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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 - 2022 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

Low co-pays for visits to your primary care provider (PCP), endocrinologist, and cardiologist $5 co-pay for PCPs, $10 co-pay for endocrinologists and cardiologists
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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
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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
Prior authorization is required
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Dental services

Preventive dental services including x-rays, cleanings, and oral exams $0 cost to member
The benefit is $1,000 annually
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Routine vision services with eyewear

Routine vision screening, lenses, frames, and/or contacts $0 cost to member
The benefit is $250 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
The benefit is $1,500 annually
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DESCRIPTION

Low co-pays for visits to your primary care provider (PCP), endocrinologist, and cardiologist


IN-NETWORK COSTS

$5 co-pay for PCPs, $10 co-pay for endocrinologists and cardiologists

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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

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


IN-NETWORK COSTS

$0 cost to member

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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
Prior authorization is required

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DESCRIPTION

Preventive dental services including x-rays, cleanings, and oral exams


IN-NETWORK COSTS

$0 cost to member
The benefit is $1,000 annually

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DESCRIPTION

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


IN-NETWORK COSTS

$0 cost to member
The benefit is $250 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
The benefit is $1,500 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) 969-5869, 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 - 2022 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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Skilled nursing facility (SNF)

No prior hospital stay is required $0 cost to member days
1 through 20
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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 & comprehensive dental services include root canal treatment, dentures, diagnostics, extractions, restorative care, deep cleaning $0 cost for up to $2,200 benefit for Ohio members,
$2,350 for Maryland members, and $1,750 for Indiana members
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Vision services

Routine vision screening, lenses, frames, and/or contacts $0 cost to member for up to $250 per year
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Comfort care items

Members may select from a catalog of products such as shampoo, lotion, deodorant, lip balm, socks, and more $0 cost to member for up to a $100 per month (the unused amount does not roll over)
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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 up to a $1,500 benefit per year
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DESCRIPTION

No prior hospital stay is required


IN-NETWORK COSTS

$0 cost to member days
1 through 20

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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 an annual wellness visit, breast cancer screening, colorectal cancer screening, diabetes screening


IN-NETWORK COSTS

$0 cost to member

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DESCRIPTION

Preventive & comprehensive dental services include root canal treatment, dentures, diagnostics, extractions, restorative care, deep cleaning


IN-NETWORK COSTS

$0 cost for up to $2,200 benefit for Ohio members,
$2,350 for Maryland members, and $1,750 for Indiana members

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DESCRIPTION

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


IN-NETWORK COSTS

$0 cost to member for up to $250 per year

icon

DESCRIPTION

Members may select from a catalog of products such as shampoo, lotion, deodorant, lip balm, socks, and more


IN-NETWORK COSTS

$0 cost to member for up to a $100 per month (the unused amount does not roll over)

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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 for up to a $1,500 benefit per year

*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.

Last modified: 01/04/2022

Discover the benefits of CommuniCare Advantage.
Call (855)-969-5869 to learn more.
CommuniCare residents call (855)-969-5861.