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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 2025, 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 2025.
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 $43.50. 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 $590.00 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 $9350.00 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 Community Care's Partnership Program (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, the plan covers prescription drugs. Once your total drug costs reach $2000, you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D is $43.50.
Additional Benefits
Community Care's Partnership Program (HMO D-SNP) provides coverage for a wide range of healthcare services. Many services, including inpatient and outpatient services, partial hospitalization, ambulance, emergency, primary care, vision, dental, and home health services, have a 20% coinsurance. The plan also offers coverage for a variety of other benefits, such as medical equipment, home infusion, dialysis services, and diagnostic and radiological services, all of which have 20% coinsurance. It's important to note that some services, like hearing exams and eyewear, have limited coverage, and prior authorization is required for certain services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but additional days, non-Medicare-covered stays, and upgrades for both are not covered. Both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric require prior authorization and have coinsurance, with the specific cost share aligning with Medicare's tier 1.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services and observation services, both with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are also covered, with a minimum coinsurance of 20% and a maximum coinsurance of 20%. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under Community Care's Partnership Program (HMO D-SNP), but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, and transportation to plan-approved health-related locations. Ground and air ambulance services have a 20% coinsurance, and there is no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Community Care's Partnership Program (HMO D-SNP). Emergency Services and Urgently Needed Services have a 20% coinsurance, but there is no copay. Worldwide Emergency Services is not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Primary Care Physician Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services have a 20% coinsurance. Chiropractic Services, Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services have a 20% coinsurance. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive services are covered under Community Care's Partnership Program (HMO D-SNP), but annual physical exams, health education, in-home safety assessments, Personal Emergency Response System (PERS), medical nutrition therapy (MNT), post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefit, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered. Kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visits have a 20% coinsurance. In-Home Support Services, and Home and Bathroom Safety Devices and Modifications are covered.
Hearing Services See details
Hearing Services are partially covered under the Community Care's Partnership Program (HMO D-SNP), with a coinsurance of at most 20% for hearing exams, though routine hearing exams and fitting/evaluation for hearing aids are not covered. Prescription hearing aids and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, with a 20% coinsurance for eye exams and eyewear. However, routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics. Prior authorization is required for all services, and all services are unlimited.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by Community Care's Partnership Program (HMO D-SNP), but require prior authorization. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under Community Care's Partnership Program (HMO D-SNP). Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, and there is no copay; however, Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by Community Care's Partnership Program (HMO D-SNP) with no coinsurance or copay; however, additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but prior authorization is required. The plan charges the Medicare-defined cost share for tier 1, and the plan does not charge cost sharing on the day of discharge, however, additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Community Care's Partnership Program (HMO D-SNP) plan's other services benefit covers over-the-counter items and meal benefits, though acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered. Meal benefits require prior authorization.
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