How Your SCO Plan Works

The better you understand your plan, the better prepared you’ll be to navigate your care and take control of your health. Here are some basics to keep in mind when using your Tufts Health Plan Senior Care Options (HMO-SNP) plan.

There is a network

In order for non-emergency/urgent medical services and prescription drugs to be covered, you need to use a provider or pharmacy in our network. Use the SCO directory to search for in-network doctors and pharmacies.

Your PCP coordinates your care

You choose a doctor to be your primary care provider (PCP), who coordinates all your care. You’ll see your PCP for routine checkups, preventative care, and treatments for common illnesses.

By overseeing your care, your PCP has the full picture, works with you to make informed decisions about your health, and can even help you avoid unnecessary expenses (such as duplicate tests) and identify safety concerns (such as harmful drug interactions).

You need a referral from your PCP to see a specialist

Your PCP helps you obtain any additional care you need. By issuing all your referrals, your PCP can make sure you get the care that is right for you.

You have access to a Care Manager

The health care system can be overwhelming. Luckily, you have a team to help you that includes a dedicated Tufts Health Plan Care Manager.

Your Care Manager can help develop your care plan, work with your doctors, manage your medications, coordinate services, and more. If you aren’t sure who your Care Manager is, give us a call at 1-855-670-5934 (TTY: 711).