MassHealth Senior Care Options (SCO)
Senior Care Options (SCO) is a health plan for MassHealth members 65 and older that combines Medicare and MassHealth benefits, including long-term care. For the wider picture, see our Massachusetts Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Combined Medicare and Medicaid health plan |
| Who runs it | MassHealth and CMS |
| Age | 65 and older |
| Care need | Any |
| Massachusetts 2026 income rule (long-term care) | Home care waivers: under $2,982 a month (300% of the SSI rate) |
| Massachusetts 2026 asset limit (single applicant) | $2,000 |
| Waiting list | No |
SCO in brief
To sum up, MassHealth and CMS oversees SCO. Who it is for: 65 and older. Care need required: Any. Waiting list status in 2026: No. Each of these points is covered in more depth below, alongside the general Massachusetts rules from our state guide. Families weighing SCO against other Massachusetts options can use the related pages at the end to compare programs side by side.
What the program is
SCO plans are run by health plans under contracts with MassHealth and Medicare. Each member has a primary care team and a care coordinator, and the plan works with a Geriatric Support Services Coordinator from the local Aging Services Access Point to plan home care. Because the plan covers both medical care and long-term care, it can move quickly to add home services after a hospital stay or arrange nursing home care when needed. Members do not need Medicare to join, but most do have it, and for them the plan covers Medicare benefits too.
Most older adults who qualify for Long-Term Care Medicaid also have Medicare. Medicare pays first for doctor visits, hospital stays and prescriptions; Medicaid pays for long-term care and many Medicare costs. A combined plan puts both programs under one card and one care team. See Dual eligibility.
Who qualifies in 2026
Eligibility for SCO comes down to these points. The person:
- Is 65 or older
- Has MassHealth Standard
- Lives in a SCO service area
Income and assets. The person must have MassHealth Standard. The income and asset figures in the table above are Massachusetts’s 2026 Long-Term Care Medicaid figures from our state guide. MassHealth’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. When one spouse applies for SCO and the other stays at home, the spouse at home keeps a protected share of the couple’s assets and may receive part of the applicant’s income. See Spousal impoverishment rules.
What services it can pay for
Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:
- Medicare and MassHealth benefits
- Home care
- Nursing home care
- Care coordination
Not every participant gets every service; the plan reflects assessed need and the help family already gives. If needs change, ask for a new assessment.
How to apply
There are two tracks, a financial one and a care one, and both must say yes. The usual path for SCO is:
- Make sure the person has MassHealth Standard and is 65 or older.
- Compare SCO plans available in your area.
- Enroll through MassHealth or the plan.
- The plan assigns a care coordinator, who assesses needs and sets up home care if needed.
For the paperwork, use our documents checklist before applying for SCO; Applying for a waiver explains the general process.
Waiting lists
SCO enrollment is voluntary and has no waiting list. Members can join or leave, with changes taking effect at the start of a following month.
More on how lists work: Waiver waiting lists.
How it relates to nursing home Medicaid
SCO plans cover nursing home care as well as home and community services, so a member stays with the same plan if they move to a nursing home. Joining SCO does not change financial eligibility: MassHealth’s long-term care rules still apply.
Where the nursing home rules still apply. Massachusetts’s financial rules for SCO track the nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. MassHealth can also use estate recovery to seek repayment for long-term care services received after 55. People who keep income above a set allowance may have to pay part of it toward their care each month.
If a nursing home becomes necessary. A Massachusetts nursing home resident keeps a 2026 personal needs allowance of $72.80 a month, and most other income goes to the facility. The state guide explains the nursing home side.
Choosing a plan: questions to ask
- Does the network include my doctors, pharmacy and hospital?
- Are my prescriptions on the plan’s drug list, and are there limits on any of them?
- Who will be my care coordinator, and how often will they check in?
- What happens if I need home care, adult day services or a nursing home later?
- What extra benefits does the plan offer, such as dental, vision, hearing or transportation?
- What are the rules for switching or leaving?
Write down the answers and the date you asked. Plans can change their networks and extra benefits from year to year.
Tips for families
- Do not wait for a crisis. Lists and assessments for SCO take time, and the start date is usually when you first request help.
- Keep copies of every SCO form, notice and letter, and write down the name of each person you speak with and the date.
- Read every notice. If services are denied, cut or ended, the notice explains how to request a fair hearing and the deadline. Requesting one before the deadline often keeps services in place during the appeal.
- Report changes in income, assets, address or living situation to MassHealth when they happen.
- Plan for renewals. Medicaid and the care assessment are both renewed, usually once a year. See Renewals.
- Think about the spouse at home. Couples have extra protections, but they have to be claimed. A certified Medicaid planner or a legal aid office can explain how the rules apply to a particular family.
Common questions
Do I need Medicare to join SCO? No, but most members have it, and the plan then covers Medicare benefits too.
Is there a premium? MassHealth members do not pay a premium for SCO.
Can I leave SCO? Yes. Enrollment is voluntary.
Does SCO cover nursing homes? Yes.
Related pages
- Massachusetts Long-Term Care Medicaid guide
- Dual eligibility
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.