CommunityCare is proud to offer Senior Health Plan, a program created especially for Medicare beneficiaries. Senior Health Plan has four Medicare Advantage Plans to fit the varying needs of Medicare beneficiaries.

• Medical & Prescription Plans
• Medical Only Plans
• Medicare & Medicaid Dual Eligibility Plan

Silver Plus

Medical and Prescription

Premium

$0 per month

Maximum Out-of-Pocket

$4,200

Primary Care Physician

$0 copay per visit

Specialist

$30 copay per visit

Emergency Room

$90 copay per visit. Waived if admitted.

Urgent Care

$30 copay per visit

Outpatient Hospital

$235 copay

Outpatient Rehabilitation

$15 copay per visit

Outpatient Diagnostic Services

$0-$150 copay, depending on the service

Hospital

$240 per day for days 1-5

DME

0% for most; 15% for wheelchairs, etc.

Platinum

Medical and Prescription

Premium

$19 per month

Maximum Out-of-Pocket

$3,900

Primary Care Physician

$0 copay per visit

Specialist

$25 copay per visit

Emergency Room

$90 copay per visit. Waived if admitted.

Urgent Care

$25 copay per visit

Outpatient Hospital

$225 copay

Outpatient Rehabilitation

$10 copay per visit

Outpatient Diagnostic Services

$0-$100 copay, depending on the service

Hospital

$235 per day for days 1-5

DME

0% for most; 15% for wheelchairs, etc.

Platinum Plus

Medical and Prescription

Premium

$83 per month

Maximum Out-of-Pocket

$4,700

Primary Care Physician

$0 copay per visit

Specialist

$25 copay per visit

Emergency Room

$90 copay per visit. Waived if admitted.

Urgent Care

$25 copay per visit

Outpatient Hospital

$200 copay

Outpatient Rehabilitation

$20 copay per visit

Outpatient Diagnostic Services

$0 - $155 copay, depending n the service

Hospital

$220 per day for days 1-7

DME

0% for most; 15% for wheelchairs, etc.

Extra Benefits

Dental

$0 for two preventive visits; $1,500 comprehensive; Prosthetics Endodontics Dentures 50% copay

Eyewear

$0 copay for eyewear up to $400 per year

OTC

$85 per quarter

Hearing Aids

Covered in Wallet

Wallet

Wallet benefit maximum is $500 per year. Wearable fitness devices are limited to $100.

Transportation

$0 copay up to 12 one-way trips. 50 mile one-way limit.

Dental

$0 for two preventive visits; $1,500 comprehensive; Prosthetics Endodontics Dentures 50% copay

Eyewear

$0 copay for eyewear up to $400 per year

OTC

$85 per quarter

Hearing Aids

Up to $500 every 2 years

Wallet

Wallet benefit maximum is $500 per year. Wearable fitness devices are limited to $100.

Transportation

$0 copay up to 12 one-way trips. 50 mile one-way limit.

Dental

$0 for two preventive visits; $1,500 comprehensive; Prosthetics Endodontics Dentures 50% copay

Eyewear

$0 copay for eyewear up to $200 per year

OTC

$40 per quarter

Hearing Aids

Up to $500 every 2 years

Wallet

Wallet benefit maximum is $300 per year. Wearable fitness devices are limited to $100.

Transportation

$0 copay up to 12 one-way trips. 50 mile one-way limit.

Part D

Tier 1 - Preferred Generic

$0 copay

Tier 2 - Generic

$5 copay

Tier 3 - Preferred Brand Name

$47 copay

Insulin Tier

$35

Tier 4 - Non-Preferred Drugs

You pay 40%

Tier 5 - Specialty Tier

You pay 33%

Tier 1 - Preferred Generic

$0 copay

Tier 2 - Generic

$5 copay

Tier 3 - Preferred Brand Name

$47 copay

Insulin Tier

$35

Tier 4 - Non-Preferred Drugs

You pay 40%

Tier 5 - Specialty Tier

You pay 33%

Tier 1 - Preferred Generic

$0 copay

Tier 2 - Generic

$5 copay

Tier 3 - Preferred Brand Name

$47 copay

Insulin Tier

$35

Tier 4 - Non-Preferred Drugs

You pay 40%

Tier 5 - Specialty Tier

You pay 33%

Documents

• Summary of Benefits
• Senior Health Plan Star Rating
• Evidence of Coverage
• Annual Notice of Change - Senior Health Plan
• Annual Notice of Change - INTEGRIS Health Partners+
• Multi-language Interpreter Services

• Summary of Benefits
• Senior Health Plan Star Rating
• Evidence of Coverage
• Annual Notice of Change - Senior Health Plan
• Annual Notice of Change - INTEGRIS Health Partners+
• Multi-language Interpreter Services

• Summary of Benefits
• Senior Health Plan Star Rating
• Evidence of Coverage
• Annual Notice of Change
• Multi-language Interpreter Services

Service Area

Adair, Cherokee, Cleveland, Craig, Creek, Delaware, Garvin, Grady, Haskell, Hughes, Kingfisher, Lincoln, Logan, Mayes, McClain, Mcintosh, Muskogee, Nowata, Okfuskee, Oklahoma, Okmulgee, Osage, Ottawa, Pawnee, Pittsburg, Pottawatomie, Rogers, Seminole, Tulsa, Wagoner, and Washington

Service Area

Adair, Cherokee, Cleveland, Craig, Creek, Delaware, Garvin, Grady, Haskell, Hughes, Kingfisher, Lincoln, Logan, Mayes, McClain, Mcintosh, Muskogee, Nowata, Okfuskee, Oklahoma, Okmulgee, Osage, Ottawa, Pawnee, Pittsburg, Pottawatomie, Rogers, Seminole, Tulsa, Wagoner, and Washington

Service Area

Adair, Cherokee, Cleveland, Craig, Creek, Delaware, Garvin, Grady, Haskell, Hughes, Kingfisher, Lincoln, Logan, Mayes, McClain, Mcintosh, Muskogee, Nowata, Okfuskee, Oklahoma, Okmulgee, Osage, Ottawa, Pawnee, Pittsburg, Pottawatomie, Rogers, Seminole, Tulsa, Wagoner, and Washington