Learn about NaviCare

With NaviCare®, you get benefits, items and services that are covered by Medicare and MassHealth Standard—plus more. We also coordinate all your care for you! You get personalized care, from your own Care Team. We want to help you meet your health goals. And when you’re a member of NaviCare HMO SNP or NaviCare SCO, you receive all the care and services you need at no cost to you.

Care designed just for your needs

Getting the right care at the right time is important for your health. As a NaviCare member, you'll have a care plan designed to help you meet your health goals. Based on your health care needs, you may receive: 

  • A personalized, in-home care plan with support services and medical care
  • Assistance with bathing, dressing and home meal preparation
  • Adult day health program providing recreational and social activities

The cost: $0

There is no cost to you. With NaviCare, there are no monthly premiums, no copayments, no coinsurance, and no deductibles.

The benefits

With NaviCare, you get benefits, items and services covered by Medicare and MassHealth Standard—and much more, at no cost to you. 
Learn more about your benefits »  

Your Care Team

When you’re a member of NaviCare, you have a team of experts who are dedicated to helping you meet your health goals. Your Care Team reviews your care plan regularly, so that they can make sure you get the benefits you're eligible for and the care you need.  And because the members of your Care Team have up-to-date information about your complete care plan, they can help you make better decisions about your care.

Each member of your Care Team has a different role:

Navigator

  • Educates you about your benefits and services
  • Helps you make medical appointments and get care and services
  • Advocates for your needs
  • Assists in developing your care plan

Nurse Case Manager (or Advanced Practitioner)

  • Assesses your clinical and daily needs
  • Teaches you about your medications and conditions
  • Makes sure you get the care and services you need after a stay in a medical facility

Geriatric Support Service Coordinator (if needed)

  • Evaluates and coordinates your need for in-home
    services
  • Helps you with your MassHealth paperwork
  • Connects you with helpful resources

Primary Care Provider

  • Directs your care
  • Provides routine medical services
  • Refers you to specialists

Behavioral Health Case Manager (as needed)

  • Identifies and coordinates services to support your mental health and well-being
  • Supports you through transitions of older adulthood
  • Helps you connect with your Care Team and mental health providers and substance-use counselors, if necessary

Clinical pharmacist (if needed)

  • Visits you after care transition to review medications and work with your medical providers

NaviCare's service area

NaviCare’s service area includes the entire state of Massachusetts except Dukes and Nantucket Counties. 

Learn more at an informational meeting

Get questions answered in person at one of our informational meetings near you. See the schedule of meetings »

Next steps

Fallon Health is an HMO plan with a Medicare contract and a contract with the Massachusetts Medicaid program. Enrollment in Fallon Health depends on contract renewal. NaviCare is a voluntary program in association with MassHealth/EOHHS and CMS.

H9001_200084_M
The information on this page was last updated on 2/4/2020.

Next steps