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A wide range of benefits—all for $0 a month1

As a CCA Medicare Excel (HMO-POS) plan member, you now get MORE benefits—including $0 primary care copays, prescription drug coverage, and $0 copays for annual dental and eye exams.

Medicare Advantage HMO POS Plan
CCA Medicare Excel
Benefits
Monthly Plan Premium1
$0
Annual Medical Deductible
$0
Maximum Out-of-Pocket Costs
No more than $3,800 annually
In-Network Referrals
None required
In-Network Primary Care Copay
$0
In-Network Specialist Copay
$10
Inpatient Hospital Stays2
Inpatient:
$295 per day for days 1–7;
$0 for days 8 and beyond
Preventive Care
$0
Prescription Drugs
$0 for Tier 1 and Tier 2, Preferred Retail
Dental Services
$0 copay for routine and preventive dental services. Comprehensive dental2 care coverage $2,000 annual maximum3
Vision Services
$300 flex card for routine eye exam and eyewear3
Hearing Services
$0 routine exam3
$1,500 per year for two hearing aids (one per ear)
Healthy Savings Card4
$240 every calendar quarter to buy plan-approved over-the-counter products
Covered 
Home Healthcare2
$0 copay
Transportation2
$0 copay per one-way trip (up to 12 per year to plan-approved locations, maximum of 20 miles)

The above chart reflects in-network costs. Costs may vary depending on plan type, product, or service. For details on out-of-network costs, see the CCA Medicare Excel plan Evidence of Coverage document below. 

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)

A detailed document to explain how your CCA Medicare Excel plan works and what care and services are covered.

CCA Medicare Excel Plan (HMO-POS) (MI) – ANOC (2024)

CCA Medicare Excel (HMO-POS) (MI) – Low Income Subsidy Premium Summary (2024)

A notice for members who qualify for extra help paying for their prescription drug coverage.

CCA Health (MI) – Medicare Star Ratings (2024)

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. This document tells you our ratings from Medicare.

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 this link will cause you to leave the CCA Health Michigan 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.

CCA Medicare Excel (HMO POS) is a health plan with a Medicare contract. Enrollment depends on contract renewal.

We’re here to support you

855-959-5855 (TTY 711)
April 1 to September 30, 8 am – 8 pm, Monday – Friday