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Medicare Advantage Plan

Care Improvement Plus Medicare Advantage Plan

Care Improvement Plus' Medicare Advantage(Regional PPO)(PPO) plan is designed for those beneficiaries with Medicare only, such as spouses and caregivers of our special needs plan members.

With comprehensive medical, hospital and prescription drug coverage, and a variety of valuable extra benefits and services, Care Improvement Plus' Medicare Advantage plan provides high quality health care with affordable premiums and predictable cost-sharing. The plan features an open-access provider network for Medicare-covered services.(Members should check to make sure their provider(s) accept the plan)

Care Improvement Plus' Medicare Advantage plan includes more benefits and services than Original Medicare, such as enhanced coverage for dental, vision, transportation, as well as care management services.

Why would Care Improvement Plus offer a standard Medicare Advantage plan?

Care Improvement Plus appreciates that our special needs plan members have loved ones and caregivers who would prefer to receive their health care coverage from the same organization. For these beneficiaries and others, Care Improvement Plus has designed its Medicare Advantage plan to offer the same high quality benefits and services our special needs plan members receive.

Caregiving Statistics:
  • More than 65 million people, provide care for a chronically ill, disabled or aged family member or friend during any given year 1
  • 30% of family caregivers caring for seniors are themselves aged 65 or over 2
  • The need for family caregivers will increase in the years ahead. People over 65 are expected to increase at a 2.3% rate, but the number of family members available to care for them will only increase at a 0.8% rate 3
  • Out of pocket medical expenses for a family that has a disabled member who needs help with activities of daily living (eating, toileting, etc.) are more than 2.5% greater (11.2% of income compared to 4.1%) than for a family without a disabled member 4
  • 78% of adults living in the community and in need of long-term care depend on family and friends as their only source of help.5

Sources:

  • 1Caregiving in the United States;National Alliance for Caregiving in collaboration with AARP; November 2009
  • 2 Source: U.S. Department of Health and Human Services, The Characteristics of Long-term Care Users. Rockville: Agency for Healthcare Research and Quality, 2001.
  • 3 Source: Mack, Katherine and Thompson, Lee with Robert Friedland. Data Profiles, Family Caregivers of Older Persons: Adult Children. The Center on an Aging Society, Georgetown University, page 2, May 2001.
  • 4 Source: Drs. Altman, Cooper and Cunningham, "The Case of Disability in the Family: Impact on Healthcare Utilization and Expenditures for Non-disabled Members," Milbank Quarterly 77 (1) pages 39 – 75, 1999.
  • 5Thompson, L. Long-term care: support for family caregivers. 2004


This page was last updated on: 9/27/2011 10:46:28 AM
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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.