As we move into 2026, there are important updates to benefits for both One Care and Senior Care Options (SCO) members.
We want to ensure you have seen some of these changes, as they are outlined in the Annual Notice of Change (ANOC) received by your CCA-covered patients. Please review the highlights below which apply to both One Care and SCO, unless otherwise stated:
1. Hearing Aids
- Coverage now includes one hearing aid per ear every 60 months.
2. Acupuncture & Chiropractic Care
- Members can access these services, but prior authorization (PA) is required after 20 visits.
3. Diabetes Supplies & Services
- Coverage includes products from Roche and Abbott for diabetes management.
4. Durable Medical Equipment (DME)
- Only Medicare and Medicaid-covered DME will be included.
5. Respite Care
- Medical respite services are now available for members experiencing homelessness.
6. Vision Care
- One Care: $75 every 24 months
- SCO: $300 annually
7. Expanded Access to Preventive Services
- Continued emphasis on preventive care with streamlined PA processes.
8. Integrated Care Coordination
- Enhanced coordination for members with complex needs.
9. Behavioral Health Support
- Reinforced coverage for mental health and substance use services.
10. Member Education
- Updated materials to help members understand and use their benefits effectively.
Effective January 1, 2026, the One Care program will transition from a Medicare-Medicaid Plan (MMP) to a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP). Members will continue to receive personalized, integrated care and access to comprehensive benefits designed to meet members’ needs. Watch for detailed guidance and education sessions in December to help you prepare for this transition and understand upcoming benefit changes.
If you have questions in the meantime, contact CCA Provider Services at 1-866-420-9332 (Mon–Wed & Fri: 8:00 a.m.–5:00 p.m.; Thu: 8:30 a.m.–5:00 p.m. ET).