Brokers

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.

2024 Plans

Silver Plus

Medical and Prescription
Premium
$0 per month
Maximum Out-of-Pocket
$4,200
Primary Care Physician
$0 copay per visit
Specialist
$35 copay per visit
Emergency Room
$90 copay per visit. Waived if admitted.
Urgent Care
$35 copay per visit
Outpatient Hospital
$290 copay
Outpatient Rehabilitation
$20 copay per visit
Outpatient Diagnostic Services
$0-$150 copay, depending on the service
Hospital
$245 per day for days 1-5
DME
0% for most; 15% for wheelchairs, etc.

Platinum

Medical and Prescription
Premium
$20 per month
Maximum Out-of-Pocket
$3,900
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
$250 copay
Outpatient Rehabilitation
$20 copay per visit
Outpatient Diagnostic Services
$0-$100 copay, depending on the service
Hospital
$240 per day for days 1-5
DME
0% for most; 15% for wheelchairs, etc.

Platinum Plus

Medical and Prescription
Premium
$96 per month
Maximum Out-of-Pocket
$4,400
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-$100 copay, depending on the service
Hospital
$195 per day for days 1-7
DME
0% for most; 15% for wheelchairs, etc.

Silver

Medical Benefits Only
Premium
$0 per month
Maximum Out-of-Pocket
$3,400
Primary Care Physician
$0 copay per visit
Specialist
$5 copay per visit
Emergency Room
$90 copay per visit. Waived if admitted.
Urgent Care
$5 copay per visit
Outpatient Hospital
$25 copay
Outpatient Rehabilitation
$0 copay per visit
Outpatient Diagnostic Services
$0-$125 copay, depending on the service
Hospital
$25 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;
Eyewear
$0 copay for eyewear up to $300 per year
OTC
$85 per quarter
Hearing Aids
Covered in Wallet
Wallet
Flex Card limit up to $300 for fitness, hearing aids, PERS, home & bathroom safety & non-Medicare DME
Transportation
$0 copay up to 12 one-way trips
Dental
$0 for two preventive visits; $1,500 comprehensive;
Eyewear
$0 copay for eyewear up to $300 per year
OTC
$85 per quarter
Hearing Aids
Up to $500 every 2 years
Wallet
Flex Card limit up to $400 for fitness, PERS, home & bathroom safety & non-Medicare DME
Transportation
$0 copay up to 12 one-way trips
Dental
$0 for two preventive visits; $1,500 comprehensive;
Eyewear
$0 copay for eyewear up to $200 per year
OTC
$40 per quarter
Hearing Aids
Up to $500 every 2 years
Wallet
Flex Card limit up to $350 for fitness, PERS, home & bathroom safety & non-Medicare DME
Transportation
$5 copay up to 12 one way trips
Dental
$0 for two preventive visits; $1,500 comprehensive;
Eyewear
$0 copay for eyewear up to $200 per year
OTC
$40 per quarter
Hearing Aids
Up to $500 every 2 years
Wallet
Flex Card limit up to $350 for fitness, PERS, home & bathroom safety & non-Medicare DME
Transportation
$5 copay up to 12 one way trips

Part D

Tier 1 - Preferred Generic
$0 copay
Tier 2 - Generic
$10 copay
Tier 3 - Preferred Brand Name
$40 copay
Insulin Tier
$35
Tier 4 - Non-Preferred Drugs
$95 copay
Tier 5 - Specialty Tier
33% of the cost
Tier 1 - Preferred Generic
$0 copay
Tier 2 - Generic
$5 copay
Tier 3 - Preferred Brand Name
$40 copay
Insulin Tier
$35
Tier 4 - Non-Preferred Drugs
$95 copay
Tier 5 - Specialty Tier
33% of the cost
Tier 1 - Preferred Generic
$0 copay
Tier 2 - Generic
$5 copay
Tier 3 - Preferred Brand Name
$40 copay
Insulin Tier
$35
Tier 4 - Non-Preferred Drugs
$95 copay
Tier 5 - Specialty Tier
33% of the cost
Tier 1 - Preferred Generic
N/A
Tier 2 - Generic
N/A
Tier 3 - Preferred Brand Name
N/A
Insulin Tier
N/A
Tier 4 - Non-Preferred Drugs
N/A
Tier 5 - Specialty Tier
N/A

Copays in GAP

Tier 1 - Preferred Generic
$0 copay
Tier 2 - Generic
$10 copay
Other Tiers
25%
Tier 1 - Preferred Generic
$0 copay
Tier 2 - Generic
$5 copay
Other Tiers
25%
Tier 1 - Preferred Generic
$0 copay
Tier 2 - Generic
$5 copay
Other Tiers
25%
Tier 1 - Preferred Generic
N/A
Tier 2 - Generic
N/A
Other Tiers
N/A

The Senior Health Plan service area is: Craig, Creek, Delaware, Hughes, Mayes, McIntosh, Muskogee, Nowata, Okmulgee, Osage, Ottawa, Pawnee, Pittsburg, Rogers, Tulsa, Wagoner and Washington counties.

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