Medicare Brokers - Plans Overview
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.
2025 Plans
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%
Remember that Senior Health Plan is the only Medicare Advantage plan contracted in-network with Ascension St. John, Hillcrest, OSU Medical and Saint Francis.