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CCA One Care (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CCA One Care (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CCA One Care (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
CCA One Care (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by Commonwealth Care Alliance, Inc. available for enrollment in 2025 to people living in BERK BAR BRI ESS FRA HMD HMP MID NOR PLY SUF WOR. The overall rating for this plan is not yet available for 2025.
It's important to know that CCA One Care (Medicare-Medicaid Plan) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
CCA One Care (Medicare-Medicaid Plan)is a Medicare-Medicaide (MMP) plan. This means you can only enroll in this plan if you meet specific criteria for both medicare and medicaid. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about CCA One Care (Medicare-Medicaid Plan).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For CCA One Care (Medicare-Medicaid Plan), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for CCA One Care (Medicare-Medicaid Plan)
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Drug Coverage
The CCA One Care (Medicare-Medicaid Plan) has an enhanced alternative drug benefit. This plan has a $0 deductible. If you qualify for the low-income subsidy, you will pay $0 for your Part D drugs. After paying your deductible, you will enter the initial coverage phase, where you pay the costs for your drugs until your total drug costs reach $2000. After this amount, you will enter the catastrophic coverage phase, where you pay nothing for your covered drugs.
Additional Benefits
The CCA One Care (Medicare-Medicaid Plan) offers a wide range of benefits with no copay for many services, including ambulance, emergency, and home health services. This plan covers essential services such as inpatient hospital stays, outpatient services, and primary care, as well as preventive services like vision and dental care. You'll also find coverage for hearing aids and medical equipment. This plan provides coverage for services such as cardiac rehabilitation, skilled nursing facilities, and dialysis services. Additionally, it includes other services like acupuncture and meal benefits, but it's important to note that some services, such as certain types of hearing aids and specific diagnostic procedures, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. Additional Days for Inpatient Hospital-Acute and Psychiatric, and Non-Medicare-covered Stay for both, are covered; however, Upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Individual and group sessions for outpatient substance abuse are not covered, and outpatient blood services have a three (3) pint deductible waived.
Partial Hospitalization See details
Partial Hospitalization benefits are covered with no copay and no coinsurance.
Ambulance and Transportation Services See details
Ambulance services are covered with no copay and no coinsurance, but ground and air ambulance services are not covered. Transportation services to plan-approved health-related locations are covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CCA One Care (Medicare-Medicaid Plan). There is no copay or coinsurance for Emergency Services or Urgently Needed Services, but Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The CCA One Care (Medicare-Medicaid Plan) covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Mental health specialty services and psychiatric services individual and group sessions are not covered.
Preventive Services See details
The CCA One Care (Medicare-Medicaid Plan) covers preventive services, including annual physical exams, health education, personal emergency response systems, nutritional/dietary benefits, home-based palliative care, additional sessions of smoking and tobacco cessation counseling, therapeutic massage (12 sessions per year), remote access technologies, home and bathroom safety devices and modifications, counseling services, kidney disease education services, and glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. The plan does not cover in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, in-home support services, support for caregivers of enrollees, fitness benefits, enhanced disease management, or telemonitoring services.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, and fitting/evaluation for hearing aids, all with no deductible. Prescription hearing aids are partially covered; inner ear, outer ear, and over the ear hearing aids are covered, but prescription hearing aids (all types) are not covered. Over-the-counter hearing aids are not covered.
Vision Services See details
The CCA One Care (Medicare-Medicaid Plan) covers vision services, including eye exams with no copay, and eyewear. Eyeglass frames are covered up to $125 every year, and you can receive one set of frames every year. Contact lenses, eyeglass lenses and eyeglasses (lenses and frames) are unlimited. Upgrades are not covered.
Dental Services See details
Dental Services are covered, including oral exams (2 per year), dental x-rays, other diagnostic dental services, prophylaxis (cleaning) (2 per year), fluoride treatment (2 per year), other preventive dental services (1 mouthguard every 24 months), and restorative services. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the CCA One Care (Medicare-Medicaid Plan), including Medicare Part B Insulin Drugs, but Medicare Part B Chemotherapy/Radiation Drugs are not covered. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the CCA One Care (Medicare-Medicaid Plan). There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) and Prosthetics/Medical Supplies, both with no copay or coinsurance, but prior authorization is required; however, Durable Medical Equipment for use outside the home, Prosthetic Devices, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. Other 1 for DME (MassHealth State DME Benefit Training in Usage, Repairs, Modifications) and Other 2 for DME (Environmental Aids and Assistive/Adaptive Technologies) are covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the CCA One Care (Medicare-Medicaid Plan), but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for this benefit.
Home Health Services See details
Home Health Services are covered by the CCA One Care (Medicare-Medicaid Plan), with no copay or coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services, including Intensive Cardiac Rehabilitation Services and Pulmonary Rehabilitation Services, are covered by the CCA One Care (Medicare-Medicaid Plan). SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, including additional days beyond Medicare-covered and non-Medicare-covered stays. There is no coinsurance or copay for the additional days beyond Medicare-covered stay, and prior authorization is required.
Other Services See details
Other Services include acupuncture, meal benefits, and additional services. Acupuncture is covered with prior authorization. Meal benefits are covered and require prior authorization. Other services are also covered, including behavioral health care services, chronic disease and rehabilitation hospital inpatient, adult day health, adult foster care, day habilitation, group adult foster care, hospice, orthotic services, speech and hearing services, behavioral health diversionary services, community-based services, abortion, gender-affirming care, transitional living program, tobacco cessation counseling, telehealth, and prescription digital therapeutics. Over-the-counter items, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Nursing Home Services are covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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