Overview

Chronic Condition Special Needs Plans

For Medicare beneficiaries with diabetes and/or heart failure ...*

Here's a plan that can help beneficiaries manage their chronic conditions better.
With comprehensive medical coverage and prescription drug coverage, health education, and a variety of valuable extra benefits and services, Care Improvement Plus Chronic Condition Special Needs Plans are designed to help Medicare beneficiaries manage their health condition and get the care they need.

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) - for Medicare beneficiaries with diabetes and/or heart failure who also have full Medicaid (QMB, QMB Plus)
• Gold Rx (Regional PPO) - for Medicare beneficiaries with diabetes and/or heart failure who do not have Medicaid or LIS (Low-Income Subsidy)
• Gold Rx Advantage (Regional PPO) - for Medicare beneficiaries with diabetes and/or heart failure who receive LIS (Low-Income Subsidy), but do not have full Medicaid

Medicare/Medicaid Special Needs Plan

Here's a plan that offers more benefits, care, and services to help manage health conditions better.
Care Improvement Plus currently covers more than 20,000 members who have both Medicare and Medicaid. We understand it can be confusing as to what Medicare covers and what Medicaid covers. As a result, Medicare beneficiaries may not be getting all the benefits, care, and services they're entitled to. We can help Medicare beneficiaries get more benefits, care, and services with our Care Improvement Plus Dual Advantage (Regional PPO) plan.

• $0** monthly plan premium for those who have Medicare and Medicaid
• $0 cost sharing (no copayments, coinsurance, or deductibles) for most covered medical services, for those who have Medicare and Medicaid

Medicare Advantage (Regional PPO) and (PPO)

Here's a plan for Medicare beneficiaries who don't have a chronic illness or Medicaid!

For Medicare beneficiaries who don't have a chronic illness or Medicaid, the Care Improvement Plus Medicare Advantage (Regional PPO) Plan might be the right plan for them. It was specifically designed for beneficiaries without Special Needs, 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.

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

• If Medicare beneficiaries currently have a Medicare Supplement policy: They may be paying more out of pocket for deductibles and coinsurance than with a Care Improvement Plus Medicare Advantage plan.
• If Medicare beneficiaries currently have a Medicare HMO: They may have more freedom of choice when it comes to the doctors and hospitals they can access with our Care Improvement Plus Medicare Advantage Plan due to its open access provider network.
• If Medicare beneficiaries are relying on Original Medicare (Parts A & B) alone: Compared to Original Medicare, with a Care Improvement Plus Medicare Advantage Plan, their level of coverage will increase, while their financial risk for excessive out-of-pocket healthcare costs will decrease.

* To be eligible for this plan you must be a Medicare beneficiary living in Arkansas, Georgia, Maryland, Missouri, South Carolina or Texas, be entitled to Medicare Part A and enrolled in Part B, and have diabetes and/or heart failure. However, individuals with End Stage Renal Disease are generally not eligible to enroll in Care Improvement Plus Silver Rx (Regional PPO), Gold Rx (Regional PPO), Gold Rx Advantage (Regional PPO), Dual Advantage (Regional PPO), Medicare Advantage (Regional PPO) or Medicare Advantage (PPO) Plans unless they are members of our organization and have been since their dialysis began.

** 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.