Formularies

For coverage dates starting 01/01/2021, refer to the following links:

For coverage dates starting 01/01/2020, refer to the following links:

Formulary Tier Structure

3-Tier Pharmacy Copayment Program

Tufts Health Freedom Plan has adopted a three-tiered approach to the cost of prescription drugs in order to provide members with choice and affordable options when it comes to prescription drugs.

All covered drugs are divided into three tiers. Providers have the option to write a prescription for a Tier-1, Tier-2 or Tier-3 drug (as defined below). Tufts Health Freedom Plan realizes there may be instances when only a Tier-3 drug is appropriate, which will require a higher copayment from the member.

Note: Tiers are subject to change throughout the year.

The 3-Tier Copayment Program places all covered prescriptions into one of the following tiers:

  • Tier-1: Medications on this tier have the lowest cost sharing amount
  • Tier-2: Medications on this tier have a higher cost sharing amount
  • Tier-3: This is the highest copayment tier have the highest cost sharing amount

4-Tier Pharmacy Copayment Program

If the member’s plan includes a 4-Tier Copayment design, all covered drugs are divided into four tiers. Providers have the option to write a prescription for a Tier-1, Tier-2, Tier-3, or Tier-4 drug (as defined below). Tufts Health Freedom Plan realizes there may be instances when only a Tier-4 drug is appropriate, which will require a higher copayment from the member.

The 4-Tier Copayment Program places all covered prescriptions into one of the following tiers:

  • Tier 1: Medications on this tier have the lowest cost sharing amount
  • Tier 2: Medications on this tier have a higher cost sharing amount
  • Tier 3: Medications on this tier have a higher cost sharing amount
  • Tier 4: Medications on this tier have the highest cost sharing amount; limited to a 30- day supply

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Provider Update Newsletter

Tufts Health Plan distributes its Provider Update* newsletter by email. In order to receive Provider Update, you must complete the online registration form.

*Copies of this information can be made available upon request by calling the appropriate Tufts Health Plan Provider call center.

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