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Important Health Connector Shopping Updates for Open Enrollment

November 6, 2019

The Health Connector Tufts Direct Plan will no longer contract with Atrius Health beginning January 2020

Tufts Direct will no longer be contracting with Atrius Health beginning January 1, 2020. This change only affects those individuals with the Health Connector Tufts Direct plan, and does not impact other Tufts products, including Tufts Premier or other Medicare and MassHealth plans.

Tufts Direct members who have a primary care provider or have seen a specialist in the last two years through the Atrius Health system will be notified of this change via a mailed letter. Members can expect to receive these letters starting the week of November 4, 2019. Members enrolled in Tufts Direct that are looking for information about this change can call Tufts at 888.257.1985 (TTY: 711).

As a reminder, members can use the available Health Connector provider search shopping tools to help determine which providers are available in different plans. All the available provider search tools reflect the most up-to-date information regarding the change in the Tufts Direct network. Atrius Health will be in network for the following plans:

  • AllWays Health Partners
  • Blue Cross Blue Shield of Massachusetts
  • Harvard Pilgrim Healthcare
  • Fallon Health Select only (Atrius Health is not included in Fallon Health Direct network)
  • Tufts Health Plan Premier

Plan comparison Tool: PlanFinder.MAhealthconnector.org

Anonymous Browsing:

https://mahealthconnector.optum.com/individual/; click on the Preview Plans button on the right-hand section of the screen.

For more information, please refer to the Health Connector's attached Talking Points.

New: OE 2020 Pilot Total Cost Estimator for Unsubsidized Members

The Health Connector is introducing a pilot total cost estimator that will be available during Open Enrollment. This new member decision support tool asks members questions about their health care needs and preferences, and then shows them the best health plan matches based on the information they entered. It also shows the member's expected total health care costs for each plan, as opposed to only seeing the monthly premium cost. The cost estimates include premiums and cost-sharing (such as deductibles, copays, and coinsurance). The tool is only available for unsubsidized members (those who do not receive subsidies) and is intended to help unsubsidized members get a sense of all the possible costs they could face in a year but is just an estimate.

The tool walks a person through some basic questions about:

  • Their family and who will be covered
  • Household Income
  • Prescriptions used by household
  • Preferences for paying more each month and less at the time of service or vice versa
  • The most they could afford if a medical emergency were to happen
  • Health care use over the past 12 months

The tool will provide members with the best health plan matches based on their responses to these questions and data about similar members. This tool is still under development and the "best plan match" feature does not include:

  • Information about providers or facilities (such as doctors, hospitals, and health centers) that are part of a plan's network
  • Information about whether specific prescription medicines are included in the plan's formulary

Members using the tool to decide on a health plan for 2020 should confirm that plans include their preferred providers, facilities, and prescriptions before enrolling.

This tool is for unsubsidized members only. Those members that receive subsidies, including all ConnectorCare members, should not use this tool because it will not reflect their costs accurately. Unsubsidized members will receive an email in November that will have the link to this tool. The emailed link is the only way unsubsidized members will find this tool and it is not publicly available because it is still in the pilot phase.