AGESPAN INC

SENIOR CARE OPTIONS (SCO) IS A VOLUNTARY MEDICARE ADVANTAGE HEALTH PLAN THAT COMBINES MEDICARE AND MASSHEALTH BENEFITS. SENIOR CARE OPTIONS IS A COMPREHENSIVE HEALTH PLAN THAT COVERS ALL OF THE SERVICES NORMALLY PAID FOR THROUGH MEDICARE AND MASSHEALTH. THIS PLAN PROVIDES SERVICES TO LOW-INCOME ADULTS AGED 65 AND OVER THROUGH A SENIOR CARE ORGANIZATION AND ITS NETWORK OF PROVIDERS. IT COMBINES HEALTH SERVICES WITH SOCIAL SERVICES BY COORDINATING CARE AND SPECIALIZED GERIATRIC SUPPORT SERVICES, ALONG WITH RESPITE CARE FOR FAMILIES AND CAREGIVERS. SCO OFFERS AN IMPORTANT ADVANTAGE FOR ELIGIBLE MEMBERS OVER TRADITIONAL FEE-FOR-SERVICE CARE. THERE ARE NO COPAYS FOR ENROLLED MEMBERS.

CHOICES: THE COMMUNITY CHOICE PROGRAM ALLOWS OLDER ADULTS WHO ARE ON MASSHEALTH TO RECEIVE EXPANDED CARE AT HOME, WHICH CAN DELAY OR PREVENT IMMINENT PLACEMENT IN A LONG-TERM CARE FACILITY. ELIGIBILITY FOR THE COMMUNITY CHOICE PROGRAM IS BASED ON THE FOLLOWING CRITERIA - AGE 60 OR OLDER; APPROVED FOR MASSHEALTH STANDARD BENEFITS; MEET THE CLINICAL CRITERIA FOR ENROLLMENT IN THE HOME AND COMMUNITY BASED SERVICES (HCBS) WAIVER; BE AT IMMINENT RISK OF NURSING HOME PLACEMENT BECAUSE OF SERIOUS HEALTH CONDITIONS AND/OR THE INABILITY TO MANAGE DAILY CARE. A CARE MANAGER AND NURSE FROM AGESPAN WILL CONDUCT A NEEDS ASSESSMENT TO DETERMINE ELIGIBILITY. THEY WILL THEN WORK WITH THE CONSUMER AND HIS/HER FAMILY MEMBERS TO DETERMINE A PLAN OF CARE, COORDINATE ALL SERVICES RECEIVED BY THE CONSUMER, CONDUCT REASSESSMENT VISITS, AND OFFER ONGOING CARE MANAGEMENT.