Below is a list of answers to frequently asked questions.
Commonwealth Care Alliance® (CCA) offers a range of Medicare plans that combine medical and dental coverage, prescription drugs, and more.
With CCA Medicare Preferred (PPO) and CCA Medicare Value (PPO), you get all your existing Medicare benefits (Medicare Parts A & B) and MORE—starting at $0. That includes $0 prescriptions, $0 dental services, $0 medical deductibles, and no referrals required for in-network doctors.
Plus, as a CCA member, you get more than just a health plan. Depending on your specific needs, you may receive a care team that helps coordinate all your medical, behavioral health, and social support needs.1
PPO stands for preferred provider organization. PPO plans provide more flexibility when picking a doctor or hospital.
With CCA Medicare PPO plans, you can see a doctor or specialist in-network without needing a referral or having to see your primary care provider (PCP) first. CCA Medicare PPO plans offer a large network of providers to choose from, and we encourage you to use an in-network provider. While you can also see out-of-network providers, what you pay for out-of-network services may be higher.
In addition to all your existing Medicare benefits (Medicare Parts A & B), CCA Medicare plans offer additional coverage for dental care, vision and hearing benefits, prescription drugs, and more.
With CCA Medicare Preferred, you pay $0 for monthly premiums, routine dental services, and medical deductibles. Plus, there are no referrals required for in-network doctors. You also get MORE benefits like vision, hearing, and a Healthy Savings card with $200 per year for over-the-counter health products.2
With CCA Medicare Value, you pay anywhere from $0 to $36.30 a month, depending on whether you qualify for Extra Help based on your income. You will also pay $0 for routine dental services and medical deductibles. Plus, there are no referrals required for in-network doctors.
CCA Medicare Value members also get MORE benefits like vision, hearing, identity theft protection, and a Healthy Savings card with up to $300 per year for over-the-counter health products and approved food items.2
CCA Medicare Preferred has a $0 monthly plan payment.
With CCA Medicare Value, you pay anywhere from $0 to $36.30 a month, depending on whether you qualify for Extra Help based on your income. Call us today to learn more.
For more information, view our CCA Medicare plan comparison. Other costs may vary depending on network, plan, product, or service.
You are eligible for CCA Medicare Preferred or CCA Medicare Value if you meet these requirements:
- You have or are eligible for both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance)
- You live in our Massachusetts service area
To enroll in CCA Medicare Preferred or CCA Medicare Value, you must live in one of these counties in Massachusetts: Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester.
The CCA network of doctors is very large. There’s a good chance your current doctors and other providers are already part of it, and you would not have to make a change.
If you do need to find a new doctor or other provider in our network, our team will be happy to help you find the best fit for you.
To see if your current providers are in the CCA network, search the CCA Provider Directory.
Yes! CCA Medicare Preferred and CCA Medicare Value both include coverage for routine dental services, up to $1,000 per year. Most comprehensive dental services, like dentures and crowns, are covered at 50%.
With CCA Medicare Preferred, all preferred generic prescription drugs will be covered with a $0 copay. With CCA Medicare Value, your cost for Tier 1 preferred generic drugs varies—from $0 to $6.50—based on the level of Extra Help you qualify for.
Learn more about CCA Medicare Preferred and CCA Medicare Value prescription drug coverage.
CCA has a network of over 1,000 contracted pharmacies in Massachusetts and a national network of nearly 60,000 contracted pharmacies.
Search the CCA Pharmacy Directory to find the right in-network pharmacy for you.
No. When you enroll in either a CCA Medicare Preferred or CCA Medicare Value plan, these plans become your Medicare coverage.
CCA works with Medicare to integrate the services we offer. That means you will only be adding MORE benefits or adding flexibility and coordination to your existing Medicare benefits. You will not lose services.
If you decide to go back to Original Medicare (Medicare Parts A & B), you must notify CCA that you want to disenroll. You may lose coverage for prescription drugs unless you enroll in a separate Part D prescription drug plan that meets CMS minimum creditable coverage standards.
You can disenroll at any time if you are not satisfied. Your disenrollment will be effective on the last day of the month in which you let us know you want to leave the plan.
We are happy to say that most members are very happy with their CCA experience.
There are limited times when you can enroll in a CCA Medicare plan.
- Initial Enrollment Period (IEP): This is when you first become eligible for Medicare—from 3 months before you turn 65 to 3 months after you turn 65. If you’re not already collecting Social Security benefits before your Initial Enrollment Period starts, you’ll need to sign up for Medicare online or contact Social Security. If you don’t enroll during this time, you might have to pay a late enrollment penalty.
- General Enrollment Period (GEP): If you miss your Initial Enrollment Period, you can still enroll during the GEP that runs from January 1 to March 31.
Once you are enrolled, there are then limited times when you can switch Medicare plans.
- Annual Enrollment Period (AEP), sometimes called Annual Election Period (AEP): every year from October 15 to December 7, you can switch Medicare plans—with your new coverage starting January 1 of the next year. If you miss this time frame, you might need to wait until the next year’s AEP to change plans.
- Special Enrollment Period (SEP): you may qualify to change plans outside of the AEP, if you are eligible for a Special Enrollment Period. Special Enrollment Periods are granted around certain life events—for example, if you move out of your plan’s service area, if you move into a skilled nursing facility or long-term care facility, or if Medicare terminates your plan.
- Open Enrollment Period (OEP): From January 1 to March 31 each year, if you’re enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or switch to Original Medicare (and join a separate Medicare Part D drug plan) once during this time.
Extra Help is a government program for eligible Medicare beneficiaries who have limited income. The Extra Help program may lower your prescription drug costs and your monthly premium payment under our CCA Medicare Value plan.
To check if you qualify for Extra Help, visit SSA.gov3 and search “Extra Help.” To apply over the phone or to request an application, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
1CCA care teams are assigned based on individual needs. Some members may not require the support of a care team.
2Certain restrictions may apply. Only at participating locations.
3When you click this link, you will leave the Commonwealth Care Alliance website.
The benefit information provided here is a brief summary, not a complete description of benefits. Benefits, formulary, and pharmacy and/or provider networks may change on January 1 of each year. Limitations, copayments, and restrictions may apply.