If you need MassHealth coverage for admission to a nursing facility, you may meet the rules for a temporary benefit to make the process easier.
To receive this temporary benefit, you’ll need to meet all eligibility requirements, except for the SC-1. The SC-1 is a form the facility submits with your admission information.
Once you’ve submitted all verifications except the SC-1 to determine your eligibility, you will be issued a notice that grants you a temporary benefit for 10 days. During these 10 days, nursing facilities can see that you are eligible for MassHealth and admit you. There will be no patient paid amount (PPA) during this 10-day temporary approval.
Once you are admitted, the facility must submit the SC-1 form to avoid any lapse in your coverage. If the SC-1 form in not submitted within the 10-day temporary approval period, your temporary benefit will end. You will get a notice if your benefit has ended.