CCA Senior Care Options (HMO D-SNP) Benefits
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$0 monthly plan payment1
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$0 drug deductible for prescriptions on the CCA formulary and prescribed over-the-counter drugs on the Medicaid formulary
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Healthy Savings card: Up to $475 quarterly to purchase plan-covered over-the-counter products2
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$0 copay for a routine eye exam and up to $350 per year for routine eyewear including frames or contacts
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$0 copay for a routine hearing exam and up to $1,000 a year for 2 hearing aids ($500 per ear)
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$0 copay for worldwide emergency coverage up to $100,000 per year outside of the U.S.
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$0 Silver&Fit® membership4
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$0 copay for doctors office visits and hospital stays3
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Teladoc Health: $0 copay for 24/7 urgent general medical services
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$0 copay for preventive and comprehensive dental services, including dentures, crowns, and implants5
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Unlimited rides to medical appointments and up to 10 one-way non-medical rides per month2
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$25 annual wellness visit reward6 added to your Healthy Savings card after your physical exam or wellness visit
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24-hour nurse line to speak with a Registered Nurse (RN)
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For members with active qualifying chronic conditions only (not all members qualify) – the quarterly value of the Healthy Savings card can be used to purchase plan-covered food and pay for utilities7
CCA Senior Care Options Benefits
CCA Senior Care Options (HMO D-SNP) (MA) – Summary of Benefits
CCA Senior Care Options (HMO D-SNP) (MA) – Evidence of Coverage
CCA Senior Care Options (HMO D-SNP) (MA) – Evidence of Coverage – Large Print
CCA Senior Care Options (HMO Medicaid) (MA) – Evidence of Coverage for MassHealth-Only Members
CCA Senior Care Options (HMO D-SNP) (MA) – Annual Notice of Changes
CCA Senior Care Options (HMO D-SNP) (MA) – Star Rating
1 You must continue to pay your Medicare Part B premium, unless it’s being paid on your behalf by MassHealth.
2 Certain restrictions apply. Contact the plan for more information.
3 Some services require prior authorization.
4 The Silver&Fit® program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty (ASH). Silver&Fit are trademarks of ASH and used with permission herein. Restrictions may apply. Only at participating locations.
5 Some services require prior authorization. Coverage limitations apply.
6 It may take several months for your reward to be processed and added to your Healthy Savings card.
7 The food and utilities benefits mentioned are part of a special supplemental program for the chronically ill. Members with chronic heart failure, cardiovascular disorders, chronic lung disorders, and diabetes may be eligible for these additional benefits. Not all members with those conditions will qualify. Certain restrictions may apply. Only at participating locations.
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. You will be covered for all services listed above as long as they are approved and/or coordinated by your primary care provider, your care team, or Commonwealth Care Alliance (CCA). For more information, call CCA Member Services or review your CCA Senior Care Options Evidence of Coverage.