Elder Q &A
---- — :Q: What is the new One Care health plan being offered? How do I find out if this is right for me?
:A: Massachusetts will be offering a new health care plan starting Oct. 1 for individuals age 21 to 64 who have Medicare Part A & B and are receiving either MassHealth Standard or CommonHealth benefits. The One Care Plan will coordinate all of their Medicare and MassHealth medical and pharmacy services in addition to personal care attendants, mental health services, substance abuse, adult day care, nursing facility care, dental services, hearing aids, vision care, chiropractic care, podiatry, and other supports. One important feature which may appeal to many recipients will be the inclusion of a Care Coordinator to assist with getting all the care needed. At this time there are three providers offering the One Care plans, unfortunately the plans are not going to be available in all parts of the state.
Basic home care services such as help with bathing, dressing, toilet use and ambulation are available with the One Care plans. There are times individuals require assistance in determining what long-term care services would be essential in remaining independent. Any enrollee in the plans has the right to request having a Long Term Services Coordinator on their team who will act as an advocate on their behalf, this position is not an employee of the One Care plan.
It is important for all of those impacted to understand One Care is not a mandatory program, individuals have the right to make the change or continue receiving care as in the past. If someone is in this age category and is on both Medicare and MassHealth, the state will be sending them a One Care information packet. If they decide they do not want to choose a plan they must inform MassHealth of their decision otherwise there is a possibility MassHealth will automatically sign them up for a plan.
There are some steps to take before joining any plan. The first is to verify whether the primary physician or other providers where care is accessed are going to be in the plan. The second is to find out if prescribed medications are covered by the plan and what costs may be involved. Before making a final decision individuals can take advantage of a no-cost counseling session with a SHINE Counselor to help them review their options.
This is one more change taking place within the next couple of months in the healthcare system, making it especially important for people to pay close attention to media releases and information they receive from Medicare or MassHealth. If this impacts your or a family member and you have questions contact a MassHealth customer service representative at 1-800—841-2900, a Medicare counselor at SHINE 1-800-243-4636 or go on-line at www.mass.gov/masshealth/onecare.
Do you have a question? We encourage inquiries and comments from our readers. Direct correspondence to firstname.lastname@example.org or Elder Services of the Merrimack Valley, Inc. 360 Merrimack Street B#5, Lawrence, MA 01843. Rosanne DiStefano is the Executive Director of Elder Services of the Merrimack Valley, Inc. For additional information or to schedule an appointment call 1-800-892-0890.