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Private insurance companies that issue managed care policies to people who qualify under Medicaid, generally on the basis of a contractual arrangement with the state. Enrollment in a managed care plan may be voluntary or mandatory for some or all Medicaid recipients in a state; and participation requirements and associated criteria vary from state to state and in some cases, from area to area within the same state. Benefits covered by Medicaid vary by jurisdiction but generally include hospitalization, physician services, emergency room visits, family planning, immunizations, laboratory and x-ray services, outpatient surgery, chiropractic care, prescriptions, eye exams, eye glasses and dental care. Other covered services may include alcohol and drug treatment, mental health services, medical equipment and supplies and rehabilitative therapy. Medical benefits are administered by the insurance companies under terms of their contract.
The Senior Care Options program is a comprehensive health plan that provides all the services covered under Medicare and MassHealth, and other benefits if determined necessary by the Primary Care Team. Services are coordinated by the team and are accessed through its preferred provider network.
Senior Whole Health is a SCO that combines health-care services with social support services. Care is delivered by medical and other professionals who are part of the senior care organization network. SCO covers many services including primary care and specialty MD visits, regular preventive health-care services, prescription drugs, lab and x-rays, emergency care, inpatient hospitalization,…
United Healthcare SCO is a health plan available in Massachusetts (Senior Care Options) that combines Medicare and Medicaid services with social supports. It covers many services including, but not limited to, primary care and specialty physician visits, regular preventive health care services, prescription drugs, inpatient hospitalization, nursing facility care, community long-term care, emergency care, and…
This health plan for people 65 years and older, who have MassHealth Standard, combines Medicare and MassHealth Standard benefits including dental care, covered prescription drugs, eye care, routine hearing exams and hearing benefit, transportation and the services of a care manager.
This is a Senior Care Options Plan from Fallon Health available to people 65 years/older who live in the service area (all of MA except the Berkshires & Islands). They must have MassHealth Standard and may have Medicare Part A & B. Enrollees receive all health care services covered by MassHealth Standard (primary & specialty…