Tufts Health One Care (HMO D-SNP) in Plymouth County, Massachusetts — 2026 plan details

Last updated Jul 18, 2026

Reviewed by Jason Burns, Editorial Steward

Published by Senior Direct Answers · Licensed under Citation License 1.0

Tufts Health One Care (HMO D-SNP) (H5314-001) is a $37-premium Medicare Advantage HMO D-SNP from Point32Health, Inc. available in Plymouth County, Massachusetts in 2026, with a -star overall rating, a $9,250 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationPoint32Health, Inc.
Plan nameTufts Health One Care (HMO D-SNP)
Contract IDH5314
Plan ID001
Segment ID0
Contract year2026
Contract categorySNP
Plan typeHMO D-SNP
SNPYes — Dual-Eligible
Monthly consolidated premium$36.60
Part C premium$0.00
Part D basic premium$36.60
Part D total premium$36.60
Annual Part D deductible$615.00
Maximum out-of-pocket (in-network)$9250.00
Overall star rating

How this plan is structured

  • $37 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
  • HMO D-SNP plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
  • $9,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
  • Service area = Plymouth County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in Plymouth County

The CMS CY2026 Landscape file lists 55 Medicare Advantage plans in Plymouth County, Massachusetts, of which 6 carry a 5.0-star overall rating and 21 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $325.00 per month, and in-network out-of-pocket maximums range from $0.00 to $9250.00.

Other 5.0-star Medicare Advantage plans in Plymouth County (first three alphabetically):

PlanOrganizationPremiumMOOP
Erickson Advantage Champion (HMO-POS C-SNP)UnitedHealth Group, Inc.$182.00$3400.00
Erickson Advantage Freedom (HMO-POS)UnitedHealth Group, Inc.$89.00$4900.00
Erickson Advantage Guardian (HMO-POS I-SNP)UnitedHealth Group, Inc.$0.00$1000.00

For the full county plan directory, see all Medicare plans in Plymouth County, Massachusetts.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H5314-001.
  2. Call the plan (Point32Health, Inc.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H5314-001 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5314-001, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 5314 are the contract number issued to the organization, and the three-digit 001 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions

Is Tufts Health One Care (HMO D-SNP) an HMO or PPO?

Tufts Health One Care (HMO D-SNP) is an HMO D-SNP — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.

Does Tufts Health One Care (HMO D-SNP) include prescription drug coverage?

Yes — Tufts Health One Care (HMO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.

What is the maximum out-of-pocket cost for Tufts Health One Care (HMO D-SNP)?

The 2026 in-network maximum out-of-pocket limit for Tufts Health One Care (HMO D-SNP) is $9250.00, per the CMS CY2026 Landscape file.

What counties offer Tufts Health One Care (HMO D-SNP) (H5314-001)?

Tufts Health One Care (HMO D-SNP) (H5314-001) is offered in ten Massachusetts counties: Barnstable County, Bristol County, Essex County, Hampden County, Hampshire County, Middlesex County, Norfolk County, Plymouth County, Suffolk County, and Worcester County.

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