Benefits Overview

CeltiCare Health offers health insurance plans with comprehensive healthcare services that suit the needs of individuals throughout Massachusetts.

View some of CeltiCare Health's benefits below. You can also view more information in our Member Handbook.        

A behavioral health condition, also called mental health or substance use disorder, causes changes in a person’s thinking, mood or behavior. This includes problems like:

  • Depression: sadness or feeling hopeless
  • Anxiety: worrying, fear, easily tired, and/or difficulty focusing
  • Drug and alcohol use
  • Attention Deficit Hyperactivity Disorder (ADHD)

Many mental health conditions are medical problems just like cancer or heart disease. These conditions can happen to anyone. They can be treated. Treatment may include talking to a therapist or taking medication. Left alone, mental health disorders can get worse.

As a Massachusetts health plan option, CeltiCare Health can help you find a provider, find local resources, plan an appointment and find transportation. Call Member Services at 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

We want you to have the best quality of life you can have.

Care Management

CeltiCare Health offers our members with complex medical needs Care Management services that are member-centered, family-focused, and culturally sensitive. Care Management can help you better understand and manage your health conditions, coordinate services, and help locate community resources you may need. For Members with severe medical conditions, Care Managers can work with you, your PCP, and other healthcare providers to develop a plan of treatment.

Our Care Managers are registered nurses or social workers. Our Member Services department can give you more information about Care Management Services. Call us at 1-855-678-6975 (TDD/TTY: 1-866-614-1949) and ask to speak to a Care Manager.

Disease Management

CeltiCare Health has several programs to improve the health of our Members that go beyond just helping you see a doctor. We work to help you understand and manage your chronic health conditions.

CeltiCare Health works with Healthy Solutions For Life® to provide you with personalized disease management services to help you control your chronic condition more effectively. This means Healthy Solutions for Life Health Coaches can help you understand more about your condition, give you tips on how to integrate the care your physician has prescribed into your daily life, call you on a regular basis to offer support and education and more. Heath coaching is provided to support people who have conditions like:

  • Asthma
  • Back Pain Management
  • Behavioral Health Disease Management
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Diabetes
  • High Blood Pressure (Hypertension/Hyperlipidemia)
  • Heart Failure
  • Tobacco Cessation
  • Weight Management

Note: The Tobacco Cessation Program also includes coverage for counseling sessions and drug therapy. Contact Member Services for details.
For more information on any of the other programs above, please contact Healthy Solutions for Life directly at 1-866-918-4459.

Behavioral Health Disease Management Programs

Behavioral Health Disease Management (DM) Programs are designed to help you if you have both a medical condition and Depression or Substance Use Disorder. We may contact you and offer help and support or you can reach out and ask for our help.

We also work with your PCP to ensure you get the help you need or are referred to an appropriate behavioral health treatment provider. Our behavioral health providers accept referrals from your PCP or you can refer yourself. In addition, our staff will work closely with you, your family and your healthcare providers to give you helpful resources that will help you accomplish both short and long-term disease specific goals.

If you have any further questions, please call us at: 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

CeltiCare Health is proud to be working with SafeLink Wireless to offer you this special, federal program. As a Member of our plan, you get all the same benefits of a SafeLink phone, plus unlimited inbound text messages and calls to CeltiCare Health member services. There is no added cost for these extras.

How to Enroll:

You take care of your health; we offer a way to earn reward dollars when you complete certain healthy behaviors.

The CentAccount Healthy Rewards program is our way to appreciate you for keeping up with your health. When you complete certain healthy activities, you receive dollar rewards! There are no fees or cost to you. It’s our way of celebrating your choice to have better health.

Now we offer even MORE rewards! EARN UP TO $210

Earning rewards is easy. When you do certain preventive health activities, CeltiCare Health shows its appreciation by offering you rewards! Your rewards will be automatically added to your CentAccount card.

See below to find out where you can spend your Healthy Rewards dollars.

2016 Award Program Dollar Value
Annual Health Needs Assessment* $30.00
Flu Shot* $30.00
Women's Well Check - Mammogram* $30.00
Men's Well Check - Prostate Exam* $30.00
Complete Tobacco Cessation Program $30.00
Annual Comprehensive Diabetes Care* $30.00
Annual Adult Well Care Visit (Increased Rewards!) $30.00
Register for the Member Secure Portal $30.00

* New for 2016
Not all awards apply to every member.

Using Your Card

Your CentAccount card can be used at certain stores and pharmacies to purchase health-related items. You can use your CentAccount Healthy Rewards Card at the following stores:

  • Dollar General
  • Family Dollar
  • Fred's
  • Meijer
  • Rite Aid

See the CentAccount Rewards Catalog for more information.

You can use your card to buy hundreds of items. Below are examples of what you can purchase at stores and pharmacies.

  • Baby Care
  • Healthy Groceries
  • Personal Care
  • Over The Counter Medicine
  • Women’s Care
  • Diabetes Care
  • Eye Care
  • Family Planning
  • Wellness Items

Activating Your Card

Earning rewards is easy! Complete one of the eligible healthy behaviors. Then reward dollars are automatically put on your CentAccount card. If it’s your first reward, a card will be mailed to you. Remember, this is not a credit card! When you receive the card, it already has funds on it.

To activate your CentAccount Rewards Card visit OTCnetwork.com or call our Member Services department at 1-855-678-6975 (TDD/TTY: 1-866-614-1949)

As a CeltiCare Health Member, you can choose who you see for your healthcare needs from our network of Providers. We have many for you to choose from. If you need help choosing a doctor, call Member Services at 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

CeltiCare Health covers emergency related dental services and preventive care and maintenance of dental diseases and oral health for adults. For questions about dental services, please call DentaQuest Customer Service at 1-800-207-5019 or TTY at 1-800-466-7566 or Translation line at 1-800-207-5019. Hours: 8:00 AM - 5:00 PM.

Preventative care visits are covered by CeltiCare Health. This means visiting the doctor for a regular check-up, rather than waiting until you are sick.

CeltiCare Health covers an annual physical for adults.

Search for a provider in our network.

We have a special program that helps you get care. The program connects you to community groups that can help. It’s called MemberConnections. A MemberConnections team member can talk to you on the phone. They will send you information and can visit your home. They will be glad to talk to you about:

  • How to choose a doctor (PCP)
  • How to change doctors
  • The healthcare you get at CeltiCare Health
  • How to use CeltiCare Health’s services
  • How to get medical advice when you cannot see the doctor
  • How to live a healthy life
  • How to get immunizations and health screenings
  • Other healthcare problems you may have

MemberConnections representatives will connect you to community social service programs. These programs will help you with food, housing and clothing.

Connections Plus

Connections Plus is a program for eligible CeltiCare Health members. The program provides a cell phone at no cost to high-risk members who do not have safe, reliable access to a telephone. This program allows our members to have 24-hour access to physicians, care coordinators, telehealth services and 911. If you qualify, a MemberConnections Representative will come to your home to teach you how to use the phone.

If you have any further questions, please call us at: 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

Our Nurse Advice Line is ready to answer your health questions 24 hours a day – every day of the year. It is staffed with Registered Nurses. These nurses have spent lots of time caring for people. Now they are ready and eager to help you.

How can our nurse advice line help me?

  • Find a doctor
  • Determine the best place to go for care – that could be your doctor, the ER or somewhere else
  • Schedule transportation
  • And more!

Not sure if you need to go to the emergency room?

Sometimes you may not be sure if you need to go to the emergency room (ER). Call the nurse advice line. They can help you decide if you have a real emergency. If you have a real emergency, go directly to the nearest hospital ER.

When you have questions, call the nurse advice line.

  • It’s free
  • It’s simple
  • It’s fast

The nurse advice staff speaks English and Spanish. If you do not speak English or Spanish, please ask for a translator.

Call 1-855-678-6975 and say "Nurse."

Interpreter services are provided free of charge to you during any service or grievance process. This includes American Sign Language and real-time oral interpretation.

If you need something translated into a language other than English, please call CeltiCare Health. We can also provide things in other formats such as Braille, CD or large print.

If you need an interpreter for your medical appointment, contact CeltiCare Health [INTERPRETER_HOURS] before your appointment. We will arrange for one to be at your appointment.

Non-Emergency Transportation Services

CeltiCare Health will help you get transportation to non-emergency, medically necessary appointments Transportation is covered by MassHealth but not provided through CeltiCare Health directly. We will coordinate with MassHealth on your behalf to get transportation if you need help. The following transportation services are covered by MassHealth.

Transportation to an Out-of-State Location:
Ambulance and other common carriers that are pre-arranged for transportation to a non-emergency service appointment that is located outside a 50-mile radius of the Massachusetts border is a covered service.

Transportation within Massachusetts:
Ambulance (land), chair car, taxi, and other common carriers that are generally pre-arranged for transportation to a non-emergency service appointment located in Massachusetts or within a 50-mile radius of the border is a covered service.

How to Get Transportation Services:
You can call MassHealth customer service yourself to arrange for transportation.

MassHealth Customer Service Center
Monday – Friday 8 a.m. – 5 p.m.
1-800-841-2900 (TTY/TDD: 1-800-497-4648)

Or, you can ask for CeltiCare Health’s assistance in arranging transportation through Member Services at 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

CeltiCare Health offers comprehensive vision care benefits. Check your Covered Benefits booklet for a full list of vision coverage.