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Network Health


Network Health Unify plan overview

MassHealth and the Centers for Medicare & Medicaid Services (CMS) launched a collaborative initiative to integrate care for people who are eligible for both Medicare and Medicaid. Through this initiative, called One Care, MassHealth and CMS seek to fully integrate the delivery and financing of Medicare and Medicaid services to this population. With Network Health Unify, our Medicare-Medicaid One Care plan for people ages 21 – 64, we provide enrollees with access to One Care's comprehensive care delivery system.

Who is eligible?

Individuals are eligible for Network Health Unify if they are Massachusetts Medicaid beneficiaries between the ages of 21 and 64 who are also eligible for Medicare due to a disability. Approximately 110,000 Massachusetts residents are eligible for the program. CMS and MassHealth jointly determine eligibility.

Benefits

Network Health Unify combines Medicare and Medicaid benefits into one expanded benefit package, including community-based long-term services and supports (LTSS), to maximize enrollees’ independence and well-being. Network Health Unify includes free coverage for services, such as:

  • Community health workers
  • Community support services (CSS)
  • Day habilitation
  • Group adult foster care
  • Home care/Homemaker services
  • Home health care services
  • Home modifications
  • Nurse midwife services
  • Peer support/Counseling/Navigation
  • Personal care assistants
  • Program of assertive community treatments (PACT)
  • Respite care 

Implementation timeline

Date

Activity

September 1, 2013

Open enrollment began for eligible individuals to opt in to the One Care program and choose a health plan

October 1, 2013

First coverage effective date 

January 1, 2014

Second coverage effective date, for enrollees who do not choose to opt out

Training

CMS and MassHealth require that all providers contracted to serve One Care enrollees receive training on certain elements of the program, covering topics such as an introduction to the program, cultural competence, and contemporary models of disability. For more information on required provider trainings for Network Health Unify, please see our frequently asked questions.

Additional resources  

For more information about how we can partner with you to serve individuals who are eligible for Network Health Unify, call us at 888-257-1985 and ask to speak with a provider services team member.


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