CCA Medicare Plan Benefits and Services
Check out our benefits for 2024
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Medicare Advantage HMO-POS Plan
CCA Medicare Excel
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Benefits
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Monthly Plan Premium1
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| $0 | |
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Annual Medical Deductible
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| $0 | |
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Maximum Out-of-Pocket Costs
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| No more than $3,800 annually | |
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In-Network Referrals
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| None required | |
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In-Network Primary Care Copay
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| $0 | |
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In-Network Specialist Copay
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| $10 | |
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Inpatient Hospital Stays2
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Inpatient: $295 per day for days 1–7; $0 for days 8 and beyond |
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Preventive Care
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| $0 | |
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Prescription Drugs
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| $0 for Tier 1 and Tier 2, Preferred Retail | |
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Dental Services
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| $0 copay for routine and preventive dental services. Comprehensive dental care2 coverage $2,000 annual maximum3 | |
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Vision Services
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| $300 flex card for routine eye exams and eyewear3 | |
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Hearing Services
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$0 routine exam3 $1,500 per year for two hearing aids (one per ear) |
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Healthy Savings Card4
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| $240 every calendar quarter to buy plan-approved over-the-counter products | |
| Covered | |
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Home Healthcare2
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| $0 copay | |
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Transportation2
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| $0 copay per one-way trip (up to 12 per year to plan-approved locations, maximum of 20 miles) |
The above reflects in-network costs. Costs may vary depending on plan type, product, or service. See the CCA Medicare Excel plan documents below for additional benefit coverage.
Do you qualify for Extra Help?
Eligible Medicare beneficiaries who have limited income may qualify for a government program called Extra Help.
To check if you qualify for Extra Help, visit SSA.gov6 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).
CCA Medicare Advantage Plan Benefit Documents
CCA Medicare Excel (HMO-POS) (MI) – Summary of Benefits (2024)
CCA Medicare Excel (HMO-POS) (MI) – Evidence of Coverage (2024)
CCA Medicare Excel Plan (HMO-POS) (MI) – ANOC (2024)
CCA Medicare Excel (HMO-POS) (MI) – Low Income Subsidy Premium Summary (2024)
CCA Health (MI) – Medicare Star Ratings (2024)
1 You have to continue to pay your Medicare Part B Premium unless your Part B premium is paid for you by Medicaid.
2 Prior authorization is required.
3 Coverage limitations apply. Refer to the Evidence of Coverage for full benefit information.
4 Certain restrictions apply. Participating locations only. Contact the plan for more information.
5 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. Certain restrictions apply. Participating in-network locations only.
6 Clicking on this link will direct you away from the CCA Health Michigan website.
Every year, Medicare evaluates plans on a 5-star rating system.
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.
CCA Medicare Excel (HMO POS) is a health plan with a Medicare contract. Enrollment depends on contract renewal.
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