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CommunityCare of Oklahoma was created in 1993 when Saint Francis Hospital and St. John’s Medical Center joined forces in the wake of health care reform recommendations at the federal level. They first created CommunityCare HMO, then quickly expanded to add a PPO option in 1994, offering coverage and services through the two medical providers.
In 1996 the company added Medicare Advantage plans to their list of products under the name Senior Health Plan. They further expanded Medicare offerings in 2003 when they created the CommunityCare 65 program to provide Medicare Supplement insurance.
Based out of Tulsa, CommunityCare today provides coverage to over 500,000 people in the state of Oklahoma. They also have offices in Oklahoma City, and are active in community programs and charities such as The United Way. Oklahoma magazine regularly rates them as the state’s number one health insurance provider, according to the company website.
CommunityCare offers both Medicare Advantage and Medicare Supplement Plans. While they don’t offer a separate Part D Prescription Drug plan, they do offer prescription drug plans to their Senior Health Plan members. Not all plans include this option, however, so it’s important to read the plans carefully.
Medicare Advantage – Senior Health Plan
Senior Health Plans are available with four different plan levels, all of which are HMO plans serviced by the two founding hospitals as well as a network of other providers. There are no PPO plans available for Medicare Advantage; as a result, the provider network will be more limited. HMO plans tend to have lower premiums than do PPOs due to the more limited provider network.
The plans are Silver, Silver Plus, Platinum, and Platinum Plus. Plans are only available in a specific coverage area, so be sure to check your county and zip code against the list. All of the plans include dental and vision coverage, although co pays and coinsurance vary.
Silver is the most basic plan and includes only medical coverage. This means that those enrolled in the plan will not have Part D coverage for prescription drugs; this will be either an out of pocket cost or enrollees will have to seek Part D coverage elsewhere. The Silver plan is a $0 premium (after your regular Medicare cost) plan with co pays of $15 for primary care visits and $35 for specialist visits. There is a $200 a day co pay for days 1-7 in hospital.
The Silver Plus plan adds Part D coverage, but retains the $0 extra premium. This is likely possible due to higher co pays – the plan has a $25 primary care co pay and 20% coinsurance for specialists. The hospital co pay is $270 a day for the first 7 days. This plan has higher co pays in most areas, including coinsurance for many things that are covered at 100% on the other plans. Prescriptions are covered at $5/30 day supply for Tier 1, up to a 33% coinsurance for Tiers 5 and 6.
The Platinum Plan includes both medical and Part D coverage. Co pays are $20 for primary care visits and $50 for specialist visits. Hospital coverage is $270 a day for days 1-7. This plan does have a premium, although relatively low due to the higher co pays.
Platinum Plus is the most expensive plan. Part D coverage is included in this plan. Co pays are $10 for primary and $35 for specialists, with $150 a day co pay for hospital stays up to 7 days. Co pays across the board are lower with this plan, and there are many services covered in full.
Both Platinum plans start at $0 co pays for Tier 1 drugs, although the other Tiers have similar co pays, including the 33% coinsurance for Tiers 5 and 6.
CommunityCare 65 is the title given to the Medicare Supplement plans offered, although they follow the lettered, standardized plans for the state.
CommunityCare 65 offers three options for Supplement Care. Plan A is required for all Medicare Supplement providers; this basic plan covers medical and hospital coinsurance as well as hospice coinsurance and three pints of blood annually.
In addition to this plan, CommunityCare offers Plans C and F. F has the most coverage, paying for all coinsurance and deductibles and including things like foreign travel emergency coverage.
Three plan offerings is fairly limited as far as selection. Most insurance companies offer at least a few more. However, Plans A and F are among the most popular; and Plan C does offer an in between option for those who want a balance of coverage and premium.
CommunityCare Medicare Pricing
CommunityCare makes it easy to determine the cost of their coverage. No quoting system is required, the rates are simply outlined in easy to read charts.
Medicare Advantage, or Senior Health Plan, options start at $0 premium for the Silver Plans. Platinum is $42 a month, while Platinum Plus is $110 a month.
Rates for Supplement plans start at $91 – $96 for Plan A, depending on where you live within the sections of the company’s service area. These are non-tobacco rates and rise if you are a tobacco user and as you grow older. Plan F starts at $159 – $165 depending on area.
All of CommunityCare’s rates fall on the low end of the spectrum, in some cases very close to the lowest we have seen for these plans; that said, we couldn’t do a direct comparison to our other rate tests, as this company doesn’t provide coverage in our sample test state.
Ratings and Reviews
CommunityCare has an A- rating with the BBB. It is unclear why they have been docked slightly in the ratings, as they have no complaints on file in the past three years.
We were unable to find any other reviews of CommunityCare’s plans. That generally indicates a good reputation, as most insurance companies do have some complaints out there. Few people take the time to write positive reviews, instead using review sites when they are upset; as a result, a company with no reviews generally hasn’t had a lot of customer service problems.
The company website states that they have a four-star rating for their Senior Health Plans from CMS (Centers for Medicare and Medicaid), the government agency that contracts with private insurers to handle Medicare plans.
The Bottom Line
If you like a local company and don’t mind the limitations of an HMO plan, CommunityCare Medicare plans are well worth investigating further. The company has a good reputation and also offers very good premiums for its plans. While they might not be quite in line with rates from the national insurers, the company’s reputation certainly balances the scales with the rates.
For a list of companies that we recommend, visit our Best Insurance Companies page.