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Member Benefits

Whichever CommuniCare Advantage plan you qualify for, our plans offer a wide range of benefits to ensure your care meets your unique healthcare goals and preferences. For each of our Medicare Advantage plans, we cover all of the standard Medicare Part A and B services, in addition to providing extra benefits and services.

CommuniCare Advantage - CSNP Benefit Highlights

CommuniCare Advantage’s CSNP plan offers a robust lineup of benefits for members, including:

Benefits* Description In-Network Costs
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Doctor visits

No copays for visits to your primary care provider (PCP), and low copays for endocrinologists, and cardiologists $0 co-pay for PCPs, $10 co-pay for endocrinologists and cardiologists
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Immunizations

Vaccines for COVID-19, Pneumonia, Influenza and Hepatitis B $0 cost to member
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Preventive
services

Many preventive services are covered, including annual wellness visit, breast cancer screening, colorectal cancer screening, diabetes screening $0 cost to member
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Help with diabetes insulin and supplies

Reduced cost sharing across a number of services, including reduced copays for all forms of insulin, diabetes supplies and services, and diabetic shoes $35 co-pay for a one month supply of all forms of insulin offered by participating drug manufacturers
$0 co-pay for diabetic supplies and services
20% coinsurance for diabetic shoes and inserts
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Dental services

Preventive & comprehensive dental services include oral exams, dentures, X-rays, extractions, fillings and deep cleanings $0 cost to member
$1,000 benefit annually
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Routine vision services with eyewear

Routine vision screening, lenses, frames, and/or contacts $0 cost to member
$250 benefit annually
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Transportation

24 one-way non-emergent medical transportations are included $0 cost to member
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Hearing services

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries) $0 cost to member
$1,800 benefit annually
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DESCRIPTION

No copays for visits to your primary care provider (PCP), and low copays for endocrinologists, and cardiologists


IN-NETWORK COSTS

$0 co-pay for PCPs, $10 co-pay for endocrinologists and cardiologists

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DESCRIPTION

Vaccines for COVID-19, Pneumonia, Influenza and Hepatitis B


IN-NETWORK COSTS

$0 cost to member

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DESCRIPTION

Many preventive services are covered, including annual wellness visit, breast cancer screening, colorectal cancer screening, diabetes screening


IN-NETWORK COSTS

$0 cost to member

icon

DESCRIPTION

Reduced cost sharing across a number of services, including reduced copays for all forms of insulin, diabetes supplies and services, and diabetic shoes


IN-NETWORK COSTS

$35 co-pay for a one month supply of all forms of insulin offered by participating drug manufacturers
$0 co-pay for diabetic supplies and services
20% coinsurance for diabetic shoes and inserts

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DESCRIPTION

Preventive & comprehensive dental services include oral exams, dentures, X-rays, extractions, fillings and deep cleanings


IN-NETWORK COSTS

$0 cost to member
$1,000 benefit annually

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DESCRIPTION

Routine vision screening, lenses, frames, and/or contacts


IN-NETWORK COSTS

$0 cost to member
$250 benefit annually

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DESCRIPTION

24 one-way non-emergent medical transportations are included


IN-NETWORK COSTS

$0 cost to member

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DESCRIPTION

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries)


IN-NETWORK COSTS

$0 cost to member
$1,800 benefit annually

*This is not a complete description of benefits. See the plan Evidence of Coverage for more information or call Member Services toll-free at (855) 969-5861, TTY 711, 8:00 a.m. – 8:00 p.m. seven days a week October 1 through March 31 (8:00 a.m. – 8:00 p.m. Monday through Friday April 1 through September 30). CommuniCare Advantage is an HMO with a Medicare contract. Enrollment in this plan depends on contract renewal.

CommuniCare Advantage - ISNP Benefit Highlights

CommuniCare Advantage’s ISNP plan benefits meet the needs of long-term care residents:

Benefits* Description In-Network Costs
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Transportation

Non-emergent medical transportations are included. $0 cost to member
Benefit varies by state
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Immunizations

Vaccines for COVID-19, pneumonia, influenza, and Hepatitis B $0 cost to member
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Preventive services

Many preventive services are covered, including an annual wellness visit, breast cancer screening, colorectal cancer screening, diabetes screening $0 cost to member
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Dental services

Preventive and comprehensive dental services include oral exams, dentures, x-rays, extractions, fillings, and deep cleanings $0 cost to member
$2,000 benefit annually
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Vision services

Routine vision screening, lenses, frames, and/or contacts $0 cost to member
Benefit varies by state
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Flex Card

Healthcare dollars to spend on over-the-counter products and benefits $0 cost to member
Benefit varies by state
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Hearing services

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries) $0 cost to member for $1,500 benefit annually
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DESCRIPTION

Non-emergent medical transportations are included.


IN-NETWORK COSTS

$0 cost to member
Benefit varies by state

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DESCRIPTION

Vaccines for COVID-19, pneumonia, influenza, and Hepatitis B


IN-NETWORK COSTS

$0 cost to member

icon

DESCRIPTION

Many preventive services are covered, including an annual wellness visit, breast cancer screening, colorectal cancer screening, diabetes screening


IN-NETWORK COSTS

$0 cost to member

icon

DESCRIPTION

Preventive and comprehensive dental services include oral exams, dentures, x-rays, extractions, fillings, and deep cleanings


IN-NETWORK COSTS

$0 cost to member
$2,000 benefit annually

icon

DESCRIPTION

Routine vision screening, lenses, frames, and/or contacts


IN-NETWORK COSTS

$0 cost to member
Benefit varies by state

icon

DESCRIPTION

Healthcare dollars to spend on over-the-counter products and benefits


IN-NETWORK COSTS

$0 cost to member
Benefit varies by state

icon

DESCRIPTION

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries)


IN-NETWORK COSTS

$0 cost to member for $1,500 benefit annually

*This is not a complete description of benefits. See the plan Evidence of Coverage for more information or call Member Services toll-free at (855) 969-5861, TTY 711, 8:00 a.m. – 8:00 p.m. seven days a week October 1 through March 31 (8:00 a.m. – 8:00 p.m. Monday through Friday April 1 through September 30). CommuniCare Advantage is an HMO with a Medicare contract. Enrollment in this plan depends on contract renewal.

CommuniCare Advantage - MAPD Emerald Benefit Highlights

CommuniCare Advantage’s MAPD Emerald plan offers a robust lineup of benefits for members, including:

Benefits* Description In-Network Costs
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Doctor Visits

No copays for visits to your primary care provider (PCP) $0 copay for PCPs
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Immunizations

Pneumonia vaccine, Influenza vaccine, COVID-19 vaccine, Hepatitis B vaccine $0 – there is no coinsurance, copayment or deductible for the pneumonia, influenza, COVID-19, and hepatitis B vaccines
icon

Preventive Services

Preventive services are covered, including annual wellness visit, breast cancer screening, colorectal cancer screening, and diabetes screening $0 cost to member
icon

Help with Diabetes Insulin and Supplies

Reduced cost sharing across a number of services, including reduced copays for all forms of insulin, diabetic supplies and services, and diabetic shoes $35 copay for a one-month supply of all forms of insulin offered by participating drug manufacturers $0 copay for diabetic supplies and services 20% coinsurance for diabetic shoes and inserts
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Dental Services

Preventive & comprehensive dental services include oral exams, dentures, x-rays, extractions, fillings, and deep cleanings $0 cost to member $2,000 benefit annually
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Vision Services

Routine vision screening, lenses, frames, and/or contacts $0 cost to member $350 benefit annually
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Home-Delivered Meals

One-time benefit of 3 meals per day for 7 days after discharge from the hospital $0 cost to member, this benefit requires case manager approval
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Hearing Services

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries) $0 cost to member $4,000 benefit every 3 years
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Fitness Benefit

Access to fitness centers, online classes, and ability to use different centers $0 cost to member
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Flex Card

Health Care dollars to spend on over-the-counter products and benefits $0 cost to member $50 benefit every 3 months
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DESCRIPTION

No copays for visits to your primary care provider (PCP)


IN-NETWORK COSTS

$0 copay for PCPs

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DESCRIPTION

Pneumonia vaccine, Influenza vaccine, COVID-19 vaccine, Hepatitis B vaccine


IN-NETWORK COSTS

$0 – there is no coinsurance, copayment or deductible for the pneumonia, influenza, COVID-19, and hepatitis B vaccines

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DESCRIPTION

Preventive services are covered, including annual wellness visit, breast cancer screening, colorectal cancer screening, and diabetes screening


IN-NETWORK COSTS

$0 cost to member

icon

DESCRIPTION

Reduced cost sharing across a number of services, including reduced copays for all forms of insulin, diabetic supplies and services, and diabetic shoes


IN-NETWORK COSTS

$35 copay for a one-month supply of all forms of insulin offered by participating drug manufacturers $0 copay for diabetic supplies and services 20% coinsurance for diabetic shoes and inserts

icon

DESCRIPTION

Preventive & comprehensive dental services include oral exams, dentures, x-rays, extractions, fillings, and deep cleanings


IN-NETWORK COSTS

$0 cost to member $2,000 benefit annually

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DESCRIPTION

Routine vision screening, lenses, frames, and/or contacts


IN-NETWORK COSTS

$0 cost to member $350 benefit annually

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DESCRIPTION

One-time benefit of 3 meals per day for 7 days after discharge from the hospital


IN-NETWORK COSTS

$0 cost to member, this benefit requires case manager approval

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DESCRIPTION

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries)


IN-NETWORK COSTS

$0 cost to member $4,000 benefit every 3 years

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DESCRIPTION

Access to fitness centers, online classes, and ability to use different centers


IN-NETWORK COSTS

$0 cost to member

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DESCRIPTION

Health Care dollars to spend on over-the-counter products and benefits


IN-NETWORK COSTS

$0 cost to member $50 benefit every 3 months

*This is not a complete description of benefits. See the plan Evidence of Coverage for more information or call Member Services toll-free at (855) 969-5861, TTY 711, 8:00 a.m. – 8:00 p.m. seven days a week October 1 through March 31 (8:00 a.m. – 8:00 p.m. Monday through Friday April 1 through September 30). CommuniCare Advantage is an HMO with a Medicare contract. Enrollment in this plan depends on contract renewal.

CommuniCare Advantage - MAPD Sapphire Benefit Highlights

CommuniCare Advantage’s MAPD Sapphire plan offers a robust line up of benefits, including:

Benefits* Description In-Network Costs
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Doctor Visits

No copays for visits to your primary care provider (PCP) $0 copay for PCPs
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Immunizations

Pneumonia vaccine, Influenza vaccine, COVID-19 vaccine, Hepatitis B vaccine $0 – there is no coinsurance, copayment or deductible for the pneumonia, influenza, COVID-19, and hepatitis B vaccines
icon

Preventive Services

Preventive services are covered, including annual wellness visit, breast cancer screening, colorectal cancer screening, and diabetes screening $0 cost to member
icon

Help with Diabetes Insulin and Supplies

Reduced cost sharing across a number of services, including reduced copays for all forms of insulin, diabetic supplies and services, and diabetic shoes $35 copay for a one-month supply of all forms of insulin offered by participating drug manufacturers $0 copay for diabetic supplies and services 20% coinsurance for diabetic shoes and inserts
icon

Dental Services

Preventive & comprehensive dental services include oral exams, dentures, x-rays, extractions, fillings, and deep cleanings $0 cost to member $1,000 benefit annually
icon

Vision Services

Routine vision screening, lenses, frames, and/or contacts $0 cost to member *Benefit varies by state
icon

Home-Delivered Meals

One-time benefit of 3 meals per day for 7 days after discharge from the hospital $0 cost to member, this benefit requires case manager approval
icon

Hearing Services

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries) $0 cost to member $800 benefit every 3 years
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Fitness Benefit

Access to fitness centers, online classes, and ability to use different centers $0 cost to member
icon

Flex Card

Health Care dollars to spend on over-the-counter products and benefits $0 cost to member *Benefit varies by state
icon

Transportation

24 one-way non-emergent medical transportations are included $0 cost to member
icon

DESCRIPTION

No copays for visits to your primary care provider (PCP)


IN-NETWORK COSTS

$0 copay for PCPs

icon

DESCRIPTION

Pneumonia vaccine, Influenza vaccine, COVID-19 vaccine, Hepatitis B vaccine


IN-NETWORK COSTS

$0 – there is no coinsurance, copayment or deductible for the pneumonia, influenza, COVID-19, and hepatitis B vaccines

icon

DESCRIPTION

Preventive services are covered, including annual wellness visit, breast cancer screening, colorectal cancer screening, and diabetes screening


IN-NETWORK COSTS

$0 cost to member

icon

DESCRIPTION

Reduced cost sharing across a number of services, including reduced copays for all forms of insulin, diabetic supplies and services, and diabetic shoes


IN-NETWORK COSTS

$35 copay for a one-month supply of all forms of insulin offered by participating drug manufacturers $0 copay for diabetic supplies and services 20% coinsurance for diabetic shoes and inserts

icon

DESCRIPTION

Preventive & comprehensive dental services include oral exams, dentures, x-rays, extractions, fillings, and deep cleanings


IN-NETWORK COSTS

$0 cost to member $1,000 benefit annually

icon

DESCRIPTION

Routine vision screening, lenses, frames, and/or contacts


IN-NETWORK COSTS

$0 cost to member *Benefit varies by state

icon

DESCRIPTION

One-time benefit of 3 meals per day for 7 days after discharge from the hospital


IN-NETWORK COSTS

$0 cost to member, this benefit requires case manager approval

icon

DESCRIPTION

Routine hearing exams, hearing aids, and hearing aid services (including evaluation and fitting, repair, and batteries)


IN-NETWORK COSTS

$0 cost to member $800 benefit every 3 years

icon

DESCRIPTION

Access to fitness centers, online classes, and ability to use different centers


IN-NETWORK COSTS

$0 cost to member

icon

DESCRIPTION

Health Care dollars to spend on over-the-counter products and benefits


IN-NETWORK COSTS

$0 cost to member *Benefit varies by state

icon

DESCRIPTION

24 one-way non-emergent medical transportations are included


IN-NETWORK COSTS

$0 cost to member

*This is not a complete description of benefits. See the plan Evidence of Coverage for more information or call Member Services toll-free at (855) 969-5861, TTY 711, 8:00 a.m. – 8:00 p.m. seven days a week October 1 through March 31 (8:00 a.m. – 8:00 p.m. Monday through Friday April 1 through September 30). CommuniCare Advantage is an HMO with a Medicare contract. Enrollment in this plan depends on contract renewal.

Discover the benefits of CommuniCare Advantage.
Call (855)-969-5861 to learn more.