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Medicare Brokers - Plans Overview

Choose the Senior Health Plan tab or the INTEGRIS Health Partners+ tab to view the common benefits & copays for these plans. Included are the links to the specific additional benefits pages. For Senior Health Plan you have the option to view either 2022 or 2021 benefits.

Senior Health Plan Plans

2022 Plans

Silver Plus

Medical and Medicare Part D (Outpatient Prescription Drug) Benefits

Plan Premium Medical Maximum out of pocketAdditional Benefits (these are benefits not covered by Medicare)
$0
You must continue to pay your Medicare Part B premium
$4,700
Wallet Benefit
Your wallet includes benefits for 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 ($0 for preventive screenings)
$35 for Specialist
Emergency & Urgent Care – Worldwide coverage$90 for Emergency Room - waived if admitted
$35 for Urgent Care
Outpatient Hospital$290 copay
Outpatient Rehab (such as Physical Therapy)$20 copay per visit
Outpatient Diagnostic Services$0-$100 copay, depending on the service
Inpatient Hospital$290 per day for days 1-5

This plan includes Part D (outpatient prescription drug coverage) - your copay will depend on what Tier level your prescription is. Copays can change if you move out of the Initial Coverage level.

Initial Coverage Level Copays 30-day Supply
Tier 1 - Preferred Generic$5 copay
Tier 2 - Generic$10 copay
Insulin Tier$35 copay for covered insulin
Tier 3 - Preferred Brand Name$40 copay
Tier 4 - non-Preferred Drugs$95 copay
Tier 5 - Specialty Tier33% of the cost

For 2022, this plan participates in the Part D Senior Savings Model which offers lower, stable and creditable out of pocket costs for covered insulin through the different Part D benefit coverage stages. You will pay a maximum of $35 for a 1-month supply of covered insulin during the Initial Coverage and Coverage Gap (or Donut Hole) stages of your benefit.

We also have mail order through CVS or Walgreens where you can purchase a 90-day supply of available drugs for a reduced cost. Mail order information.

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.

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