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Answers to frequently asked questions
about Senior Care Options

When you join a new health care plan, you always have questions. Here are some of the most frequently asked questions about the Commonwealth Care Alliance Senior Care Options. If you have other questions that aren’t answered here, please call Member Services at 866-610-2273 (TTY 711) from 8 a.m. to 8 p.m., 7 days a week.

  • What is Senior Care Options?

    Senior Care Options (SCO) is a healthcare program for people over age 65 who have both Medicare and MassHealth Standard or just MassHealth Standard. With SCO, you get your MassHealth Standard coverage and MORE—at no additional cost. SCO provides a team of health professionals all working with you to help you stay safe, independent, and living in your home. Your team includes a primary care provider, nurses, specialists, and a geriatric support coordinator. You can receive care in your providers' offices or in your home, whichever works best for you.

  • What are the benefits of Senior Care Options?

    With Senior Care Options (SCO), you get all the services you received through your MassHealth Standard coverage, and more. This includes primary and specialty medical care, preventive care, emergency care, X-rays and lab tests, medical supplies and equipment, prescription drugs, and more at no cost to you. Click here

    for a complete list of Commonwealth Care Alliance SCO services and benefits.
  • What does Senior Care Options cost? Is there a monthly premium?

    You will not pay any money to Commonwealth Care Alliance for your health coverage.
    Important: If you pay a premium to MassHealth or Medicare, you must continue to pay your premiums to keep your coverage.

  • I lost my ID card. How do I get a new one?

    Please call our Member Services team at 866-610-2273 (TTY 711), and we’ll be happy to send you a replacement ID card.

  • What if I want to change my primary care provider (PCP)?

    You may change your primary care provider (PCP) for any reason, at any time, and choose another doctor from the Commonwealth Care Alliance network. To find a new doctor, click below to search our Online Provider Directory or call our Member Services team at 866-610-2273 (TTY 711).
    Search the Senior Care Options Online Provider Directory.

  • Do I have to change my primary care provider or specialists
    when joining SCO?

    When you become a member of Commonwealth Care Alliance, you must choose a provider in our network to be your primary care provider. We have a large network of quality primary care providers and specialists, so there’s a good chance your current doctors and other providers are in our network and you won’t have to make a change. To see if your doctors and other providers are in the Commonwealth Care Alliance network, search our online provider directory.
    Search the Senior Care Options Provider Directory 
    You may also call our Member Services team at 866-610-2273 (TTY 711).

  • I received a bill from a doctor or other medical provider. What do I do with it?

    As a Commonwealth Care Alliance member, you DO NOT have to pay any bills for the services we cover. If you receive a bill from a doctor or medical provider, please send or fax it to:

    Commonwealth Care Alliance
    Member Services Department
    30 Winter Street, Boston, MA 02108
    Fax: 617-426-1311.

    Please note: You must submit any medical bills you receive to us within twelve (12) months of the date you received the service, item, or drug.

  • What dental services are covered under my plan?

    Your plan covers comprehensive dental services at no cost to you. Your dental benefits include:

    • Exams, cleanings, and X-rays
    • Fillings, extractions, and gum disease treatment
    • Crowns, bridges, and root canals
    • Dentures and implants
    • Other services that are medically necessary
  • How do I use my dental benefits?

    Once you receive your CCA member ID card, schedule an appointment with  general dentist in our network. You can find an in-network dentist by using our provider directory or by calling Member Services at 866-610-2273 (TTY 711) from 8 a.m. to 8 p.m., 7 days a week. Your dentist will assess and treat you, and will also refer you as necessary for services that require prior authorization.

  • How do I find a dentist?

    You can find a dentist in the Commonwealth Care Alliance network by using our provider directory or by calling Member Services at 866-610-2273 (TTY 711) from 8 a.m. to 8 p.m., 7 days a week.

  • How do I get transportation approved?

    All non-emergency transportation, whether medical or non-medical, requires prior authorization. During your assessment or thereafter, please communicate with your care partner your need for transportation.

  • Is there prescription drug (Medicare Part D) coverage?

    Yes. As a Commonwealth Care Alliance SCO member, you have no costs for your prescription drug coverage. We’ll cover the drugs listed in our formulary as long as they are medically necessary. Your enrollment entitles you to needed over-the-counter drugs and health care supplies free of charge with a prescription.

  • What is a care team?

    A care team is a group of people that will get to know your needs and work with you to help you create and carry out a personal care plan. Your care team will include a primary care provider, nurses, specialists, and a geriatric support coordinator. They’ll talk to you about who you’d like to provide care services and when you’d like to get the services. Your care team will work with you to become more independent or to stay independent.

For detailed information on out-of-network coverage rules, see your Evidence of Coverage (Member Handbook): Using the Plan’s Coverage for your Medical and Other Covered services.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Benefits, formulary, and/or pharmacy network may change on January 1 of each year.

 
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