The Franklin Library, the first public library in the United States/Photo by Douglas Flynn

Senior Care Options (SCO) is a health insurance program for dually eligible Medicare and Medicaid recipients, 65 years of age or older.

No one is required to join Senior Care Options. Enrollment is voluntary.

In addition to health care benefits, members can receive Home Care Services through BayPath Elder Services. A team of health professionals from the Senior Care Options agency and BayPath Elder Services work collaboratively with the client and their loved ones to develop a plan of individualized care for each client. Services are provided by a network of medical and other professionals (including a primary care doctor, nurses, specialists, and a geriatric social support coordinator).

SCO Eligibility

The Eligibility requirements for the SCO program include:

  • 65 or older
  • Eligible for MassHealth (Standard)
  • Do not have end-stage renal disease
  • Agree to receive covered health services exclusively through the SCO plan

The program is open to elders in all living situations, including those living independently, those living at home with support services, and those in long-term care facilities.

What benefits come with enrollment in SCO?

When you enroll in Senior Care Options, you will get:

  • Coordination of your health care, including a centralized record of your medical information
  • Individualized assessment
  • Primary and specialty medical care
  • Preventive care
  • Emergency care
  • X-rays and lab tests
  • Medical supplies and equipment
  • Prescription drugs
  • Mental health and substance abuse treatment
  • Rehabilitative therapy
  • Nursing facility care if needed
  • Community long-term care hospitalization
  • Transportation for services included in your health plan
  • Specialized geriatric support services
  • Adult day care
  • Dental care and eye care
  • 24-hour access to medical support
  • Home care services
  • Family caregiver support

All health care services covered by MassHealth Standard. If you have Medicare in addition to MassHealth, you will also get all health care services covered by Medicare.

Important facts to know about SCO

After you enroll in Senior Care Options, MassHealth will only cover services provided by your senior care organization and its network of providers. It will not cover services from other doctors or health care providers, except in an emergency.

If you enroll in Senior Care Options and then decide it is not right for you, you can end your enrollment and go back to regular MassHealth coverage at any time.

You must continue to be eligible for Medicaid Standard while enrolled in a Senior Care Options plan and submit all required Medicaid documentation to continue eligibility.

What MetroWest caregivers should know about SCO

There are five different SCO programs offered at BayPath Elder Services. While there are some similarities between the SCOs, each uses a different model of service delivery and has different operating standards.

Related information and additional web resources

General information about the SCO Program can be found on the Massachusetts state website, including a guide to SCO Programs for MassHealth providers.

For more information and to request an enrollment form by phone, call the MassHealth Senior Care Options hotline at 1-888-885-0484 (TTY 1-888-821-5225) or contact the Senior Care Options organization directly as stated above.

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