Senior Health Plan resources
For details on Benefits Information, Grievance & Appeals Procedures, Out-of-Network Coverage, Quality Assurance Policies, Rights & Responsibilities Upon Disenrollment, and Applicable Conditions and Limitations, select the proper Evidence of Coverage booklet that coresponds with your plan. These booklets provide details about your Medicare health coverage and explains how to get the care you need for your plan.
| Senior Health Plan Medicare Advantage Plans | |
|---|---|
| Senior Health Plan Silver | |
| Senior Health Plan Platinum | |
| Senior Health Plan Platinum Plus | |
Additional Senior Health Plan Information
Use the links below for more information about CommunityCare Senior Health Plan.
Popular Forms
- Advanced Directive
- Appointment of Representative
- Auto Bank Draft Authorization
- Individual Election Form
- Medicare Prescription Drug Coverage Determination Request Instructions
- Model Coverage Determination Request Form
- Pcp Change Form
- PHI Authorization Form
- Prescription Authorization Form
- Redetermination/Appeal Request Form
- Request for Disenrollment
- Short Enrollment Form
- Working Aged Form
Click Here to download Adobe Acrobat Reader for free.
Pharmacy and Prescription Drug Resources
Mail Order Prescription Drug Program
Choose from two convenient options. Click here for more mail order prescription information.
$0 Copay Program
Zero Copay on Select Generic Formulary Drugs.
On-line Formulary
Search for prescription medications that promote clinically useful and cost-effective drug therapy.
Find a Pharmacy
Search the most current list of participating Pharmaices.
Monthly Plan Premiums for People who get Extra Help from Medicare
If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan. Click here view the low income subsidy premium table.
Drug Management Programs
For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. These requirements and limits ensure that our members use these drugs in the most effective way and also help us control drug plan costs. Click here for more information regarding our drug management programs.
CMS Best Available Evidence Policy
CMS has created a best available evidence (BAE) policy, which requires sponsors whose plans cover Part D prescription drugs to provide access to those drugs at the correct low-income subsidy (LIS) cost-sharing level when presented with evidence of a beneficiary’s LIS eligibility, even if the sponsor’s system and CMS’s system do not yet reflect that eligibility. Click here to view the Best Available Policy and related resources located on the CMS website.
Need more Information?
Please call our Customer Services Department at 1-800-642-8065 if you have any questions. Customer Services Representatives will be available Monday through Sunday from 8:00 am to 8:00 pm, CST. TTY/TDD users should call 1-800-722-0353.You can also get information about the Medicare Program and Medicare health plans by visiting www.medicare.gov on the Web or by calling 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048. Medicare customer service representatives are available 24 hours a day, seven days a week, to answer questions about Medicare.
