Member Services
If you have any questions or concerns, please call our Member Services Representatives toll-free at 1-866-610-CARE (2273), Monday through Friday, 8:00 A.M. to 5:00 P.M.
Unique Features of CCA’s Senior Care Options ProgramCommonwealth Care Alliance will work in partnership with you, your family, and your Primary Care Physician (PCP) to coordinate all appropriate services. All covered services are provided through CCA’s extensive contracted network, including specialists, hospitals, community-based home care providers, and skilled nursing facilities. Your PCP will arrange hospital and nursing home care through CCA’s contracted facilities. CCA only contracts with physicians who have considerable experience in caring for seniors. Your Primary Care Physician (PCP) is responsible for coordinating your medical care, and calling upon additional specialists, if necessary. CCA contracts with community based health centers that are experienced in serving the elder populations. If your care requires it, you will be assigned a Primary Care Team (PCT). Your Primary Care Team (PCT) will work together with your Primary Care Physician (PCP) to coordinate medical support service needs. Your PCT will include a Geriatric Support Services Coordinator (GSSC), as well as a nurse practitioner, registered nurse, or physicians’ assistant. Each member of the PCT will have experience in caring for seniors. Your PCP and Primary Care Team (PCT) will work together with you and anybody you choose, such as family members or caregivers, to construct a comprehensive Individual Care Plan (ICP), designed for your specific needs. Your Individualized Care Plan (ICP) includes all health care, health-related, or social support services that your PCP or PCT has authorized or recommended you to receive. Your PCP will coordinate these services. In order to ensure the most appropriate services, your PCP will review and approve any changes to the ICP, whether adding, altering, or discontinuing a service. Your PCP will personally reassess your needs at least every six months, or more frequently, if necessary. Thanks to CCA’s unique relationship with CMS and MassHealth, members have the privilege of receiving all of Medicare and Medicaid’s coverage and services, in addition to benefits and services not traditionally covered by these programs. Other advantages to participating in the SCO program include:
Member Responsibilities
Member Rights to Exceptions and AppealsAt Commonwealth Care Alliance we are committed to ensuring that you are satisfied with the care you receive. You have the right to voice a complaint if you ever have a problem or concern with your care, your provider of care, your prescription program or coverage, or any aspect of the Senior Care Options (SCO) Program. You also have the right to appeal any decision or our failure to approve, arrange, or provide any services that you believe are necessary. If you would like to file a complain or appeal, please call our Member Services Representatives toll-free at 1-866-610-CARE (2273), Monday through Friday, 8:00 A.M. to 5:00 P.M. (TTY users please dial 1-866-322-7357). You may also fax your written complaint to: 617-426-3097 or mail your written complaint to: Commonwealth Care Alliance Member Services Department
*Filing a complaint will not negatively affect your SCO plan or coverage. |
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Our Senior Care Options (SCO) program allows for your Primary Care Physician (PCP) to coordinate a comprehensive range of health care, health-related, and social support services tailored to fit your individual needs. Your PCP is dedicated to providing a personalized approach to your care so that you, your family, and CCA network providers are able to fluidly work together on your behalf. Commonwealth Care Alliance (CCA) provides access to nurses, services, and information on a 24-hour basis, 7 days a week.