2023 CCA Medicare Maximum benefits
With CCA Medicare Maximum—pay $0 and get MORE benefits!1
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$0 monthly plan payment and medical deductibles1
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$0 prescription and over-the-counter drugs
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$0 annual eye exam and up to $300 a year for eyewear
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$0 copay for routine foot care, up to 4 visits per year
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50 one-way medical and non-medical2 rides a year
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Speak with a registered nurse (RN) 24 hours a day, 7 days a week
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NEW! Silver&Fit® membership3 that includes a fitness membership with access to an in network fitness center of your choosing, Fit at Home programming for at-home fitness, home fitness kits and more
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$0 doctor’s office visits and hospital stays—PLUS a $25 reward added to your Healthy Savings card after your annual wellness visit4
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$0 dental, including comprehensive services5 Maximum coverage of $3,500 per year
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Healthy Savings card: $675 every 3 months to purchase Medicare-approved OTC items such as hand sanitizer, masks, first-aid supplies, dental care, cold symptom supplies, and others at in-network retailers6
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$0 copay for routine hearing exam – 1 per year
$4,000 annual allowance for 2 aids (one per ear) every year
The information above is based on in-network costs. For detailed information on CCA Medicare Maximum benefits, see the Evidence of Coverage below.
CCA Medicare Maximum Benefit Documents
CCA Medicare Maximum RI – Summary of Benefits (2023)
CCA Medicare Maximum RI – Evidence of Coverage (2023)
CCA Medicare Maximum RI – Annual Notice of Changes (2023)
CCA Medicare Maximum RI Low Income Subsidy– Premium Summary (2023)
CCA Medicare Maximum RI – Star Ratings (2023)
1 You have to continue to pay your Medicare Part B Premium unless your Part B premium is paid for you by Medicaid.
2 The non-medical transportation benefit is 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.
3 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 locations.
4 It may take several months for your wellness visit to be processed and for your benefit to be allocated to your Healthy Savings card.
5 Prior authorization is required.
6 Certain restrictions may apply. Only at participating locations. Contact the plan for more information.
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 can get this document for free in other formats, such as large print, braille, or audio. Call 833-346-9222 (TTY 711), 8 am to 8 pm, 7 days a week, from October 1 to March 31. (April 1 to September 30: 8 am to 8 pm, Monday to Friday, and 8 am to 6 pm, Saturday and Sunday.) The call is free.
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