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CCA Senior Care Options (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CCA Senior Care Options (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 Senior Care Options (HMO D-SNP) in 2025, please refer to our full plan details page.
CCA Senior Care Options (HMO D-SNP) is a HMO D-SNP plan offered by Commonwealth Care Alliance, Inc. available for enrollment in 2025 to people living in BRI, ESS, FRA, HMD, HMP, MID, NOR, PLY, SUF, WOR. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that CCA Senior Care Options (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 Senior Care Options (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 Senior Care Options (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 Senior Care Options (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $33.80. 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 CCA Senior Care Options (HMO D-SNP) plan has a deductible of $590. During the initial coverage phase, you will pay 25% coinsurance for all tiers of drugs at standard pharmacies, and 25% coinsurance at standard mail order pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs. If you qualify for the low-income subsidy, you will pay $33.80.
Additional Benefits
The CCA Senior Care Options (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Many services, including preventive services, home health services, and ambulance services, have either no copay or a 20% coinsurance. Other services like inpatient hospital, outpatient services, emergency services, and primary care also have a 20% coinsurance. The plan also includes vision, hearing, and dental benefits, along with coverage for medical equipment and home infusion services. Vision services cover eye exams with a 20% coinsurance and offers a $350 combined maximum plan benefit for eyewear. Hearing services have a 20% coinsurance for hearing exams, and dental services cover Medicare Dental Services with a 20% coinsurance. Additionally, the plan covers up to $475 every three months for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with coinsurance costs that follow Original Medicare. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services are covered, with a 20% coinsurance for Outpatient Hospital Services, Observation Services, and Outpatient Blood Services. Ambulatory Surgical Center (ASC) Services, Individual Sessions for Outpatient Substance Abuse, and Group Sessions for Outpatient Substance Abuse are also covered, each with a minimum and maximum coinsurance of 20%.
Partial Hospitalization See details
Partial Hospitalization is covered under the CCA Senior Care Options (HMO D-SNP) plan. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by CCA Senior Care Options (HMO D-SNP). Ground and air ambulance services are covered with 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 the CCA Senior Care Options (HMO D-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, and Worldwide Emergency Services has a maximum benefit coverage of $100,000.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Primary Care Physician Services, Physician Specialist Services, 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 for some services. Occupational Therapy Services have a 20% coinsurance. Podiatry Services are not covered.
Preventive Services See details
The CCA Senior Care Options (HMO D-SNP) plan covers preventive services including Medicare-covered services with no copay, an annual physical exam with 20% coinsurance, and additional preventive services. The additional preventive services include Health Education, In-Home Safety Assessment, 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, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered. The plan also covers Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with a coinsurance of 20%.
Hearing Services See details
Hearing services are partially covered by the CCA Senior Care Options (HMO D-SNP) plan. Hearing exams have at most a 20% coinsurance, but routine hearing exams and fitting/evaluation for hearing aids are not covered, and prescription hearing aids and OTC hearing aids are also not covered.
Vision Services See details
Vision services include eye exams with 20% coinsurance, and eyewear benefits. Routine eye exams are not covered, and the plan offers a $350 combined maximum plan benefit coverage amount for all eyewear every year.
Dental Services See details
Dental services are partially covered by the CCA Senior Care Options (HMO D-SNP) plan. Medicare Dental Services are covered with a 20% coinsurance, while Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while 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 under the CCA Senior Care Options (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Prosthetic Devices and Diabetic Supplies have a 20% coinsurance, and Medical Supplies have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the CCA Senior Care Options (HMO D-SNP) plan. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, and there is no copay.
Home Health Services See details
Home Health Services are covered by the CCA Senior Care Options (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services. There is a coinsurance for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered for SNF, nor does it cover non-Medicare-covered stays for SNF.
Other Services See details
Other Services includes acupuncture and over-the-counter (OTC) items. Acupuncture is covered for 6 treatments per year. OTC items are covered up to $475 every three months, and includes nicotine replacement therapy and naloxone. Other services such as meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and Private Duty Nursing Services are not covered.
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