Use the links below to get answers to some of the most frequently asked questions regarding Senior Health Plan.
CommunityCare Senior Health Plan was created especially for people on Medicare. CommunityCare has contracted with the federal government to operate Senior Health Plan. There are four Medicare Advantage Plans to fit the varying needs of Medicare beneficiaries.
CommunityCare has a contract with the Federal government to provide Medicare services. Under this contract, the government pays us a fixed monthly amount of money for each Medicare member we serve. CommunityCare handles virtually all paperwork and medical services for our members.
No. You must be enrolled in both Medicare Parts A & B in order to be enrolled in our plan. However, while you are a member of Senior Health Plan you will only show your CommunityCare ID card. Keep your red, white, and blue Medicare card in a safe place in case you need it later.
Yes. You choose your own primary care physician from a long list of physicians affiliated with Senior Health Plan. You may choose any primary care physician (PCP) you wish, but we recommend that you select one close to home. This will give you the chance to build a stronger doctor-patient relationship.
Yes. You may change doctors for any reason, as long as the new doctor you select is a CommunityCare Senior Health Plan provider. Simply call Customer Service and we will help you select another doctor.
CommunityCare Senior Health Plan gives you worldwide coverage for medical emergencies. If you find yourself in an emergency, whether inside or outside Senior Health Plan's
service area, go to the nearest doctor or hospital or call 911.
Your safety is what counts!
We ask that you notify your doctor within 48 hours or as soon as reasonably possible to arrange follow-up care.
A copayment of $100 for Platinum, Platinum Plus and Silver Members and $80 for Silver Plus Members is required for emergency treatment, but is waived upon admission to a hospital.
Emergency medical condition means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent
layperson, with an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:
Three of our plans are Medicare Advantage Prescription Drug (MAPD) plans and include Medicare Part D prescription drug coverage –Silver Plus, Platinum and Platinum Plus. Our Silver plan is Medical only coverage and does not include Part D. Call us at (918) 594-5323 for more information about our plans or you may also refer to the Summary of Benefits for more information about our Senior Health Plan options.
Keep in mind that if you enroll in our Silver Plan (Medical Only), you cannot enroll in a Part D plan with another company. Also, if you don't have Medicare prescription drug coverage or creditable coverage (meaning prescription drug coverage that is as good as Medicare's), you may have to pay a late enrollment penalty if you enroll in Medicare prescription drug coverage in the future.
You may end your membership in our plan only during certain times of the year, known as enrollment periods. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the annual Medicare Advantage Disenrollment Period. In certain situations, you may also be eligible to leave the plan at other times of the year. Chapter 10 of the 2018 Evidence of Coverage provides information about ending your membership. Click here for more information regarding Disenrollment.