Tufts Health Public Plans, Inc.

What the CMS Data Shows About Tufts Health Public Plans, Inc.

Tufts Health Public Plans, Inc. operates under CMS contract H5314, issued by Tufts Health Plan (parent organization Point32Health, Inc.). The contract is classified as a HMO product, which governs how enrollees access care: HMOs require in-network providers and referrals for most specialist care, trading network flexibility for lower cost-sharing. This contract is also flagged in CMS data as a Special Needs Plan (SNP), meaning enrollment is restricted to beneficiaries meeting specific eligibility criteria, chronic condition, dual Medicare-Medicaid status, or institutional residence. Service area spans 1 state (MA) and 10 counties, a geography set at the CMS service-area definition level.

The overall CMS Star Rating for this contract is not yet published by CMS. Individual measure-level data is not published for this contract. Ratings at 4+ stars trigger federal Quality Bonus Payments that insurers typically reinvest in supplemental benefits.

On costs, this contract lists a monthly plan premium of $14.70 (Part C + D combined) and an annual Part D drug deductible of $615.00, from the CMS CY2026 Landscape file; every enrollee also pays the standard Part B premium. Supplemental-benefit detail is not available in the public file for this contract. Before enrolling, verify that your preferred providers participate in the plan's network for your specific county, review the current Summary of Benefits, and confirm that your prescriptions appear on the plan formulary. All figures shown come from CMS public-use files for the 2026 contract year; this page is informational only and is not personalized Medicare counseling advice.