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With CCA Medicare Maximum—pay $01 and connect to coverage that cares.

  • $0 monthly plan payment and medical deductibles1

  • $0 prescription and over-the-counter drugs

  • $0 annual eye exam and up to $350 a year for eyewear

  • $0 copay for routine foot care, up to 4 visits per year

  • 50 one-way medical and non-medical2 rides per year

  • Speak with a registered nurse (RN) 24 hours a day, 7 days a week

  • 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

  • $0 doctor’s office visits and hospital stays4PLUS a $25 reward added to your Healthy Savings card after your annual wellness visit5

  • $0 dental, including comprehensive servicesMaximum coverage of $4,000 per year

  • Healthy Savings card: $750 every calendar quarter to purchase plan-approved OTC items such as hand sanitizer, masks, first-aid supplies, dental care, cold symptom supplies, and others at in-network retailers.7

    Some members with qualifying chronic conditions may be able to use these funds for approved food and utilities, too2

  • $0 copay for routine hearing exam – 1 per year

    $4,000 annual allowance for 2 hearing aids (one per ear)

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 (HMO D-SNP) (RI) – Annual Notice of Changes (2024)

A document that tells you about the changes to the plan’s benefits, coverage, and rules for 2024.

CCA Medicare Maximum (HMO D-SNP) (RI) – Summary of Benefits (2024)

A brief summary of the benefits and services covered by your CCA Medicare Maximum plan.

CCA Medicare Maximum (HMO D-SNP) (RI) – Evidence of Coverage (2024)

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

CCA Medicare Maximum (HMO D-SNP) (RI) – Low Income Subsidy Plan Premium Summary (2024)

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

CCA Medicare Maximum (HMO D-SNP) (RI) – 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.

CCA Health (RI) – Comprehensive Needs Assessment Form

If you prefer to print and mail it, please send to:

Commonwealth Care Alliance
101 Wason Ave, 3rd floor
Springfield, MA 01107

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, approved food, and utility benefits 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.

3 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.

4 Prior authorization is required.

5 It may take several months for your reward to be processed and added to your Healthy Savings card. Certain restrictions apply. Participating locations only. Contact the plan for more information.

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

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

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. 

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.

To learn more or become a member

833-611-5887 (TTY 711)
October to March, 8 am – 8 pm, 7 days a week