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CCA One Care (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CCA One Care (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CCA One Care (HMO D-SNP) in 2026, please refer to our full plan details page.
CCA One Care (HMO D-SNP) is a HMO D-SNP plan offered by CareSource available for enrollment in 2026 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 2026.
It's important to know that CCA One Care (HMO D-SNP) 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 (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. 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 (HMO D-SNP).
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 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.00. 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 a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $8845.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
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Drug Coverage
The CCA One Care (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered medications before the plan begins to pay its share. Specific drug coverage tier details, including individual copayments and coinsurance rates for different medication categories, are currently not available for this plan. To fully understand your potential out-of-pocket costs, it is recommended to review the plan's specific formulary or contact the provider directly.
Additional Benefits
The CCA One Care (HMO D-SNP) plan provides comprehensive medical coverage featuring no copays for major services, including inpatient hospital stays, home health care, and skilled nursing facility services. However, many outpatient services, specialist visits, diagnostic tests, and emergency care require a 20% coinsurance. This plan helps manage immediate out-of-pocket costs by offering no copays across almost all covered benefits, though prior authorization is required for several key services. For prescription drugs, Medicare Part B insulin is covered with a $35 copay, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance with no copay. It is important to note that this plan does not cover routine dental cleanings, hearing aids, routine vision exams, or fitness benefits. Additionally, other common supplemental offerings like acupuncture, over-the-counter items, and meal benefits are excluded from coverage.
Inpatient Hospital See details
CCA One Care (HMO D-SNP) covers inpatient hospital services, including acute and psychiatric stays, with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered because additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under CCA One Care (HMO D-SNP) are covered with no copays, though a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for outpatient hospital and ambulatory surgical center services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization services are covered under the CCA One Care (HMO D-SNP) plan with no copay and a 20% coinsurance.
Ambulance and Transportation Services See details
CCA One Care (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. For transportation, some services are covered, but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
CCA One Care (HMO D-SNP) covers emergency and urgent care services with a 20% coinsurance and no copay, which is waived if you are admitted to the hospital within 24 hours. For worldwide emergency services, some services are covered but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
CCA One Care (HMO D-SNP) covers primary care, specialist visits, mental health, psychiatric, and physical therapy services with no copay and a 20% coinsurance, while telehealth benefits feature no copay and no coinsurance. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Preventive services are partially covered by CCA One Care (HMO D-SNP), featuring no copay and no coinsurance for Medicare-covered zero-dollar preventive services. Covered kidney disease education and screenings like glaucoma and diabetes self-management training have no copay but require a 20% coinsurance, while annual physical exams, fitness benefits, and health education are not covered.
Hearing Services See details
Hearing services are partially covered by CCA One Care (HMO D-SNP), which offers covered hearing exams with no copay and no coinsurance. However, routine hearing exams, fitting and evaluations, prescription hearing aids, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
CCA One Care (HMO D-SNP) vision services are covered with no copay and 20% coinsurance for eye exams, and no copay and no coinsurance for eyewear. Although some services are covered, routine eye exams, other eye exam services, contact lenses, eyeglasses, lenses, frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by CCA One Care (HMO D-SNP), which provides Medicare-covered dental care with no copay and a 20% coinsurance, subject to prior authorization. Other services, including preventive cleanings, oral exams, x-rays, restorative treatments, endodontics, periodontics, and orthodontics, are not covered.
Home Infusion bundled Services See details
CCA One Care (HMO D-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis Services are covered under the CCA One Care (HMO D-SNP) plan, requiring no copay and a 20% coinsurance for covered treatments.
Medical Equipment See details
CCA One Care (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under CCA One Care (HMO D-SNP) with no copayment, though a 20% coinsurance and prior authorization are required for all services. This includes coverage for diagnostic procedures, lab services, outpatient X-rays, and both diagnostic and therapeutic radiological services.
Home Health Services See details
CCA One Care (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
CCA One Care (HMO D-SNP) covers Cardiac Rehabilitation Services with no copay, but in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by CCA One Care (HMO D-SNP) with no copay and no coinsurance, and a prior three-day inpatient hospital stay is not required. Prior authorization is required for these services, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are not covered under the CCA One Care (HMO D-SNP) plan, as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage.
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