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Senior Health Plan - Plans Overview

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

2025 Plans

Silver Plus

Medical and Prescription
Service Area
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
Service Area
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
Service Area
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
Fitness Plus Benefit
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
Fitness Plus Benefit
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
Fitness Plus Benefit
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

Deductible
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%
Deductible
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%
Deductible
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

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

Senior Health Plan is an HMO plan and a D-SNP plan with a Medicare & Medicaid contract. Enrollment in Senior Health Plan depends on contract renewal.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact www.medicare.gov or 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. Medicare customer service representatives are available 24 hours a day, 7 days a week. TTY/TDD users should call 1-877-486-2048.

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