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Who Can Enroll

Care Improvement Plus offers three Medicare Advantage Prescription Drug (MA-PD) plans. Chronic Condition Special Needs Plans
Care Improvement Plus Chronic Condition Special Needs Plans are for Medicare beneficiaries with diabetes and/or heart failure. To be eligible for these plans beneficiaries must:
  • be entitled to Medicare Part A and enrolled in Part B
  • have been diagnosed with diabetes and/or heart failure, and
  • reside in Arkansas, Georgia, Maryland, Missouri, South Carolina and Texas.
A choice of plan options
We offer a choice of options for the Care Improvement Plus Chronic Condition Special Needs Plan.
  • Silver Rx (Regional PPO SNP) - for Medicare beneficiaries with diabetes and/or heart failure who also have full Medicaid
  • Gold Rx (Regional PPO SNP) - for Medicare beneficiaries with diabetes and/or heart failure who do not have Medicaid or LIS (Low-Income Subsidy)

Note: Individuals with End Stage Renal Disease are generally not eligible to enroll in Care Improvement Plus Silver Rx (Regional PPO SNP), or Gold Rx (Regional PPO SNP).

Click here to view our 2011 plan benefits for the Chronic Condition Special Needs Plans.

Medicare/Full Medicaid Special Needs Plan
The Care Improvement Plus Dual Advantage (Regional PPO SNP) Plan is a Medicare/Full Medicaid Special Needs Plan for Medicare beneficiaries who have both Medicare and Full Medicaid. To be eligible for this plan, beneficiaries must be:
  • entitled to Medicare Part A and enrolled in Part B
  • enrolled in state Medicaid and may include any other dual eligible beneficiaries whom the State holds harmless for Part A and Part B cost sharing, and
  • reside in Arkansas, Missouri, and Texas.

Note: Individuals with End Stage Renal Disease are generally not eligible to enroll in Care Improvement Plus Dual Advantage (Regional PPO SNP) Plan unless they are members of our organization and have been since their dialysis began.

Click here to view our 2010 plan benefits for the Dual Advantage (Regional PPO SNP) Plan.

Medicare Advantage (Regional PPO) and (PPO)
If you are helping a Medicare beneficiary who has Medicare only, the Care Improvement Plus Medicare Advantage (Regional PPO) Plan might be the right plan for them. It was specifically designed for beneficiaries who don't qualify for Special Needs Plans (such as spouses and caregivers of our Special Needs Plan members). This plan focuses on helping beneficiaries proactively manage their health, so they can feel their best and stay active. To be eligible for this plan, beneficiaries must be:
  • entitled to Medicare Part A and enrolled in Part B
  • reside in Arkansas, Georgia, Missouri, South Carolina and Texas

In addition, we also offer a Medicare Advantage (PPO) Plan for Medicare beneficiaries who reside in certain counties in Arkansas, Georgia, Missouri, South Carolina, and Texas.

Note: Individuals with End Stage Renal Disease are generally not eligible to enroll in Care Improvement Plus Medicare Advantage (Regional PPO) or Care Improvement Plus Medicare Advantage (PPO) unless they are members of our organization and have been since their dialysis began.

Click here to view our 2010 plan benefits for the Medicare Advantage (Regional PPO) Plan and Medicare Advantage (PPO) Plan.

Scope of Sale Appointment Confirmation Form
Under the Medicare Marketing Guidelines, agents are to clearly identify the types of products that will be discussed before marketing to a prospect. Agents must obtain an agreement from prospects regarding the products they intend to discuss during a sales appointment. The scope of appointment must be agreed upon and documented before the sales appointment either in writing or through a recorded phone conversation.

Care Improvement Plus has implemented a Scope of Appointment Procedure and has developed a Scope of Sales Appointment Confirmation Form



This page was last updated on: 8/31/2010 4:06:45 PM

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Care Improvement Plus is a Medicare Advantage organization with a Medicare contract. The Care Improvement Plus contract with CMS is renewed annually and coverage availability beyond the end of the current contract year is not guaranteed. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2013.

The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. For more information contact the plan. To be eligible for a Care Improvement Plus plan you must be a Medicare beneficiary living in Arkansas, Georgia, Missouri, South Carolina, Texas and select counties in Illinois, Iowa, Indiana, Maryland, New Mexico, New York, Wisconsin and have both Medicare Part A and Part B to enroll.

To be eligible for a Care Improvement Plus Chronic Conditions Special Needs Plan, you must have diabetes and/or heart failure. To be eligible for Care Improvement Plus Dual Advantage, you must be enrolled in state Medicaid and be a dual eligible beneficiary whom the State holds harmless for Part A and Part B cost sharing.

Members may enroll in the plan only during specific times of the year. Contact Care Improvement Plus for more information. If you have diabetes, heart failure, or Medicaid/Low Income Subsidy, you may qualify to enroll in a Care Improvement Plus Special Needs Plan ANYTIME of the year by exercising a “Special Election Period.

You must continue to pay your Medicare Part B premium. If you are a full benefit dual beneficiary and your Part B premium is paid for by the State, you will not be responsible for paying your Part B premium. Premiums, copays, coinsurance and deductibles may vary based on the level of help received. Limitations, copayments and restrictions may apply.

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

  • 1–800–MEDICARE (1–800–633–4227). TTY users should call 1–877–486–2048, 24 hours a day/7 days a week;
  • The Social Security Office at 1–800–772–1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1–800–325–0778; or
  • Your State Medicaid Office.

People with limited incomes may qualify for extra help to pay their prescription drug costs. If eligible, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this extra help, contact your local Social Security office, or call Social Security at 1–800–772–1213.TTY users should call 1–800–325–0778. You can also apply for extra help online at www.socialsecurity.gov/prescriptionhelp. If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare will pay all or part of your plan premium. If Medicare pays only a part of this premium, we will bill you for the amount that Medicare doesn’t cover.

Premiums, copays, coinsurance, and deductibles may vary based on the level of help that beneficiaries may receive. Contact the plan for further details. Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under nonroutine circumstances, and quantity and restrictions may apply. It may cost more to get care from out–of–network providers, except in an emergency. If there isn’t a network provider available for you to see, you can go to an out–of–network provider but still pay the in–network amounts except for members who live in our Maryland service areas. Those members can only use doctors, specialists, or hospitals in–network. The health providers in our network can change at any time.