EOBs for plan members are temporarily unavailable to view online. If you have questions about plan benefits, please contact the CommunityCare customer service team for assistance.

Plan Details

CommunityCare Silver 1 Classic

98905OK0170057-01
Plan Year:
2017
Individual Deductible:$2,000
Individual Out of Pocket Maximum:$6,350
Office Visit Copay:$45
Preferred Generics:$20
Preferred Brand Name:$55*
Non-Preferred Brand Name:$75*
Specialty:$200*
Individual Rx Deductible:$500
*Subject to the deductible.

Essential Benefits

All health plans in the exchanges are required to provide a minimum set of benefits which are termed essential benefits. These benefits include:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health services
  • Substance use disorder services
  • Prescription drug coverage
  • Rehabilitative and habilitative services and devices
  • Preventative and wellness services
  • Pediatric Services