Bringing Medicare and MassHealth Together - SCO (Senior Care Options)

Linda Slota, Director Webster Senior Center

Senior Care Options is a new program that combines health-care services with social support services to help you maintain your health and stay in your own home. With SCO, a team of medical professionals works together to provide you with care that is individually tailored to your needs. Plus, your SCO doctor provides coverage 24 hours a day, so you can get information or help any time you need it.

How Do I Get My Care?

With SCO, you and your family are in control of your health care. When you join, you and your family meet with a doctor that you choose from the SCO network. Together, you develop a care plan that is designed just for you. Your doctor, along with a team of nurses, specialists, and a geriatric support services coordinator, coordinate all of our care, so you can get the health care you need when you need it.

What is Covered?

SCO covers all the health care services you get from MassHealth. If you have Medicare, those services are covered too. The care is delivered by medical and other professionals who are part of a network, called a senior care organization, that was created specifically to serve seniors.

SCO covers many services including:

• Primary care visits
• Specialty physician visits
• Regular preventaive health care services
• Prescription drugs
• Lab and X-rays
• Emergency care
• Inpatient hospitalization
• Mental health treatment services
• Substance abuse treatment services
• Nursing facility care
• Community long term care
• Transportation for medical care
• Other services that are in your care plan

What are the Benefits of Joining?    

There are many benefits of joining. In addition to all of the services that MassHealth and Medicare cover, you get:

• Coordination of your care including:
• A team of professionals who know you and your health-care needs
• A centralized record of your health and medical information
• Your active involvement in all of the decisions made about your care
• Individualized care including:
• A care plan that is designed specifically for you
• Specialized geriatric support services
• 24 hour access to a team of professinals who can answer your questions or give you information you may need
• Supportive Care for you and your family to help you stay at home such as:
• Rehabilitative therapies
• Medical equipment
• Home care services
• Respite care for your family or other caregiver

Is This an HMO?

No. senior care organizations are different from HMOs (health maintenance organizations). As with an HMO, you choose a primary care doctor from the SCO network who coordinates your care. But unlike an HMO, SCO covers all of the services that MassHealth and Medicare cover, including comprehansive prescription drug coverage, long-term care and supportive care at home. 

Do I Have to Join SCO?