Disclaimers

• CommunityCare Options is a PPO plan with a Medicare contract. Enrollment in CommunityCare Options depends on contract renewal
• You may join or leave a plan only at certain times. Please call CommunityCare Options Customer Service at 1-800-333-3275. TTY/TDD only, call 1-800-722-0353, Monday through Friday from 8:00 am to 8:00 pm. Or, call Medicare at 1-800-MEDICARE (1-800-633-4227) for more information. TTY users should call 1-877-486-2048. You can call this number 24 hours a day, 7 days a week.
• You can join CommunityCare Options if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area.
• CommunityCare Options has formed a network of doctors, specialists and hospitals. You will pay less using in-network providers. You can ask for a current provider directory or use our online search on the website for the most up-to-date information
• You must continue to pay your Medicare Part B premium, even if the CommunityCare Options premium is $0.
• CommunityCare Options has formed a network of pharmacies. You must use a network pharmacy to receive plan benefits. We may not pay for your prescriptions if you use an out-of-network pharmacy, except in certain cases. The pharmacies in our network can change at any time. You can ask for a current Pharmacy Network List or search the CommunityCare Options provider directory on this website.
• As a member of CommunityCare Options, you have the right to make complaints and to ask us to reconsider decisions we have made. A complaint is also called a "grievance". A coverage decision that involves your medical care is called an "organization determination". When a coverage decision involves a Part D medication, it is called a "coverage determination". When you ask us to reconsider a decision we made, it means you are asking for an "appeal". To learn more, click on the links below. Additionally, CommunityCare Options Customer Service can help if you have any questions or concerns.
  • Medicare Part D Coverage Decisions and Appeals
  • Summary of Medicare Part C and Part D Grievances, Coverage Decisions and Appeals (Deluze and Premier)
  • Summary of Medicare Part C Grievances, Coverage Decisions and Appeals (Choice)
  • National Coverage Determination (NCD) notification
  • Initiate a Part D Coverage Decision
  • Initiate a Part C Coverage Decision
  • Initiate a Part C or Part D appeal