Our Programs & Member Eligibility

Senior Whole Health NHC (HMO SNP)

Senior Whole Health NHC (HMO SNP) is designed for members who receive home and community-based support services because they have functional deficits. These services help persons who normally qualify for a nursing home (Nursing Home Certifiable) to remain safely at home.

Benefits & Services.

Members get all their MassHealth Standard benefits, Medicare benefits and Medicare Part D Prescription plan, plus:

  • $0 doctor appointments
  • $0 dental visits
  • $0 vision visits
  • $0 prescription and over-the-counter drugs
  • 24/7 phone access to a Senior Whole Health Nurse Care Manager
  • Transportation to and from medical appointments (limitations apply)
  • Health club/gym membership (limitations apply)
  • Personal Care Team who helps members receive quality medical, social and community based services

Who can join Senior Whole Health NHC (HMO SNP)?

Eligible beneficiaries may enroll at any time of the year if they:

  • Are 65 years old or older; and
  • Have both Medicare Part A and Part B, and MassHealth Medicaid eligibility; and
  • Live in Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk or Worcester county.

Senior Whole Health (HMO SNP)

As a Medicare Advantage Special Needs Plan (SNP), Senior Whole Health covers all members' Medicare benefits, MassHealth Standard benefits and Medicare Part D Prescription plan — all in one plan, with one card.

Benefits & Services.

Members get all their MassHealth Standard benefits, Medicare benefits and Medicare Part D Prescription plan, plus:

  • $0 doctor appointments
  • $0 dental visits
  • $0 vision visits
  • $0 prescription and over-the-counter drugs
  • 24/7 phone access to a Senior Whole Health Nurse Care Manager
  • Transportation to and from medical appointments (limitations apply)
  • Health club/gym membership (limitations apply)
  • Personal Care Team who helps members receive quality medical, social and community based services

Who can join Senior Whole Health (HMO SNP)?

Eligible beneficiaries may enroll at any time of the year if they:

  • Are 65 years old or older; and
  • Have both Medicare Part and B, and MassHealth Medicaid eligibility; and
  • Live in Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk or Worcester county.


Senior Whole Health (SWH) Senior Care Options (SCO) Program

Those who have MassHealth Standard, but do not have Medicare Part A and/or Part B coverage, may be eligible to enroll in our MassHealth Senior Care Options (SCO) program offering the same benefits listed above in addition to all the MassHealth Standard benefits.

Who can join Senior Whole Health (SWH) Senior Care Options (SCO)?

 Eligible beneficiaries may enroll at any time of the year if they:

  • Are 65 years old or older; and
  • Have MassHealth Standard; and
  • Live in Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk or Worcester county.
Last Updated 02/03/2016