CCA Medicare Maximum Plan Benefits

¹ You have to continue to pay your Medicare Part B Premium unless your Part B premium is paid for you by Medicaid.

² Coverage limitations apply. Refer to the Evidence of Coverage for full benefit information.

³ Prior authorization is required.

⁴ The benefits mentioned are part of a special supplemental program for the chronically ill. Not all members qualify. Certain restrictions may apply. Only at participating locations. Contact the plan for more information.

⁵ Certain restrictions apply. Participating locations only. Contact the plan for more information.

⁶ The Silver&Fit^® program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit are trademarks of ASH and used with permission herein. Restrictions may apply. Only at participating in-network locations.

Costs may vary depending on network, plan type, product, or service. 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 Maximum (HMO D-SNP) is a health plan with a Medicare contract and a contract with the State Medicaid program. Enrollment depends on contract renewal.