2025 Oklahoma Dual Complete

Senior Health Plan Oklahoma Dual Complete

CommunityCare offers a Dual Option Special needs plan. You must have both Medicare and Medicaid to be eligible to enroll. You must also live in our service area: Adair, Canadian, Cherokee, Cleveland, Comanche, Craig, Creek, Delaware, Garvin, Grady, Haskell, Hughes, Jefferson, Kingfisher, Latimer, LeFlore, Lincoln, Logan, Mayes, McClain, McIntosh, Muskogee, Nowata, Okfuskee, Oklahoma, Okmulgee, Osage, Ottawa, Pawnee, Payne, Pittsburg, Pottawatomie, Pushmataha, Rogers, Seminole, Sequoyah, Stephens, Tulsa, Wagoner, and Washington

Medical and Medicare Part D (Outpatient Prescription Drug) Benefits

Plan Premium	Medical Maximum out of pocket	Additional Benefits (these are benefits not covered by Medicare)
$0 You must continue to pay your Medicare Part B premium	$8,850	Dental Benefits Routine Vision & Eyewear Non-emergency transportation Over-the-Counter (OTC) Benefit

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	You pay $0 or 20% ($0 for preventive screenings) You pay $0 or 20%
Emergency & Urgent Care – Worldwide coverage	You pay $0 to 20% up to $110 per visit You pay $0 to 20% up to $45 per visit
Outpatient Hospital	You pay $0 or 20%
Outpatient Rehab (such as Physical Therapy)	You pay $0 or 20%
Outpatient Diagnostic Services	You pay $0 or 20%
Inpatient Hospital	You pay $1,676 per benefit period.

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	You pay $0
Tier 3 - Preferred Brand Name	You pay 24% Coinsurance
Insulin Tier	$35 copay
Tier 4 - Non-Preferred Drugs	You pay 25% Coinsurance
Tier 5 - Specialty Tier	You pay 25% Coinsurance

* 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.

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. Or you can join us at one of our seminars where we go through your plan options. Our Sales team is available by phone 8:00 to 6:00 Monday through Friday.