Tufts Medicare Preferred HMO Prime Rx (HMO) in Worcester 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 Medicare Preferred HMO Prime Rx (HMO) (H2256-033) is a $203-premium Medicare Advantage HMO from Point32Health, Inc. available in Worcester County, Massachusetts in 2026, with a 4.0-star overall rating, a $3,850 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Point32Health, Inc. |
|---|---|
| Plan name | Tufts Medicare Preferred HMO Prime Rx (HMO) |
| Contract ID | H2256 |
| Plan ID | 033 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | HMO |
| SNP | No |
| Monthly consolidated premium | $203.00 |
| Part C premium | $177.10 |
| Part D basic premium | $1.10 |
| Part D total premium | $25.90 |
| Annual Part D deductible | $0.00 |
| Maximum out-of-pocket (in-network) | $3850.00 |
| Overall star rating | 4.0 |
How this plan is structured
- $203 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 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.
- $3,850 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 = Worcester 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 Worcester County
The CMS CY2026 Landscape file lists 58 Medicare Advantage plans in Worcester County, Massachusetts, of which 0 carry a 5.0-star overall rating and 30 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.
For the full county plan directory, see all Medicare plans in Worcester 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:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H2256-033.
- 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.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H2256-033 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H2256-033, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 2256 are the contract number issued to the organization, and the three-digit 033 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 Medicare Preferred HMO Prime Rx (HMO) an HMO or PPO?
Tufts Medicare Preferred HMO Prime Rx (HMO) is an HMO — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.
Does Tufts Medicare Preferred HMO Prime Rx (HMO) include prescription drug coverage?
Yes — Tufts Medicare Preferred HMO Prime Rx (HMO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $0.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for Tufts Medicare Preferred HMO Prime Rx (HMO)?
The 2026 in-network maximum out-of-pocket limit for Tufts Medicare Preferred HMO Prime Rx (HMO) is $3850.00, per the CMS CY2026 Landscape file.
What counties offer Tufts Medicare Preferred HMO Prime Rx (HMO) (H2256-033)?
Tufts Medicare Preferred HMO Prime Rx (HMO) (H2256-033) is offered in one Massachusetts county: Worcester County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.