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Community Care's Partnership Program (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Community Care's Partnership Program (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Community Care's Partnership Program (HMO D-SNP) in 2026, please refer to our full plan details page.
Community Care's Partnership Program (HMO D-SNP) is a HMO D-SNP plan offered by Community Care, Inc. available for enrollment in 2025 to people living in Eastern Wisconsin. This plan received an overall rating of 2.5 out of 5 stars in 2026.
It's important to know that Community Care's Partnership Program (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:
Community Care's Partnership Program (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 Community Care's Partnership Program (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 Community Care's Partnership Program (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.10. 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 $9250.00 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
Community Care's Partnership Program (HMO D-SNP) features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered medications before your plan benefits kick in. Understanding these upfront costs is an important step in evaluating whether this Medicare Advantage plan fits your budget and healthcare needs. Specific drug tier details, such as copayments and coinsurance for generic or brand-name medications, are not available for this plan. To verify if your specific prescriptions are covered and to determine your exact costs, you should consult the plan's comprehensive formulary.
Additional Benefits
Community Care's Partnership Program (HMO D-SNP) offers medical coverage with no copays for most services, though outpatient, specialist, and diagnostic benefits are subject to a 20% coinsurance. Essential care such as inpatient hospital stays, home health services, and skilled nursing facility care are covered with no copay and no coinsurance. Prior authorization is required for many of these core medical services to be covered. The plan provides extra benefits like over-the-counter items and up to 48 round trips per year for plan-approved transportation with no copay or coinsurance. While Medicare-covered dental and hearing exams are available at no cost, routine dental, routine vision, and hearing aids are not covered. Durable medical equipment, diabetic supplies, and emergency services are also covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital and psychiatric services are partially covered by Community Care's Partnership Program (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit does not cover upgrades, additional days, or non-Medicare-covered stays.
Outpatient Services See details
Outpatient services are covered by Community Care's Partnership Program (HMO D-SNP) with no copay, though a 20% coinsurance and prior authorization are required for most services. Covered benefits include outpatient hospital care, ambulatory surgical center services, outpatient substance abuse therapy, and outpatient blood services.
Partial Hospitalization See details
Community Care's Partnership Program (HMO D-SNP) covers partial hospitalization with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Community Care's Partnership Program (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered, offering up to 48 round trips per year to plan-approved health-related locations with no copay and no coinsurance, though transport to any health-related location is not covered.
Emergency Services See details
Community Care's Partnership Program (HMO D-SNP) covers emergency services with a 20% coinsurance up to $115 per visit and no copay, and urgently needed services with a 20% coinsurance up to $40 per visit and no copay. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Community Care's Partnership Program (HMO D-SNP) covers primary care, specialist, therapy, mental health, and psychiatric services with no copay and 20% coinsurance, alongside covered telehealth options. Podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Community Care's Partnership Program (HMO D-SNP) partially covers preventive services with no copays, though a 20% coinsurance applies to kidney disease education, glaucoma screenings, diabetes self-management, digital rectal exams, and post-welcome-visit EKGs. An annual physical exam and additional benefits such as fitness programs, health education, and in-home safety assessments are not covered.
Hearing Services See details
Community Care's Partnership Program (HMO D-SNP) covers hearing exams with no copay, no coinsurance, and no deductible, although prior authorization is required and routine exams and fitting evaluations are not covered. While some prescription hearing aid services are covered, specific sub-services including inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered under Community Care's Partnership Program (HMO D-SNP) with no copay, 20% coinsurance, and no deductible, though prior authorization is required. While some services are covered, routine eye exams, contact lenses, and eyeglasses are not covered.
Dental Services See details
Dental services under Community Care's Partnership Program (HMO D-SNP) are limited to Medicare-covered dental services, which are available with no copay and no coinsurance, though prior authorization is required. Routine and comprehensive dental benefits, including oral exams, cleanings, x-rays, and orthodontic services, are not covered by this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Community Care's Partnership Program (HMO D-SNP) with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and other drugs, require a coinsurance ranging from no coinsurance up to 20%, while Medicare Part B insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under Community Care's Partnership Program (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Community Care's Partnership Program (HMO D-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and preferred vendor limitations apply to durable medical equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Community Care's Partnership Program (HMO D-SNP) with prior authorization, though lab services are not covered. Covered services, including diagnostic procedures, radiological services, and outpatient X-rays, require no copay but are subject to a 20% coinsurance.
Home Health Services See details
Community Care's Partnership Program (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Community Care's Partnership Program (HMO D-SNP) covers some cardiac rehabilitation services with no copay, subject to prior authorization. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Community Care's Partnership Program (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, as additional days beyond the Medicare-covered limit are not covered. Prior authorization and a prior three-day inpatient hospital stay are required for admission.
Other Services See details
Community Care's Partnership Program (HMO D-SNP) partially covers other services, providing over-the-counter (OTC) items with no copay, no coinsurance, and no maximum benefit limit via a debit card. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this benefit.
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