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CommunityCare is here for you. We are dedicated to taking care of our members and ensuring you have access to health care services.

Advantage Medicare Plan Premier

Medical and Medicare Part D (Outpatient Prescription Drug) Benefits

Plan Premium Medical Maximum out of pocketAdditional Benefits (these are benefits not covered by Medicare)
You must continue to pay your Medicare Part B premium

Common Medical benefits and your copays - remember that if you reach your Medical Maximum Out of Pocket limit, the rest of your Medicare-covered medical services are paid by CommunityCare

Doctors Visits provider search$0 for Primary Care
$40 for Specialist
Emergency & Urgent Care – Worldwide coverage$90 for Emergency Room - waived if admitted
$40 for Urgent Care
Outpatient Hospital$325 copay
Outpatient Rehab (such as Physical Therapy)$40 copay per visit
Outpatient Diagnostic Services$0-$300 copay, depending on the service
Inpatient Hospital$300 copay each day for days 1-7

This plan includes Part D (outpatient prescription drug coverage) - your copay will depend on what Tier level your prescription is. Copays can change if you move out of the Initial Coverage level.

Initial Coverage Level Copays formulary search30-day Supply
Tier 1 - Preferred Generic$0 copay - * $0 copay for an extended day supply
Tier 2 - Generic$12 copay - * $0 copay for an extended day supply
Tier 3 - Preferred Brand Name$40 copay
Tier 4 - non-Preferred Drugs$95 copay
Tier 5 - Specialty Tier33% of the cost

We also have mail order through CVS or Walgreens where you can purchase a 90-day supply of available drugs for a reduced cost. Mail order information.

You can call our Medicare team at 918-594-5275 for more information on this plan or other options. We are available Monday through Friday from 8:00 to 6:00.

Directories and Searches

Enrollment Options

If you are not sure which plan best suits you, give us a call at 918-594-5275. One of our representatives will help you select the right plan for you.

Plan Documents

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