How do I know where to refer a Tufts Health Plan patient for inpatient or partial hospitalization?
Most members of Tufts Health Plan’s health maintenance organization (HMO) are assigned to a designated facility, a specific hospital that is responsible for their inpatient, partial-hospitalization and intensive outpatient care needs. However, if a situation is emergent, a member can have a level of care assessment at any emergency room. Members with a point of service (POS), exclusive provider option (EPO), or preferred provider organization (PPO) plan can be treated at any age appropriate designated facilities . POS and PPO members are also covered at non-designated facilities for an additional cost. You or your Tufts Health Plan member may call the Tufts Health Plan Mental Health Department at 800-208-9565 and use our IVR system to obtain eligibility and additional information on a member’s designated facility, if one is assigned, or any other inpatient options.
