Prior authorization resources

Harvard Pilgrim Health Care

• Harvard Pilgrim Commercial Referral/Auth./Notification Quick Reference Guide 

Harvard Pilgrim Health Care (New Hampshire only)

• Harvard Pilgrim Health Care-NH Commercial Prior Authorization
   

Tufts Medicare Preferred

• Tufts Medicare Preferred (HMO and PPO) Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines 
• Tufts Medicare Preferred (HMO and PPO) Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines (Eff. beginning 06.01.2026)

Tufts Health Senior Care Options

• Tufts Health Plan Senior Care Options Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines
• Tufts Health Plan Senior Care Options Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines (Eff. beginning 06.01.2026)

Tufts Health One Care

• Tufts Health One Care Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines
• Tufts Health One Care Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines (Eff. beginning 06.01.2026)
• Tufts Health One Care Behavioral Health Prior Authorization (PA) and Notification Grid

Tufts Health MATogether

• Tufts Health MATogether-MassHealth ACO Prior Authorization

Tufts Health RITogether

• Tufts Health RITogether Medicaid Prior Authorization

Behavioral Health

• Tufts Health RITogether Behavioral Health Prior Authorization (PA) and Notification Grid
• Tufts Health Together and Tufts Health Direct Behavioral Health Prior Authorization (PA) and Notification Grid