When you join a new health plan, you have questions. We are here to help. These are some of the most common questions about Commonwealth Care Alliance Senior Care Options (HMO D-SNP).
CCA Senior Care Options is a health plan for people aged 65 and over who have MassHealth Standard or MassHealth Standard and Medicare.
When you join, you keep all the benefits you currently get through your MassHealth Standard coverage, like: primary and specialty medical care, preventive care, emergency care, and X-rays and lab tests.
AND, you get MORE benefits—at $0 cost to you, including:
- A Healthy Savings (OTC) card with up to $524 per year in 2022 ($1,140 per year in 2023) to spend on health-related items and approved food
- Transportation for medical appointments and certain activities
- Full dental care
- Vision and hearing care
- Prescription drugs with no out-of-pocket costs
Click here to see the full list of CCA Senior Care Options benefits. Some services, items, and drugs may require pre-approval (“authorization”).
You will not pay any money to Commonwealth Care Alliance (CCA) 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.
Most likely, yes. Commonwealth Care Alliance has a large network of doctors. There’s a good chance your current doctors and other care providers are in our network.
When you become a member, you must choose a provider in our network to be your primary care provider (PCP) .
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 mail or fax it to:
Commonwealth Care Alliance
Member Services Department
30 Winter Street, Boston, MA 02108
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.
Once you receive your Commonwealth Care Alliance member ID card, schedule an appointment with a general dentist in our network. You can find a dentist by using our Provider Directory or by calling Member Services. Your general dentist can also refer you for special dental services that require pre-approval (“authorization”).
Click here for a complete list of CCA Senior Care Options benefits and services.
If you do not have access to transportation, Commonwealth Care Alliance can help you with rides to and from medical appointments. We also cover 8 one-way trips per month for non-medical needs, like grocery shopping or church.
Talk to your care partner about your transportation needs. After your care partner adds transportation to your care plan, you can schedule rides through our transportation manager, Coordinated Transportation Services (CTS). Call Member Services and dial 4 to connect to CTS.
Yes. As a CCA Senior Care Options member, you have no costs for your prescription drugs. We will cover the drugs listed in our formulary as long as they are medically necessary. We cover over-the-counter drugs with a prescription too.
Your Commonwealth Care Alliance care team works together to direct and deliver the care and services you need. They work closely with your doctor, other care providers, and community resources. Your care team includes your CCA care partner and other specialists focused on your specific needs, like nursing care, behavioral health, housing, and food resources. You and your care team will make important decisions together according to your personal care plan.
For detailed information on out-of-network coverage rules, see your Evidence of Coverage: Using the Plan’s Coverage for Your Medical and Other Covered Services (Chapter 3).
For detailed information on your transportation benefit, see your Evidence of Coverage: Benefit Chart (Chapter 4, Section 2).
The benefit information provided here is a brief summary, not a complete description of benefits. Benefits, formulary, pharmacy, and/or provider networks may change on January 1 of each year. Limitations, copayments, and restrictions may apply. You will be covered for all services listed above as long as they are approved and/or coordinated by your primary care provider, your care team, or Commonwealth Care Alliance (CCA). For more information, call CCA Member Services or review your CCA Senior Care Options Evidence of Coverage.