Frequently Asked Questions (FAQs)
Who can join?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.
You are eligible for membership in Senior Whole Health NHC (HMO SNP) if:
- You are 65 years old or older; and
- You have both Medicare Part A and B, and MassHealth Medicaid eligibility; and
- You live in Bristol, Hampden, Essex, Middlesex, Norfolk, Plymouth, Suffolk or Worcester county.
- You do not meet the eligibility criteria listed above.
- You are diagnosed with End-Stage Renal Disease (ESRD). However, if you develop ESRD while a member of Senior Whole Health NHC (HMO SNP) you can stay in the program.
- You are subject to a six (6)-month deductible period (spend-down).
- You are a resident of an intermediate care facility for the intellectually disabled.
- You are an inpatient in a chronic disease or rehabilitation hospital.
If you meet the eligibility requirements above but are not nursing home certifiable, you may qualify for Senior Whole Health Special Needs Plan (HMO SNP).
If you have MassHealth Standard, but do not have Medicare Part A and/or Part B coverage, you may be eligible to enroll in our MassHealth Senior Care Options (SCO) program.
What is Senior Whole Health's service area?Senior Whole Health's service area includes Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester County. In addition to other eligibility requirements, you must reside in our service area to become a Senior Whole Health member.
Do I still get my Medicare and MassHealth benefits?Yes, you still receive all your Medicare, MassHealth Standard, and Medicare Part D Prescription Drug benefits. Plus more benefits and services from Senior Whole Health.
When is the open enrollment period?Eligible beneficiaries may enroll at anytime of the year.
Last Updated 04/23/2018
H2224_2016_099 Approved 01/08/2016