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Your Choice 3-Tier Option— A Tiered Provider Network Plan

2020 Tiering List

Your Choice is a Tufts Health Plan tiered provider network comprised of providers, specialists and .

As part of our National Committee for Quality Assurance (NCQA) accreditation and our own quality standards, we are committed to contracting only with high-performing hospitals. Every doctor and every hospital in the Your Choice network has been carefully evaluated, and every provider and hospital in the Your Choice network meets our standard for quality of care.

Because not all doctors and hospitals charge the same costs, we’ve factored in cost- efficiency in our evaluation, and we have separated Your Choice providers into three tiers. Provider groups and their primary hospital affiliation are in the same tier to reflect referral patterns that those physicians would make most often.*

Below is a list of all the hospitals in Tufts Health Plan’s network and their tiers.

In choosing a tier, members must consider how much they are willing to pay out-of- pocket for the doctor and/or hospital they prefer. If members want the most cost- effective option, they should choose a doctor or hospital from Tier 1. If the doctor or hospital is in Tier 2 or Tier 3, they have the freedom to choose, but they will pay higher out-of-pocket costs.

Members pay different levels of copayments, coinsurance, and/or deductibles depending on their plan design and the tier of the provider delivering a covered service or supply. Your plan may make changes to a provider’s tier annually. Please consult the Your Choice provider directory or visit the provider search tool at tuftshealthplan.com and click on Find a Doctor to determine the tier of providers in the Your Choice Tiered Provider Network.

*We have created the provider tiers for Your Choice at the physician group level—not on an individual provider basis. A physician’s tier does not guarantee the quality of care that members might receive from a specific physician or practice group, or a certain health outcome. Members should always speak with their physician when making decisions about where to get care.

Your-Choice-3-Tier-Hospital-List-09/19 HOSPITAL TIER STATE

Anna Jaques Hospital 1 MA

Athol Hospital 1 MA

Baystate Franklin Medical Center 1 MA

Baystate Medical Center 1 MA

Baystate Noble Hospital 1 MA

Baystate Wing Memorial Hospital 1 MA

Beth Israel Deaconess Medical Center - Plymouth 1 MA

Beth Israel Deaconess Medical Center 1 MA

Beth Israel Deaconess Medical Center Needham 1 MA

Beth Israel Deaconess Medical Center - Milton 1 MA

Boston Medical Center 1 MA

Brockton Hospital (Signature) 1 MA

Cambridge Health Alliance 1 MA

Carney Hospital 1 MA

Charlton Memorial Hospital 1 MA

Dana-Farber Cancer Institute 1 MA

Good Samaritan Medical Center 1 MA

Harrington Hospital 1 MA

Heywood Hospital 1 MA

Holy Family Hospital 1 MA

HOSPITAL TIER STATE

Holy Family Hospital at Merrimack Valley Hospital 1 MA

Holyoke Medical Center 1 MA

Lahey Clinic Hospital 1 MA

Lawrence General Hospital 1 MA

Lowell General Hospital 1 MA

Marlborough Hospital 1 MA

Melrose Wakefield HealthCare Lawrence Memorial Hospital 1 MA

Melrose Wakefield HealthCare Melrose Wakefield Hospital 1 MA

Mercy Medical Center 1 MA

MetroWest Medical Center 1 MA

Milford Regional Medical Center 1 MA

Morton Hospital and Medical Center 1 MA

Mount Auburn Hospital 1 MA

Nashoba Valley Medical Center 1 MA

New England Baptist Hospital 1 MA

Northeast Hospital Corp (Addison Gilbert Hospital) 1 MA

Northeast Hospital Corp (Beverly Hospital) 1 MA

Norwood Hospital 1 MA

South Shore Hospital 1 MA

St. Anne's Hospital 1 MA

HOSPITAL TIER STATE

St. Elizabeth's Medical Center 1 MA

St. Luke's Hospital 1 MA

St. Vincent Hospital 1 MA

Sturdy Memorial Hospital 1 MA

Tobey Hospital (Southcoast) 1 MA

Tufts Medical Center 1 MA

UMass Memorial HealthAlliance - Clinton Hospital 1 MA

UMass Memorial Medical Center 1 MA

Winchester Hospital 1 MA

Alice Peck Day Hospital 2 NH

Androscoggin Valley Hospital 2 NH

Brattleboro Memorial Hospital 2 VT

Cape Cod Hospital 2 MA

Catholic Medical Center 2 NH

Cheshire Medical Center 2 NH

Concord Hospital 2 NH

Cottage Hospital 2 NH

Elliot Hospital 2 NH

Exeter Hospital 2 NH

Falmouth Hospital 2 MA

HOSPITAL TIER STATE

Franklin Regional Hospital 2 NH

Frisbie Memorial Hospital 2 NH

Huggins Hospital 2 NH

Kent County Hospital 2 RI

Lakes Region General Hospital 2 NH

Landmark Medical Center 2 RI

Littleton Regional Hospital 2 NH

Maine Medical Center 2 ME

Mary Hitchcock Memorial Hospital 2 NH

Memorial Hospital NH 2 NH

Miriam Hospital 2 RI

Monadnock Community Hospital 2 NH

Mount Ascutney Hospital 2 VT

New London Hospital 2 NH

Newport Hospital 2 RI

Our Lady of Fatima Hospital 2 RI

Parkland Medical Center 2 NH

Portsmouth Regional Hospital 2 NH

Rhode Island Hospital 2 RI

Roger Williams Medical Center 2 RI

HOSPITAL TIER STATE

South County Hospital 2 RI

Southern Maine Medical Center 2 ME

Southern N.H. Medical Center 2 NH

Southwestern Vermont Medical Center 2 VT

Speare Memorial Hospital 2 NH

Springfield Hospital 2 VT

St. Joseph Hospital (Nashua) 2 NH

The Westerly Hospital 2 RI

Upper Connecticut Valley Hospital 2 NH

Valley Regional Hospital 2 NH

Weeks Medical Center 2 NH

Wentworth-Douglass General Hospital 2 NH

Women and Infants Hospital 2 RI

York Hospital 2 ME

Berkshire Medical Center 3 MA

Boston Children's Hospital 3 MA

Brigham & Women's Faulkner Hospital 3 MA

Brigham and Women's Hospital 3 MA

Cooley Dickinson Hospital 3 MA

Emerson Hospital 3 MA

HOSPITAL TIER STATE

Fairview Hospital 3 MA

Martha's Vineyard Hospital 3 MA

Massachusetts Eye & Ear Infirmary 3 MA

Massachusetts General Hospital 3 MA

Nantucket Cottage Hospital 3 MA

Newton-Wellesley Hospital 3 MA

North Shore Medical Center (Salem Hospital) 3 MA

North Shore Medical Center (Union Hospital) 3 MA