Senior Health Plan

CommunityCare is proud to offer Senior Health Plan, a program created especially for Medicare beneficiaries. CommunityCare Senior Health Plan has contracted with the federal government to provide Medicare services and is owned by Saint Francis Hospital and St. John Medical Center in Tulsa (other physicians and providers are available in our network). Senior Health Plan’s contract with CMS is renewed annually. As a result, the availability of coverage beyond the end of the current contract year is not guaranteed. Benefits, limitations, service areas and premiums are subject to change on January 1 of each year.

Senior Health Plan has three Medicare Advantage Plans to fit the varying needs of Medicare beneficiaries for health coverage or Part D prescription drug coverage.

Plan Name	Premium	Description
Senior Health Plan Silver	$0	Medical Only Hospital Copay - $150 per day, days 1-5 Primary Care Physician Copay - $15 per visit
Senior Health Plan Platinum	$31	Medical with Part D Hospital Copay $250 per day, days 1-5 Primary Care Physician Copay - $25 per visit
Senior Health Plan Platinum Plus	$81	Medical with Part D Hospital Copay - $150 per day, days 1-5 Primary Care Physician Copay - $15 per visit
For additional information regarding our Senior Health Plans or to compare benefits of each plan, Click here to view the Summary of Benefits.

Although Medicare is a Federal program, Senior Health Plan is available only to individuals who live in our plan service area. To stay a member of our plan, you must keep living in this service area. The service area is described below:

Our service area includes these counties in Oklahoma: Creek, Rogers, Tulsa, and Wagoner Counties.

Our service area includes these parts of counties in Oklahoma: Osage County, (the following zip codes only):74002, 74035, 74054, 74060, 74063, 74070, 74084, 74126, and 74127; Washington County, (the following zip codes only): 74003, 74005, 74006, 74029, 74051, 74061, 74070.

If you plan to move out of the service area, please contact Member Services.

Find helpful information regarding our Senior Health Plan on our Senior Health Plan Resources page. Don't forget to check out Senior Health Plan seminars and social classes.

Senior Health Plan Seminars

• Tulsa Area Seminar Schedule.
• Tulsa Area Social Classes Schedule.

Disclaimers

• You may join or leave a plan only at certain times. Please call Senior Health Plan at the telephone number listed in the previous section of this web page or 1-800-MEDICARE (1-800-633-4227) for more information. TTY users should call 1-877-486-2048. You can call this number 24 hours a day, seven days a week.
• You can join Senior Health Plan if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area. However, individuals with End Stage Renal Disease are generally not eligible to enroll in Senior Health Plan unless they are members of our organization and have been since their dialysis began.
• Senior Health Plan has formed a network of doctors, specialists, and hospitals. You can only use doctors who are part of our network. The health providers in our network can change at any time. You can ask for a current Provider Directory for an up-to-date list or search the Senior Health Plan provider directory on this website. If you choose to go to a doctor outside of our network, you must pay these services yourself. Neither Senior Health Plan nor the Original Medicare Plan will pay for these services.
• You must continue to pay your Medicare Part D premium, even if the Senior Health Plan premium is $0.
• Senior Health Plan has formed a network of pharmacies. You must use a network pharmacy to receive plan benefits. We may not pay for your prescriptions if you use an out-of-network pharmacy, except in certain cases. The pharmacies in our network can change at any time. You can ask for a current Pharmacy Network List or search the Senior Health Plan provider directory on this website.
• As a member of Senior Health Plan, you have the right to request a coverage determination, which includes the right to request an exception, the right to file an appeal if we deny coverage for a prescription drug, and the right to file a grievance. You have the right to request a coverage determination if you want us to cover a Part D drug that you believe should be covered.
  • Click here for the Part D coverage determinations and appeals summary, including instructions for filing a grievance and requesting a coverage determination.
  • Click here for details regarding the coverage determination appeals process.

Get helpful information about our Senior Health Plan including Forms, Frequently Asked Questions, Benefits Information, Evidence of Coverage for MA and MA-PD, Disenrollment Responsibilities, Grievance & Appeals Procedures, Out-of-Network Coverage, Privacy Notice, and more.