An Economical Plan for People With Medicare

CommunityCare is proud to offer Senior Health Plan, a program created especially for Medicare beneficiaries. CommunityCare Senior Health Plan is a Federally-Qualified HMO with a Medicare contract and is owned by Saint Francis Health System and St. John Health System 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.

Quality Improvement Organization

(paid by Medicare to check on the quality of care for people with Medicare)

There is a designated Quality Improvement Organization for serving Medicare beneficiaries in each state. For Oklahoma, the Quality Improvement Organization is called KEPRO.

KEPRO has a group of doctors and other health care professionals who are paid by the Federal government. This organization is paid by Medicare to check on and help improve the quality of care for people with Medicare. KEPRO is an independent organization. It is not connected with our plan.

You should contact KEPRO in any of these situations:

  • You have a complaint about the quality of care you have received.
  • You think coverage for your hospital stay is ending too soon.
  • You think coverage for your home health care, skilled nursing facility care, or Comprehensive Outpatient Rehabilitation Facility (CORF) services are ending too soon.
Method KEPRO
(Oklahoma’s Quality Improvement Organization) - Contact Information
CALL 1-888-315-0636
Monday – Friday, 9:00 am to 5:00 pm (ET, CT, MT)
TTY 1-855-843-4776
This number requires special telephone equipment and is only for people who have difficulties with hearing or speaking.
Attention: Beneficiary Complaints
5201 W. Kennedy Blvd., Suite 900
Tampa, FL 33609

Your Opinion Counts!

Each year, the Centers for Medicare and Medicaid Services (CMS) randomly surveys members about the care and services received from their doctor and from CommunityCare. You may be chosen to share your opinion about the health care services you receive.

The survey does not take long to complete. It has topics about how often you got care as soon as you thought you needed it, how well your doctor coordinated your care and the rating of your prescription drug plan.

If you are randomly chosen to do a survey, you may get the survey in the mail or receive a phone call from SPH Analytics/Morpace, an independent company that does survey work for Medicare and CommunityCare. Your answers are completely confidential. Once all surveys are compiled, CommunityCare receives a general report from SPH Analytics/Morpace.

We hope you will take a few minutes to share your thoughts with us. Your feedback will help us understand how well we are serving you. Thank you for any comments.

Improving Drug Utilization Review Controls in Part D

As required by the Comprehensive Addiction and Recovery Act (CARA) the Centers for Medicare and Medicaid Services (CMS) finalized new opioid policies for drug plans starting on January 1, 2019.

The new policies include improved safety alerts when opioid prescriptions are dispensed at the pharmacy and drug management programs for patients determined to be at-risk for misuse or abuse of opioids or other frequently abused drugs.

Please click on the applicable link below for more information.

Annual Wellness or Preventive Medicine Visits: Why it is important

When it comes to your health, you hear about eating a balanced diet, getting plenty of exercise, etc. But do you remember to see your doctor each year? An annual wellness or preventive medicine visit is a great time to develop a strategy with your doctor to maintain or improve your health.

If you have not had an annual wellness or preventive medicine visit in the last 12 months, talk to your doctor's office about scheduling this important service focused on your health. Be sure to let them know the appointment is for a Medicare annual wellness or preventive visit. This will allow them to ensure there is enough time set aside for your appointment.

Even if you are healthy, it is a good idea to have an annual wellness or preventive medicine visit at your doctor's office. Make an appointment today!

If you would like assistance making an appointment, contact Customer Service at (918) 594-5323 and ask to speak to a Member Engagement Specialist.

Medication Therapy Management (MTM) Programs

CommunityCare Senior Health Plan offers a medication therapy management program. Its purpose is to help you receive the most effective medications while helping to reduce the risk of side effects and interactions as well as your out-of-pocket costs.

Requesting a Provider or Pharmacy Directory

If you need help finding a network provider and/or pharmacy, please call (918) 594-5323 or click the links below:

If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email

CareWeb Member Connection

Senior Health Plan Members can access their benefit details and more online with CareWeb Member Connection.

Health and Wellness

Your health is important!

Did you know:
  • Your physicians work together to coordinate your care

    Your primary doctor coordinates your health care by ordering lab work, like blood sugar (A1c) or cholesterol tests, and preventive screenings, like a mammogram or colonoscopy. Your primary doctor also coordinates treatments with other providers so you get the right care when and where you need it.

  • Activity is essential for your physical and mental health

    Find an activity or two that you enjoy and will keep doing. Exercise does not have to be boring, or cost a lot of money. Your doctor can provide advice about the type and level of exercise that's best for you. Activity can:

    • Lower blood pressure and blood sugar levels
    • Boost your ability to do daily activities and prevent falls
    • Raise your quality of life
    • Build up your mental well being
  • Getting a flu shot is an annual event

    Flu season often starts in early fall and can last into late spring. Many doctors like to give flu shots early so the vaccine will last through the whole season. If flu season is not over, it’s not too late to get the shot.

CommunityCare Senior Center

At our CommunityCare Senior Center you can learn more about Senior Health Plan, receive help with enrollment, receive customer service and attend health education classes.

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 Evidence of Coverage booklet that corresponds with your plan from the "Forms & Resources" section of this site. These booklets provide details about your Medicare health coverage and explain how to get the care you need for your plan.

Links to Other Helpful Senior Health Plan Information:

Senior Health Plan Service Areas

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: Craig, Creek, McIntosh, Muskogee, Nowata, Osage, Tulsa, Wagoner and Washington

If you plan to move out of the service area, please contact Customer Service.


  • CommunityCare is an HMO with a Medicare contract. Enrollment in Senior Health Plan depends on contract renewal.
  • You may join or leave a plan only at certain times. Please call Senior Health Plan 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 for these services yourself. Neither Senior Health Plan nor Original Medicare will pay for these services.
  • You must continue to pay your Medicare Part B premium, even if the Senior Health Plan premium is $0.