CommunityCare Options Gold

Medical and Medicare Part D (Outpatient Prescription Drug) Benefits

Plan PremiumAdditional Benefits (these are benefits not covered by Medicare)
You must continue to pay your Medicare Part B premium
Wallet Flex Card - for gym memberships & more
Use your Nations Benefit Flex card to purchase gym memberships, home & bathroom safety devices and more. Learn more about your wallet benefit here!

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 $0 for Primary Care
$40 for Specialist
30% of the cost
Emergency & Urgent Care - Worldwide Coverage$90 for Emergency Room
$40 for Urgent Care
$90 for Emergency Room
$40 for Urgent Care
Outpatient Hospital$260 30% of the cost
Outpatient Rehab (such as Physical Therapy)$2030% of the cost
Outpatient Diagnostic Services (lab, X-ray, MRI)$0-$125, depending on the service30% of the cost
Inpatient Hospital$245 each day for days 1-630% of the cost

This plan includes Part D (outpatient prescription drug coverage) - your copay will depend on what Tier level your prescription is. Check our formulary to see what tier your drug is in. Copays can change if you move out of the Initial Coverage level. Your copays may also be different if you have Extra Help or if you also have Medicaid.

Outpatient Prescription Drug Copays* 30-day Supply
Tier 1 - Preferred Generic$0 copay
Tier 2 - Generic$5 copay
Insulin Tier$35 copay
Tier 3 - Preferred Brand Name$40 copay
Tier 4 - Non-Preferred Drugs$95 copay
Tier 5 - Specialty Tier33% of the cost

* These are your copays while you are in the Initial Coverage Stage of your Part D coverage. For more information, see the Pharmacy and Prescription Info page.

Save time and money by ordering an extended day supply (up to 100 days) of your drugs with our convenient mail order program.

You can call our Medicare team at 918-594-5275, TTY/TDD (800) 722-0353, for more information on this plan or other options. We are available Monday through Friday from 8:00 to 6:00.

Members on a Medicare Retiree group plan may have different benefits. Check your plan year benefit grid or call Customer Service with questions. Be sure to let us know what retiree group you are with.

Directories and Searches

Enrollment Options

You can enroll in a Medicare Advantage plan when you are new to Medicare, during the Annual Election period (Oct. 15 – Dec. 7), or if you have a special election period. Call our team at to see if you are eligible to enroll, or visit our ABC's (and D) of Medicare page.

Call our team if you have any questions about this plan at 918-594-5275, Monday through Friday from 8:00 am to 6:00 pm (TTY/TDD users 1-800-722-0353).

Plan Documents