Frequently Asked Questions

Get answers to some of the most frequently asked questions regarding CommunityCare Options.

What is CommunityCare Options (PPO)?

CommunityCare Options is a Medicare Advantage Plan – also knows as Part C. Medicare Advantage Plans combine the benefits of Original Medicare A & B and include benefits not covered by Original Medicare such as dental, vision and prescription drug coverage. CommunityCare Options is contracted with Medicare to administer your benefits – in other words, we pay your claims.

What are my benefits if I’m traveling?

You have worldwide coverage for urgent & emergency care.

Do I lose my Medicare when I join?

No. You must be enrolled in Medicare A & B and continue to pay your Part B premium in order to enroll in a Medicare Advantage plan. However, while you are a member of CommunityCare Options, you will show your CommunityCare Options ID card when you receive services. Your provider may request to see your Medicare card to update their information, but CommunityCare Options is paying your claims.

When can I enroll in CommunityCare Options?

The earliest you can enroll is when your Medicare A and B are effective. You can submit an application up to three months before your Medicare A & B begins, and as late as three months after your Medicare A & B effective date. Once you enroll in a plan, you are generally "locked into" that plan for the calendar year and can change plans during the Annual Election Period (AEP).

The Annual Election Period begins October 15th and ends December 7th of each year. There are also circumstances during the year when you might be able to enroll. If you have moved into the service area and this is a new option for you, you have a special election period. There are also special election periods for people who have Medicaid, Extra Help or Low-Income Subsidy, or for those in nursing homes. If you want to know if you qualify for a Special Election Period, call our Medicare team at 918-594-5275.

For more information read the ABC's (and D) of Medicare.

Do I choose my own doctor?

Yes. This plan is a PPO, so you have the option to see providers that are not in our network. Keep in mind though that you will generally pay 30% of the cost when using out of network providers.

Search our provider directory.

What do I do in an emergency?

CommunityCare Options provides worldwide coverage for medical emergencies. If you find yourself in an emergency, whether inside or outside CommunityCare Options's service area, go to the nearest doctor or hospital or call 911. Your safety is what counts!

We ask that you notify your doctor within 48 hours or as soon as reasonably possible to arrange follow-up care.

What about pharmacy benefits?

CommunityCare Options Gold includes Medicare Part D prescription drug coverage. Call us for more information, or you may also refer to the Summary of Benefits or Evidence of Coverage.

You can also visit the Pharmacy and Prescription Info page for more information.

What are my disenrollment rights and responsibilities?

You may end your membership in our plan only during certain times of the year, known as enrollment periods. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the Medicare Advantage Open Enrollment Period. In certain situations, you may also be eligible to leave the plan at other times of the year. Until your membership ends, you must keep getting your medical services and drugs through our plan. Chapter 10 of the 2024 Evidence of Coverage provides information about ending your membership. More information regarding Disenrollment.

Do you have questions about Medicare?

If you are new to Medicare and have questions, visit our ABC's of Medicare page.