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Care Improvement Plus
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About Care Improvement Plus

In 2003, perhaps the most significant legislative change in the history of Medicare was signed into law–the Medicare Modernization Act (MMA). The MMA introduced several important changes to Medicare, including Medicare Advantage Prescription Drug health plans that allow seniors to select from a variety of health plan options that best fit their needs. Among the new Medicare options are Special Needs Plans (SNPs). SNPs are Medicare Advantage plans that provide better coverage and preventive care for three specific groups of Medicare beneficiaries: those with chronic illnesses, those residing in nursing homes, and low-income individuals who qualify for both Medicare and Medicaid.

Care Improvement Plus, a Medicare Advantage plan offered by XLHealth Corporation, is the leading provider of Medicare health plans uniquely designed for beneficiaries with diabetes and/or heart failure, as well as those with both Medicare and full Medicaid.

Through a comprehensive and innovative approach to care management, Care Improvement Plus provides high quality benefits and services to ensure its members receive the best care for their individual health needs.

With more than 115,000 members across 12 states, Care Improvement Plus seeks to serve as a model of how care coordination can improve patient outcomes, and reduce health care spending while supporting the costliest Medicare beneficiaries.

Care Improvement Plus offers a choice of plan options, including:
  • Chronic Conditions Special Needs Plans for Medicare beneficiaries with diabetes and heart failure
  • Dual Eligible Special Needs Plans for Medicare beneficiaries with both Medicare and full Medicaid
  • Medicare Advantage Prescription Drug Plans for those beneficiaries without special needs, such as spouses and caregivers of Special Needs Plan members

Care Improvement Plus provides plans including comprehensive Medicare coverage and a Part D prescription drug benefit, plus additional services such as dental, vision, transportation coverage, and care management support.

Care Improvement Plus was established in 2006 as a Chronic Conditions SNP offered to residents of select counties in Maryland. While the company remains focused on serving beneficiaries with chronic conditions, its rapid success led it to expand its service area and create additional SNP and MAPD plan offerings. Today, more than seven million Medicare beneficiaries are eligible to become Care Improvement Plus members.

Improving Medicare Coverage

Care Improvement Plus is transforming the way Medicare beneficiaries experience health care. Members receive more benefits and services than Original Medicare and many traditional Medicare Advantage plans. All of Care Improvement Plus' plans are designed to empower members to take an active role in managing their health.

Focusing on the Chronically Ill

Medicare beneficiaries living with complex chronic diseases such as diabetes and heart failure have special health care needs beyond medication and regularly scheduled doctor appointments. For these beneficiaries, Care Improvement Plus takes a care management approach that focuses on identifying and treating complications such as blindness, neuropathy, and high cholesterol before they become serious and lead to hospitalization.

Serving the Underserved

For Medicare beneficiaries with both Medicare and Medicaid, it can be confusing to understand what is covered by Medicare and Medicaid. As a result, these beneficiaries may not be getting all the benefits, care, and services they are entitled to. Care Improvement Plus offers support services to help dual-eligible beneficiaries access more benefits, coordinating their care and ensuring that they obtain necessary services. In addition, Care Improvement Plus plans include an open-access provider network with no referral requirements for Medicare-covered services. (Members should check to make sure their provider(s) accept the plan).

More Services for Less

Medicare beneficiaries, especially those with chronic conditions and/or on limited incomes, often see a number of different doctors, take many different medications and require additional medical supplies for their daily care. For these beneficiaries, out–of–pocket health care costs can quickly add up. Care Improvement Plus offers low-cost coverage designed to help members better afford their health care. $0 monthly premium and $0 cost sharing plan options encourage members to get the care they need before complications develop.



This page was last updated on: 1/19/2012 12:51:23 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.