) is still covered in 2025. They have the most-updated list of providers near you and can help you select a new provider(s), if necessary.
- Tufts Direct can be reached by calling (888) 257-1985. You can also check the provider options offered by Tufts by going to tuftshealthplan.com/directproviders.
- A reminder, the deadline to make any changes to your Health Connector health insurance is December 23. You may want to check with Tufts soon, to give yourself time to consider your options.
For Health Connector Tuft Health Direct members considering a different health plan:
- Hospitals and doctors affiliated with UMass Medical Center and Boston Children’s Hospital will no longer be available to Tufts Health Direct members starting January 1.
- If you are a current Tufts member who wants to be able to go to a hospital or see a doctor that is no longer covered, you will need to switch health plans.
- You can get help looking for a new plan.
- It’s important to remember that because it is Open Enrollment, you can switch plans if you’d like. Open Enrollment runs until January 23, but if you want to switch plans in time for coverage on January 1, you will need to finish the process – including paying your first premium for your new plan – by December 23, 2024.
Below is a screenshot of the messaging that will be displayed in the online application at MAhealthconnector.org (also known as HIX) as an applicant or member goes through the shopping screens. It reads:
“Tufts Direct is experiencing provider network changes for 2025, and your doctors and hospitals may not be available through Tufts Direct plans. Please review Tufts Direct’s 2025 provider network carefully and contact your provider and Tufts Direct at 888-257-1985 or visit their website at tuftshealthplan.com/directproviders to confirm whether your preferred providers remain in-network before enrolling for 2025 coverage. Please note the Health Connector continues to offer a wide selection of plan options from numerous carriers, through which members may continue to access health care providers no longer in the Tufts Direct network.”
