Policies and requirements
- Your rights and responsibilities
As a Tufts Health Plan – Network Health member, you have certain rights and responsibilities.
As a Tufts Health Plan – Network Health member, you have the right to make an Inquiry (ask a question or make a request) at any time about our operations.
- Grievances and Appeals
As a Tufts Health Plan – Network Health member, you can file a Grievance with us about something we do or appeal a decision we make.
We protect our members' information.
- Mental health parity
As a Tufts Health Forward member, we must provide the same level of benefits for any mental health and substance abuse problems you may have as for physical problems you may have.
- Advance directives
Advance directives are written instructions, sometimes called a living will or durable power of attorney, to make your wishes known about medical treatments.
- Quality program description
Our quality program helps us make sure you get the right care, at the right time and the right place.
- Quality program evaluation
We measure what happens through our quality program to make sure we're helping our members.
- Referral requirement for specialty services
We need a primary care provider (PCP) referral for certain specialty services for some members to help us make sure you get the care you need.
Your Member Handbook also includes most of the above information. To get a printed copy of our Member Handbook or any of the other above attachments, please call us at 888-257-1985 (TTY: 888-391-5535), Monday through Friday, from 8 a.m. to 5 p.m.