At Senior Whole Health, our mission is to maximize the quality of life, health, security and independence of our members.
We help our members and their families understand the complex world of healthcare. At Senior Whole Health, we help manage their care and arrange for them to receive the services they need. We do this with sensitivity to the challenges of those who don't speak English while catering to the cultural diversity of the more than 30 different languages our members speak.
Since enrolling its first member in Massachusetts in 2004, Senior Whole Health (SWH) has led the way as an affordable and innovative healthcare plan for "dual-eligibles" — people who qualify for both Medicare and Medicaid. Senior Whole Health is both an approved Medicare Special Needs Plan (SNP) and a Medicare Part D Plan. Available in Massachusetts and New York, Senior Whole Health provides members with better experiences through personal care management and comprehensive benefits.
Upon enrollment, members receive an initial home assessment to evaluate their needs from Senior Whole Health's Personal Care Team, which includes a nurse care manager and community resource coordinator.
These skilled healthcare professionals then develop a customized care plan to ensure that members obtain the right balance of medical, social and community-based services so that they remain healthy, independent and living within the comfort of their own homes.
Senior Whole Health's vision is to be a national leader in integrated healthcare that is simple, comprehensive, humane and respectful of its members.
Senior Whole Health's mission is to maximize our members' quality of life, health, security and independence by offering a voluntary healthcare plan that's simple to join, provides security and peace of mind through support and advocacy, and helps members live as independently as possible through comprehensive, community-based support and services.
Senior Whole Health integrates all Medicare, Medicaid and Medicare Part D Pharmacy benefits into one cohesive and comprehensive plan that is easy to use and easy to understand.
Senior Whole Health members and providers have 24/7 phone access to a Senior Whole Health Nurse Care Manager. Senior Whole Health Community Resource Coordinators arrange and organize services as well as act as advocates for our members. Home visits, collaboration with the members' doctors, availability of interpreters, and phone accessibility ensure a personal touch and quick response for our members.
Senior Whole Health members and their caregivers are involved in decisions regarding their healthcare. Access to an array of home and community-based services help to support our members in the residence of their choice, whether it is at home, in assisted living, a nursing home, or other location.
At Senior Whole Health, we measure our success by the quality of life we are able to provide our members.
We believe Senior Whole Health's unique approach to persons eligible for both Medicare and Medicaid offers care the way we all would like it — helpful, personal, coordinated, and providing a range of services based on individual needs.
Senior Whole Health, which currently insures seniors in Massachusetts and New York, offers comprehensive plans, each of which is designed to facilitate at-home living.
In its New York State service areas, Senior Whole Health offers:
- Medicare Advantage (HMO SNP) Medicaid Advantage PLUS — NHC Plan: A comprehensive Medicare Advantage Medicaid Advantage PLUS health plan for seniors 65 or older who are eligible for long term care and have both Medicare and Medicaid.
- Medicaid Managed Long Term Care (MLTC) Plan: Provides care, services and assistance with daily activities to Medicaid-eligible adults 21 years or older who are also eligible for long term care.
- SWH Whole Health FIDA Plan: FIDA is a new type of managed care plan for people who have both Medicare and Medicaid in New York State who require community or facility based long-term services and supports (LTSS).
In its Massachusetts service areas, Senior Whole Health offers:
- Senior Whole Health NHC (HMO SNP): A comprehensive healthcare plan for seniors who have both Medicare Part A and B, and MassHealth Standard. 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.
- Medicare Advantage Special Needs Plan (SNP): Senior Whole Health (HMO SNP) combines seniors’ Medicare benefits and MassHealth Standard benefits, including Medicare Part D, all in one convenient plan.
- Senior Care Options (SCO) Program: A comprehensive healthcare plan offering the same benefits as our Senior Whole Health HMO SNP for seniors with MassHealth Standard only.