Complaints

This profile includes complaints for Tufts Health Plan's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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• 

  Tufts Health Plan

  1 Wellness Way Canton, MA 02021-1166

• 

  Tufts Health Freedom Insurance Company

  11 S Main St STE 203 Concord, NH 03301

• 

  Tufts Health Plan

  75 Fountain St Fl 1 Providence, RI 02902-0050

• 

  Tufts Health Freedom Insurance Company

  11 S Main St STE 203 Concord, NH 03301

• 

  Tufts Health Freedom Insurance Company

  11 S Main St STE 203 Concord, NH 03301

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:04/03/2023

  Type:Customer Service Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was told that I would have coverage for docs appointment on 26 October and November and apparently theyre saying I did not despite the fact that weeks ahead of time I did. But the hospital and myself Ive been trying to get a hold of them with them either saying the same thing out with me they have not responded whatsoever. It is very clear that this is a scam through the state and attempting to get myself and Im on the hook for $1500 with my service was supposed to be free. Complete in confidence and crooks.

  Customer Answer

  Date: 04/14/2023

  I have heard back from the business stating that mass health would be responsible. Both of them state the other one would be how are masshealth just yesterday said that they would cover. However, Im not sure if they are going to cover with Tufts health insurance or not, and would like to keep this open until the matter is resolved.

  Business Response

  Date: 04/17/2023

  The plan will reach out directly to the member to discuss these concerns.

  Customer Answer

  Date: 04/18/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response submitted by the business and look forward to hearing from the business by EOD 5/2/2023. 
  
  Regards,
  
  *************************

• Initial Complaint

  Date:02/08/2023

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  A few weeks ago I filed a complaint about ******************* and Tufts Health Plan sending me a bill seeking payment from services provided back in 2020. I had already paid those bills but they have resent bills asking for more money because they recalculated their payments from then and determined I now owed more. I already paid the bill 3 years ago and it isn't okay for businesses to randomly ask for thousands of dollars of more ******* years later on settled bills!I now have another bill from the ****** ******************* Physicians Organization for an extra $1,820.36 for the same reason! I need these bills waived as improper and any credit report damage corrected. The other bill caused ****** ******************* to immediately send me to collection because I was 3 years late in paying from the moment they increased my billing amount!

  Business Response

  Date: 02/09/2023

  The individual who submitted this concern does not correlate to the individual listed on the attached BCH invoice, therefore we are unable to respond to due to HIPPA regulations. 

  Customer Answer

  Date: 02/09/2023

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  They have sent me to collections based upon rebilling me three years after I already paid for services. Their corporate greed clearly affects me.
  
  Regards,

  *****

   

   

• Initial Complaint

  Date:01/25/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  1. On January 28, 2020, I had an X-Ray at ****** ******************* (BCH).2. BCH then billed Tufts Health Plan $1894 3. In February 2020, Tufts Health Plan Paid $1085.26 under an agreed adjustment rate between the two parties and my father (***********************) was billed $75, which he paid.4. In December 2022, nearly 3 years later, Tufts Health Plan retracted payment of the $1085.26 and posted payment of $835.94 5. On January 12, 2023, BCH created a new invoice stating my father owes them $250.32 6. On January 18, 2023, ***********************, LLC, a debt collector, created an invoice directed to both me and my father on behalf of BCH for $250.32 7. On January 23, 2023, we received both invoices in the mail at our house.8. On January 25, 2023, a call to a BCH representative occurred, where the representative referred us back to Tufts for an explanation of why they changed their payment.We were billed 3 years ago, paid the bill so it should have ended there. Re-billing us 3 years later is insane and then sending us to collection on top of that is abusive beyond belief! We need 2 resolutions - an end to this billing and correction to our credit reports that we were ever late on payment and we were sent to collection!

  Business Response

  Date: 01/26/2023

  This has been forwarded to the Grievance Team for research. An acknowledgement letter will be sent with contact information.

  Customer Answer

  Date: 01/27/2023

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  This does not resolve the egregious actions taken by Tufts Health Plan and ****** ******************* where my bill was paid in full several years ago and then my father and I were sent to collection at the same time we notified of this corporate greed. We have also notified the ************* ************************* of the outrageous actions taken by these entities.

  
  Regards,

  *****

   

   

  Business Response

  Date: 01/30/2023

  A grievance acknowledgement letter was mailed on 1/27/23 which included the name of the Analyst who has been assigned the complaint this letter includes the contact information.  The Analyst may be contacted directly with any questions or additional information.

  The complaint will be thoroughly investigated following our standard grievance process and a response with the results of the investigation and next steps will be sent directly to the member within 30days of receipt of the compliant.

  Customer Answer

  Date: 01/31/2023

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  This is clearly not a solution to the injustice inflicted upon us.  
  
   
  FAQ
  
  Regards,

  *****

   

   

• Initial Complaint

  Date:12/02/2022

  Type:Sales and Advertising Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I am a contracted health care provider with Tufts Health. I called them on 10/28/22 due to missing 6 checks that they had issued to me as payment for services I provided to their members. They stated in my phone call that the checks that were missing had been cashed. I checked all of my records and found that I had not cashed them, and that I suspect they were stolen. I asked Tufts Health what we could do -- they stated they could email me copies of the cashed checks within **** business days so I could seek legal action against whoever fraudulently cashed these checks. I requested that they send them. On 11/14/22 I called them back again to check on the status of receiving copies of these checks. They stated that on 11/2/22 there was a note in their file from their finance department stating they could not give me copies. I asked the person at Tufts why -- they stated no further info was given. They then reported to me that they would resubmit the request with another request for further info. They stated I would receive a response back within 3-5 business days.On 11/18/22 I called again due to not receiving a response. They stated that I needed to wait until 11/22/22 for additional information.On 11/28/22 I called again due to still not receiving any further information. The call center person I spoke with stated they were filing individual requests for each check, and that the finance department supervisor would email me within 72 hours to schedule a time to talk further about these stolen checks. My ref# for this call is AR112822.Today is 12/2/22. I have not received any further followup communication from Tufts. They have not attempted to reach out to me about this matter. All I am asking for is a copy of the cashed checks so I can seek legal action against whoever stole the checks, but they are refusing to provide it to me.

  Business Response

  Date: 12/02/2022

  This complaint has been directed to the appropriate department for handling Provider Complaints, outreach will be made directly to address these concerns.

   

  Customer Answer

  Date: 12/08/2022

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved. 
  

  I was contacted directly by the Business as stated in their message and they provided me with exactly the information I was looking for. I will communicate directly with them from this point forward. Thank you BBB and Tufts for resolving my problem.

  
  Regards,
  
  *********************

• Initial Complaint

  Date:10/12/2022

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  We filed for a gym membership reimbursement for myself and my wife with Tufts ****************** as part of our annual benefit in Mar-Apr 2022.Due to a clerical error on part of our gym (BSC), initial receipt had one month membership fee listed separately. Tufts called this a "club usage fee for towels etc" and denied it for both. I got the error corrected and resubmitted a new receipt. This time Tufts approved my claim but denied my wife's even though same/similar receipt was submitted for her. This issue was escalated to "*******" who probably got the same erroneous receipt and denied it too. There's a hearing process which I cannot exercise as the amount is lower than $100 (69,99).I called Tufts again to refill and review the claim. This request is still not being processed. I have been dealing with this for last 6 months. Tufts employees have been lethargic in handling this claim and don't respond to my phone messages. They are an inefficient and incompetent organization.I need this claim rightfully processed and money reimbursed. So looking for your help. My case is ******* clear and even some Tufts employees as well as HHS department employees admit Tufts is in the wrong.I can provide names and extensions of some of the employees I have spoken to.Thanks *********************

  Business Response

  Date: 10/13/2022

  Thank you. The plan will reach out to the member directly to discuss their concerns.

  Customer Answer

  Date: 10/31/2022

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  I have not received a reply from tufts.  

  Business Response

  Date: 10/31/2022

  The member was contacted on 10.31.22 in response to their concern and this has been closed per documentation of the call 10.31.22 as no further questions.

• Initial Complaint

  Date:08/24/2022

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have a referral from my GI Dr for endoscopy due to liver issues and waited for 4 weeks for my procedure: I received a call from the Md the evening before they cancelled because tufts wouldnt cover it. The Md at Tufts deemed it unnecessary despite previous testing indicating its needed. I need this test before surgery and have needed the surgery for months. What is my recourse? The Md never responded to My Dr for peer to peer discussion and my md was working on this all week. Horrible product and service Tufts insurance.

  Business Response

  Date: 08/25/2022

  The plan has received this complaint and will respond to the member directly.

• Initial Complaint

  Date:07/29/2022

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My husband has an autoimmune disease and requires infusions every 3 weeks. We finally got tufts to approve the treatment 2 weeks ago and now they are denying it. My husband is 8 weeks past his treatment date, meaning his last treatment was 11 weeks ago. This company has a serious internal communication problem. They initially denied it because "they don't su infusions every 3 weeks, only every 4 weeks. Then they denied it because they don't use ********** They've blamed the hold up on the doctor then on the pharmacy. The reason they gave for the denial today was a change in doctors, but he's had the same neurologist for 20 years. We could go to an ER who has a neurologist on hand but they don't do a rapid infusion and that means a 3 day in-patient stay. This is ridiculous! We've bent over backwards doing everything they've asked to get this through and they keep playing games. So my husband's sits here losing strength every day and is at high risk of causing permanent damage because he can't get his infusion meds

  Business Response

  Date: 08/03/2022

  The plan has received this complaint and will respond to the member directly.

• Initial Complaint

  Date:06/24/2022

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Starting on January 2022 Tufts was billing $129 a month for Member Premium. In April, after they were paid the $129 a letter from Tufts saying the Monthly member premium was $92.70 effective 01/01/2022. Tufts was contacted about the over payments that were made to that date.After many contacting Tufts several times they finally agreed that they were over paid and would issue a credit for $145.20. Instead they actually sent a check for the $145.20 which was fine. However on the next **** sent they added a charge for $145.20 to the total due for for that statement. They also charged $$20.10 for a Direct Payment fee. When asked about this $20.10 they said it was some sort of computer software issue and had been added to all bills sent out, in error, and should be disregarded. Tufts insisted The **** was just confusing and they weren't actually charging the $145.10. They May **** they sent shows a credit of $52.50, which Tufts says is incorrect and they are actually owed money for **** Tufts has been asked repeatedly to please send a "clean" **** that does not include theses erroneous charges. Their response was they cannot.All that is wanted is for Tufts to send a **** that accurately shows that correct amount due them for services.************************* Member number S00165274

  Customer Answer

  Date: 07/04/2022

  I have not heard from the business in response to my complaint.

  Business Response

  Date: 07/05/2022

  This complaint was received back on 6/24/2022 and will be responded to the member accordingly within the timeframes provided.

  Customer Answer

  Date: 07/05/2022

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  [You must provide details of why you are not satisfied with this resolution.  If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
  
  Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
  
  FAQ
  
  Regards,

  ****