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Care Improvement Plus
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2012 Overview

Care Improvement Plus Chronic Condition Special Needs Plan

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 SNP) (PPO SNP) - for those with diabetes and/or heart failure and who also have Medicare and Medicaid
  • Gold Rx (Regional PPO SNP) (HMO SNP) (PPO SNP) - for those with diabetes and/or heart failure and who do NOT receive Medicaid

To be eligible for our Silver Rx (PPO SNP) Plans and Gold Rx (PPO SNP) (HMO SNP) plans, you must reside in the following counties:

SILVER RX AND GOLD RX (PPO SNP) COUNTIES:
Arkansas: Ashley, Benton, Boone, Bradley, Carroll, Franklin, Jefferson, Logan, Lonoke, Madison, Miller, Ouachita, Pulaski, Scott, Sebastian, Washington
Georgia : Baldwin, Barrow. Bibb, Clarke, Clayton, DeKalb, Fulton, Gwinnett, Henry, Jones, Morgan, Muscogee, Newton, Oconee, Richmond, Rockdale
Missouri : Benton, Cedar, Christian, Clay, Cole, Dade, Douglas, Greene, Henry, Hickory, Jackson, Lawrence, Ozark, Pike, Polk, St. Charles, St. Louis, Vernon, Webster
Illinois: Brown. Fulton, Morgan, Peoria, Pike, Schuyler, Tazewell, Warren
Iowa: Cedar, Iowa, Johnson, Polk, Pottawattamie
Indiana: Allen, De Kalb, Fulton, Grant, Huntington, Jay, Kosciusko, Lagrange, Noble, Wabash
New Mexico: Bernalillo, Cibola, DeBaca, Dona Ana, Eddy, Guadalupe, Lincoln, Mora, Sierra, Socorro, Torrance
New York: Albany, Erie, Hamilton, Rensselaer, Saratoga, Schenectady
Wisconsin: Brown, Dodge, Green, Jefferson, Manitowoc, Ozaukee, Racine, Walworth, Washington, Waukesha
South Carolina: Abbeville, Allendale, Calhoun, Cherokee, Claredon, Greenville, Greenwood, Lexington, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Spartanburg, Union
Texas: Bexar, Bowie, Brazoria, Brooks, Cass, Chambers, Collin, Culberson, Dallas, Denton, Dimmit, Duval, EI Paso, Ellis, Fort Bend, Guadalupe, Harris, Hood, Hudspeth, Hunt, Jefferson, Jim Hogg, Johnson, Kaufman, Kenedy, Kleberg, Liberty, Montgomery, Navarro, Nueces, Orange, Polk, Presidio, Red River, Tarrant, Taylor, Titus, Van landt, Wilson, Wood, lavala, Smith, Washington

GOLD RX (HMO SNP) COUNTIES:
Maryland: Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Charles, Harford, Howard, Montgomery, Prince George's, St. Mary's

Care Improvement Plus Medicare/Full Medicaid Special Needs Plan

For Medicare beneficiaries who have both Medicare (Parts A and B) and Full Medicaid

Care Improvement Plus currently covers more than 20,000 members who have both Medicare and Full 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 SNP) (PPO SNP) plans.

Our Care Improvement Plus Dual Advantage Plan is for beneficiaries with both Medicare and Full Medicaid features:
  • $0 monthly plan premium
  • $0 cost sharing (no copayments, coinsurance, or deductibles) for Medicare covered services

To be eligible for our Dual Advantage (PPO SNP) Plans you must reside in the following counties:
Arkansas: Ashley, Benton, Boone, Bradley, Carroll, Franklin, Jefferson, Logan, Lonoke, Madison, Miller, Ouachita, Pulaski, Scott, Sebastian, Washington
Georgia: Baldwin, Barrow, Bibb, Clarke, Clayton, DeKalb, Fulton, Gwinnett, Henry, Jones, Morgan, Muscogee, Newton, Oconee, Richmond, Rockdale
Missouri: Benton, Cedar, Christian, Clay, Cole, Dade, Douglas, Greene, Henry, Hickory, Jackson, Lawrence, Ozark, Pike, Polk, St. Charles, St. Louis, Vernon, Webster
Iowa: Cedar, Iowa, Johnson, Polk, Pottawattamie
Indiana: Allen, De Kalb, Fulton, Grant, Huntington, Jay, Kosciusko, Lagrange, Noble, Wabash
South Carolina: Abbeville, Allendale, Calhoun, Cherokee, Claredon, Greenville, Greenwood, Lexington, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Spartanburg, Union
Texas: Bexar, Bowie, Brazoria, Brooks, Cass, Chambers, Collin, Culberson, Dallas, Denton, Dimmit, Duval, EI Paso, Ellis, Fort Bend, Guadalupe, Harris, Hood, Hudspeth, Hunt, Jefferson, Jim Hogg, Johnson, Kaufman, Kenedy, Kleberg, Liberty, Montgomery, Navarro, Nueces, Orange, Polk, Presidio, Red River, Tarrant, Taylor, Titus, Van landt, Wilson, Wood, lavala, Smith, Washington

Care Improvement Plus Medicare Advantage Preferred Provider Plan

Here's a plan for Medicare beneficiaries who have Medicare only

The Care Improvement Plus Medicare Advantage (Regional PPO) (PPO) and Medicare Advantage Only (PPO) Plans were specifically designed for beneficiaries who don't qualify for our 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 our Medicare Advantage (PPO) and Medicare Advantage Only (PPO) Plans you must reside in the following counties:

MEDICARE ADVANTAGE (PPO) COUNTIES:
Arkansas: Ashley, Benton, Boone, Bradley, Carroll, Franklin, Jefferson, Logan, Lonoke, Madison, Miller, Ouachita, Pulaski, Scott, Sebastian, Washington Georgia: Baldwin, Barrow, Bibb, Clarke, Clayton, DeKalb, Fulton, Gwinnett, Henry, Jones, Morgan, Muscogee, Newton, Oconee, Richmond, Rockdale
Missouri: Benton, Cedar, Christian, Clay, Cole, Dade, Douglas, Greene, Henry, Hickory, Jackson, Lawrence, Ozark, Pike, Polk, St. Charles, St. Louis, Vernon, Webster
Illinois: Brown, Fulton, Morgan, Peoria, Pike, Schuyler, Tazewell, Warren
Iowa: Cedar, Iowa, Johnson, Polk, Pottawattamie
Indiana: Allen, De Kalb, Fulton, Grant, Huntington, Jay, Kosciusko, Lagrange, Noble, Wabash
New Mexico: Bernalillo, Cibola, DeBaca, Dona Ana, Eddy, Guadalupe, Lincoln , Mora, Sierra, Socorro, Torrance
New York: Albany, Erie, Hamilton, Rensselaer, Saratoga, Schenectady
Wisconsin: Brown, Dodge, Green, Jefferson, Manitowoc, Ozaukee, Racine, Walworth, Washington, Waukesha
South Carolina: Abbeville, Allendale, Calhoun, Cherokee, Claredon, Greenville, Greenwood, Lexington, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Spartanburg, Union
Texas: Bexar, Bowie, Brazoria, Brooks, Cass, Chambers, Collin, Culberson, Dallas, Denton, Dimmit, Duval, EI Paso, Ellis, Fort Bend, Guadalupe, Harris, Hood, Hudspeth, Hunt, Jefferson, Jim Hogg, Johnson, Kaufman, Kenedy, Kleberg, Liberty, Montgomery, Navarro, Nueces, Orange, Polk, Presidio, Red River, Tarrant, Taylor, Titus, Van Zandt, Wilson, Wood, Zavala, Smith, Washington

MEDICARE ADVANTAGE ONLY (PPO) COUNTIES:
Wisconsin: Brown, Dodge, Green, Jefferson, Manitowoc, Ozaukee, Racine, Walworth, Washington, Waukesha

  • 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 the person your helping is 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 health care costs will decrease.


This page was last updated on: 9/27/2011 5:19:48 PM
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Copyright © 2006 - 2012 Care Improvement Plus
Y0072_OE12_4511 CMS Approved 11/15/2011

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.