MedicareCommons™

Neutral. Transparent. Retrieval-first.

array(20) { ["plan_name"]=> string(39) "Senior Health Plan Silver Savings (HMO)" ["plan_id"]=> string(9) "H3755-007" ["org_name"]=> string(38) "CommunityCare Senior Health Plan (HMO)" ["plan_type"]=> string(3) "HMO" ["region"]=> string(45) "Select counties in N.E. and Central Oklahoma " ["moop"]=> string(7) "4200.00" ["deductible"]=> string(12) "Data missing" ["inpatient_hospital"]=> string(107) "$265.00 (days 1–5), $0.00 (days 6–90)
Prior Authorization Required, Referral Required" ["snf"]=> string(110) "$0.00 (days 1–20), $140.00 (days 21–100)
Prior Authorization Required, Referral Required" ["pcp"]=> string(53) "% - % Coinsurance
Referral Required" ["specialist"]=> string(48) "$20.00 Copay
Referral Required" ["urgent_care"]=> string(78) "$20.00 Copay
Prior Authorization Required, Referral Required" ["er"]=> string(79) "$250.00 Copay
Prior Authorization Required, Referral Required" ["ambulance_ground"]=> string(79) "$250.00 Copay
Prior Authorization Required, Referral Required" ["ambulance_air"]=> string(79) "$250.00 Copay
Prior Authorization Required, Referral Required" ["dental"]=> string(47) "Not Covered
Referral Required" ["vision"]=> string(90) "% - % Coinsurance
$300.00/yr eyewear
Referral Required" ["hearing"]=> string(47) "Not Covered
Referral Required" ["rx"]=> array(2) { ["deductible"]=> string(11) "Not Covered" ["tiers"]=> array(0) { } } ["data_status"]=> string(2) "ok" }
🩺 Doctor’s Office Visits
Service 2026 2025
PrimaryComing soon% - % Coinsurance
Referral Required
SpecialistComing soon$20.00 Copay
Referral Required
🏥 Emergency, Urgent, and Inpatient Hospital Coverage
Service 2026 2025
Emergency room careComing soon$250.00 Copay
Prior Authorization Required, Referral Required
Urgent careComing soon$20.00 Copay
Prior Authorization Required, Referral Required
Ground ambulanceComing soon$250.00 Copay
Prior Authorization Required, Referral Required
Inpatient hospital careComing soon$265.00 (days 1–5), $0.00 (days 6–90)
Prior Authorization Required, Referral Required
Skilled Nursing FacilityComing soon$0.00 (days 1–20), $140.00 (days 21–100)
Prior Authorization Required, Referral Required
🦶 Foot Care
Service 2026 2025
Foot Exams and Treatments (Medicare-covered)Coming soon20% Coinsurance
Prior Authorization Required, Referral Required
Routine Foot CareComing soon0% - 20% Coinsurance
Prior Authorization Required, Referral Required
💆 Chiropractic Care
Service 2026 2025
Medicare-covered chiropracticComing soon0% - 15% Coinsurance
Prior Authorization Required, Referral Required
Routine chiropracticComing soon20% Coinsurance
Prior Authorization Required, Referral Required
🧠 Mental Health Services
Service 2026 2025
Outpatient individual therapyComing soon$15.00 Copay
Prior Authorization Required, Referral Required
Outpatient group therapyComing soon$0.00 Copay
Prior Authorization Required, Referral Required
Inpatient psychiatric hospital careComing soon$265.00 (days 1–5), $0.00 (days 6–90)
Prior Authorization Required, Referral Required
🏋️ Rehabilitation Services
Service 2026 2025
Physical therapy and speech/language therapyComing soon$30.00 Copay
Referral Required
Occupational therapyComing soon$20.00 Copay
Referral Required
🧰 Medical Equipment and Supplies
Service 2026 2025
Diabetes suppliesComing soon% - % Coinsurance
Prior Authorization Required, Referral Required
Durable medical equipmentComing soon$30.00 Copay
Referral Required
ProstheticsComing soon$0.00 - $30.00 Copay
Referral Required
🔬 Diagnostics, Lab Services, and Imaging
Service 2026 2025
Diagnostic radiology servicesComing soon$20.00 Copay
Referral Required
Lab servicesComing soon$20.00 Copay
Prior Authorization Required, Referral Required
Outpatient x-raysComing soon$0.00 - $30.00 Copay
Referral Required
Diagnostic tests and proceduresComing soon$20.00 Copay
Referral Required
💉 Medicare Part B Drugs
Service 2026 2025
ChemotherapyComing soon% - % Coinsurance
Referral Required
Other Part B drugs (Medicare-covered)Coming soon% - % Coinsurance
Referral Required

Supplemental Benefits

🦷 Dental Services
Service 2026 2025
Medicare Covered Preventive DentalComing soonNot Covered
Referral Required
Oral examComing soon% - % Coinsurance
Referral Required
Dental x-raysComing soon% - % Coinsurance
Referral Required
CleaningComing soonNot Covered
Referral Required
PeriodonticsComing soon% - % Coinsurance
Referral Required
EndodonticsComing soon50% Coinsurance
Referral Required
Restorative ServicesComing soon50% Coinsurance
Referral Required
Dental MaximumComing soonNot Covered
👂 Hearing Aids and Services
Service 2026 2025
Fitting/evaluationComing soon% - % Coinsurance
Referral Required
Hearing aidsComing soon$0.00 Copay
Referral Required
Hearing examComing soonNot Covered
Referral Required
Hearing MaximumComing soonNot Covered
👓 Vision Services
Service 2026 2025
Medicare-covered eye examComing soonNot Covered
Referral Required
Routine eye examComing soon% - % Coinsurance
Referral Required
Eyewear benefitsComing soon% - % Coinsurance
Referral Required
Vision Eyewear MaximumComing soon$300.00/yr eyewear
{listing_template_3} {listing_template_4}

Part D Plan Premium

The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.

{name} Prescription Drug Plan Premium Details
Basic Part D Premium: ${part_d_basic_premium}
Supplemental Part D Premium: ${part_d_supplemental_premium}
Total Part D Premium: ${part_d_total_premium}
Low-Income Premium Subsidy: ${part_d_lips_amount}
Low-Income Premium Subsidy Paid by CMS: ${part_d_lips_cms_pays}
Low-Income Subsidy Premium: ${part_d_lis_premium}

For more details, visit the Social Security Extra Help program.

Prescription Drug Plan Deductible

This plan has a ${deductible} annual Part D deductible. You'll pay this deductible at the pharmacy before {carrier} starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, {name} may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

{name} Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
*Deductible does not apply.