Learn about NaviCare
With NaviCare®, you get covered Medicare and MassHealth Standard benefits, items and services—and many others. We also coordinate all your care for you! You get personalized care, from your own Care Team, which includes a Navigator and nurse case manager who are assigned to you. 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 good 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
There is no cost to you. With NaviCare, there are no monthly premiums, no copayments, no coinsurance, and no deductibles.
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, based on information in a shared electronic record. 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:
- Organizes your benefits and services
- Arranges rides to and from medical appointments
- Advocates for your needs
Nurse case manager (or Advanced Practitioner)
- Assesses your clinical needs
- Teaches you about your medications and conditions
- Makes sure you get the care you need at the time
of care transition
Geriatric support service coordinator (if needed)
- Evaluates and coordinates your need for in-home
- 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 (if needed)
- Coordinates services to address your mental health
and substance use disorder needs
- Coordinates with your team and mental health
and substance use providers
Facility liaison (if needed)
- Connects your team with the staff at your
NaviCare's service area
NaviCare’s service area is Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester Counties, and a portion of Franklin County. The portion of Franklin County includes: Erving (01344), New Salem (01355), North New Salem (01364), Orange (01364), Warwick (01378), Wendell (01379) and Wendell Depot (01380).
Learn more at an informational meeting
Get questions answered in person at one of our informational meetings near you. See the schedule of meetings »
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.
NaviCare SCO is available to anyone age 65 and older who has MassHealth Standard and lives in the service area. Individuals who also have Medicare Parts A and B may enroll in NaviCare HMO SNP.
This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year.
You must continue to pay your Medicare Part B premium unless the Commonwealth of Massachusetts pays this premium for you. The provider network may change at any time. You will receive notice when necessary.
H9001_N_2017_16 Approved 10142016
The information on this page was last updated on 10/1/2016.