You may be eligible for a Dual Special Needs Plan

Did you know that if you have both Medicare and MassHealth, you may be dual-eligible? This means you have the choice to enroll in a Dual Special Needs Plan (D-SNP). If you do, you may get extra benefits. That’s because a D-SNP combines benefits from both Medicare and Medicaid to provide coordinated care and extra support services. This puts all your care into a single plan with one care team, one card, and one phone number.

A D-SNP can offer extra benefits at no additional cost, such as:

• Rides to the doctor
• Help at home
• Dental care
• Eyeglasses

Explore your care options

If you’re interested in a D-SNP—there are three options.

1. Senior Care Options (SCO) is a comprehensive managed care program implemented by the Executive Office of Health and Human Services (EOHHS) in collaboration with the Centers for Medicare & Medicaid Services (CMS) for the purpose of delivering and coordinating all Medicare- and Medicaid-covered benefits for eligible Massachusetts individuals managed by a SCO Plan using a person-centered model of care.

To enroll in SCO, you must:

• be 65 years of age or older
• be enrolled in MassHealth Standard, the state's Medicaid program for individuals 65+
• live in a geographic area that offers SCO services

2. One Care is a comprehensive managed care program implemented by EOHHS in collaboration with CMS for the purpose of delivering and coordinating all Medicare- and Medicaid-covered benefits for MassHealth Members eligible for both programs. Services are developed and delivered based on an Enrollee’s person-centered assessment and care plan.

To enroll in One Care, you must:

• be between the ages of 21-64
• have a disability
• have Medicare Parts A and B
• qualify for Medicare Part D
• have MassHealth Standard or MassHealth CommonHealth
• not have private health insurance
• not take part in a Home and Community Based Service
• live in an area covered by a One Care plan

3. Program of All-inclusive Care for the Elderly (PACE) is a program run by MassHealth and Medicare, with its own interdisciplinary teams and individualized care plans to keep elders in their communities.

To enroll in PACE, you must:

• be 55 or older
• live in the service area of a PACE organization
• be certified by the state as eligible for nursing home care
• be able to live safely in the community
• agree to receive health services exclusively through the PACE organization

To get more information, you can:

• Call the state’s Medicaid office or Medicare
• Visit Medicare.gov or the state’s Medicaid website
• Speak with a licensed insurance agent
• Ask a trusted provider or community resource for guidance