CommunityCare Senior Health Plan (HMO)
Plan ID: H3755-7-0
Plan Summary Page2027 Senior Health Plan Silver Savings (HMO) H3755 — 007 — 0 is a Medicare Advantage plan . It has received a 4-out-of-5 star rating from CMS for 2027.
Learn more about Senior Health Plan Silver Savings (HMO) H3755 - 007 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.
4 / 5 stars for 2027
$0.00 /mo
Monthly premium
$4500.00
Out-of-pocket maximum (In-Network)
Enroll online
Call to enroll
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Get personalized help from a licensed insurance agent
1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
2027 Senior Health Plan Silver Savings (HMO) H3755 — 007 — 0 is a HMO offered in Select counties in N.E. and Central Oklahoma by Communitycare Government Programs, Inc.. It has a monthly premium of $0.00 and includes a Part B premium discount of $100.00.
Monthly plan premium
$0.00
Standard Part B premium (estimated)
$209.50
Part B premium reduction
$100.00
Estimated net Part B premium after giveback
$109.50
Note:
CMS has not yet announced the official 2027 standard Medicare Part B premium. The estimated 2027 premium is $209.50, per the 2026 Medicare Trustees Report; we'll update this page when CMS publishes the final amount. Your actual Part B premium may differ based on income (IRMAA), late enrollment penalties, Medicaid assistance, disability status, or other factors. Most people enrolled in Medicare Part B are required to pay this premium.
Special needs plan type
No
Out-of-pocket maximum (In-Network)
$4500.00
Plan Organization:
Communitycare Government Programs, Inc.
Parent Company:
St Francis Health System & St John Health System
Plan Type:
HMO
Location:
Select counties in N.E. and Central Oklahoma
Drugs Covered:
No
Drug Formulary:
Pharmacies:
Doctors Link:
The amount you must pay each year before your plan starts to pay for covered services.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Senior Health Plan Silver Savings (HMO) does not provide drug coverage. If drug coverage is something you need, you should consider shopping for other plans that do provide cost sharing on drugs.
Senior Health Plan Silver Savings (HMO) also provides the following benefits.
Inpatient Hospital benefits are covered.
Inpatient Hospital-Acute benefits are covered.
| Days 1-5: | Days 6-90: | |
|---|---|---|
| Copayment | 250.00 | 0.00 |
More Details:
Copayment for Medicare-covered stay
0.00
Not covered.
Not covered.
Not covered.
Inpatient Hospital Psychiatric benefits are covered.
| Days 1-5: | Days 6-90: | |
|---|---|---|
| Copayment | 250.00 | 0.00 |
More Details:
Copayment for Medicare-covered stay
0.00
Not covered.
Not covered.
Outpatient Services benefits are covered.
All Outpatient Hospital Services benefits are covered.
Outpatient Hospital Services benefits are covered.
Cost Sharing:
Observation Services benefits are covered.
Cost Sharing:
Ambulatory Surgical Center (ASC) Services benefits are covered.
Cost Sharing:
Not covered.
Individual Sessions for Outpatient Substance Abuse benefits are covered.
More Details:
Minimum copayment
25.00
Maximum copayment
25.00
Group Sessions for Outpatient Substance Abuse benefits are covered.
More Details:
Minimum copayment
25.00
Maximum copayment
25.00
Not covered.
Partial Hospitalization benefits are covered.
Partial Hospitalization benefits are covered.
Cost Sharing:
Partial Hospitalization benefits are covered.
Cost Sharing:
Ambulance and Transportation Services benefits are covered.
All Ambulance Services benefits are covered.
Ground Ambulance Services benefits are covered.
Cost Sharing:
Air Ambulance Services benefits are covered.
Cost Sharing:
Not covered.
Transportation Services - Plan Approved Health-related Location benefits are covered.
More Details:
Number of trips
12
Description
Non-emergency transportation is provided by the plan's contracted transportation service provider using wheelchair vans and passenger automobiles.
Not covered.
Emergency Services benefits are covered.
Emergency Services benefits are covered.
Cost Sharing:
More Details:
Enter number of days or hours
48
Urgently Needed Services benefits are covered.
Cost Sharing:
Not covered.
Worldwide Emergency Coverage benefits are covered.
Cost Sharing:
Worldwide Urgent Coverage benefits are covered.
Cost Sharing:
Worldwide Emergency Transportation benefits are covered.
Cost Sharing:
Primary Care benefits are covered.
Not covered.
Chiropractic Services benefits are covered.
Cost Sharing:
Not covered.
Occupational Therapy Services benefits are covered.
Cost Sharing:
Physician Specialist Services benefits are covered.
Cost Sharing:
Not covered.
Individual Sessions for Mental Health Specialty Services benefits are covered.
More Details:
Minimum copayment
25.00
Maximum copayment
25.00
Group Sessions for Mental Health Specialty Services benefits are covered.
More Details:
Minimum copayment
25.00
Maximum copayment
25.00
Podiatry Services benefits are covered.
More Details:
Minimum copayment
35.00
Maximum copayment
35.00
Other Health Care Professional benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
35.00
Not covered.
Individual Sessions for Psychiatric Services benefits are covered.
More Details:
Minimum copayment
25.00
Maximum copayment
25.00
Group Sessions for Psychiatric Services benefits are covered.
More Details:
Minimum copayment
25.00
Maximum copayment
25.00
Physical Therapy and Speech-Language Pathology Services benefits are covered.
Cost Sharing:
Additional Telehealth Benefits benefits are covered.
Cost Sharing:
Opioid Treatment Program Services benefits are covered.
More Details:
Minimum copayment
25.00
Maximum copayment
25.00
Preventive Services benefits are covered.
Medicare-covered Zero Dollar Preventive Services benefits are covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Other Preventive Services benefits are covered.
Not covered.
Not covered.
Not covered.
Not covered.
Hearing Services benefits are covered.
Not covered.
Routine Hearing Exams benefits are covered.
More Details:
Number of visits
1
Fitting/Evaluation for Hearing Aid benefits are covered.
More Details:
Number of visits
1
Prescription Hearing Aids benefits are covered.
More Details:
Maximum amount
250.00
Not covered.
Not covered.
Not covered.
Not covered.
OTC Hearing Aids benefits are covered.
More Details:
Quantity for Hearing Aids
1
Vision Services benefits are covered.
Not covered.
Routine Eye Exams benefits are covered.
More Details:
Number of visits
1
Eyewear benefits are covered.
More Details:
Combined maximum amount
200.00
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Dental Services benefits are covered.
Medicare Dental Services benefits are covered.
Cost Sharing:
Other Dental Services benefits are covered.
More Details:
Maximum amount
1000.00
Oral Exams benefits are covered.
More Details:
Number of visits
2
Description
Periodic, detailed and extensive problem focused, re-evaluation exams are limited to 2 per 12 months. Limited oral evaluation problem focused is limited to 3 per 12 months.
Dental X-Rays benefits are covered.
More Details:
Number of X-Rays
1
Description
Bitewings (1-4 films) limited to 1 per 12 months. Panoramic images, vertical bitewings (7-8 images) and intraoral complete series limited to 1 per 36 months.
Prophylaxis (Cleaning) benefits are covered.
More Details:
Number of visits
2
Description
Limited to 2 (two) treatments per 12 month period.
Fluoride Treatment benefits are covered.
More Details:
Number of visits
2
Description
Limited to 2 (two) treatments per 12 month period.
Not covered.
Restorative Services benefits are covered.
More Details:
Number of visits
1
Description
Amalgam and resin fillings are limited to once per 24 months, per tooth. Protective restoration is limited to 1 per lifetime.
Adjunctive General Services benefits are covered.
More Details:
Number of visits
1
Description
Palliative treatment is only allowed with a limited oral evaluation and x-rays
Endodontics benefits are covered.
Cost Sharing:
More Details:
Number of visits
1
Description
Root canals are limited to 1 per lifetime per tooth.
Coinsurance percentage
50
Periodontics benefits are covered.
More Details:
Number of visits
1
Description
Scaling and root planing are limited to once per quadrant per 36 months. Full mouth debridement is limited to 1 per 36 months.
Prosthodontics, removable benefits are covered.
Cost Sharing:
More Details:
Number of visits
1
Description
Removable partial and complete dentures are limited to 1 per 60 months. Adjustments are limited to 2 per 12 months. Repairs and replacement of broken teeth are limited to 1 per 12 months.
Coinsurance percentage
50
Not covered.
Not covered.
Not covered.
Oral and Maxillofacial Surgery benefits are covered.
More Details:
Number of visits
1
Description
Extractions are limited to 1 per tooth per lifetime. Coronectomy is limited to 1 per tooth per lifetime.
Not covered.
Not covered.
Dialysis Services benefits are covered.
More Details:
Minimum coinsurance
20
Maximum coinsurance
20
Medical Equipment benefits are covered.
Durable Medical Equipment (DME) benefits are covered.
More Details:
Minimum coinsurance
0
Maximum coinsurance
15
Not covered.
Prosthetic Devices benefits are covered.
More Details:
Minimum coinsurance
20
Maximum coinsurance
20
Medical Supplies benefits are covered.
Cost Sharing:
Not covered.
Not covered.
Not covered.
Not covered.
Diagnostic and Radiological Services benefits are covered.
Not covered.
Diagnostic Procedures/Tests benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
250.00
Not covered.
Not covered.
Diagnostic Radiological Services benefits are covered.
Cost Sharing:
More Details:
Minimum copayment
0.00
Not covered.
Not covered.
Not covered.
Not covered.
Skilled Nursing Facility (SNF) benefits are covered.
| Days 1-20: | Days 21-100: | |
|---|---|---|
| Copayment | 0.00 | 221.00 |
Not covered.
Other Services benefits are covered.
Not covered.
Over-the-Counter (OTC) Items benefits are covered.
More Details:
Maximum plan benefit coverage amount
30.00
Attestation
The Nicotine Replacement Therapy (NRT) being offered does not duplicate any Part D OTC or formulary drugs.
Not covered.
Not covered.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
SMID: MULTIPLAN_HCIHNMEDADVRX27_M
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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