The
2002 ENF for the Charles/MGH renovation project specifically called out that in the chosen design, "Connections to the Blue Line are direct and limit need for redundant construction".
This diagram is from the
2010 DEIR for the Red-Blue Connector:
While the DEIR had some questionable decisions like using a TBM rather than cut-and-cover, it serves as a good overview. The platform, and any tail tracks (if built), would not be under the existing station piers. The elevators, escalators, and stairs to the new Blue Line level would all fit in the existing lobby north of the Red Line tracks; minimal construction around and south of the tracks would be needed.