We offer our members a range of plans to fit their budgets and their particular health needs. To learn more about our Medicare Advantage Plans, please review the information and links below.
Prescription Drug Coverage
Current members should call _______, TTY/TDD _____________, 24 hours, seven (7) days a week for questions related to the Medicare Part D Prescription Drug program. Prospective members should call ___________, TTY/TDD __________ for questions related to the Medicare Part D Prescription Drug program.
Health Plan Benefit Options
- 2008 Health Plans
You must receive all routine care from plan providers. Your primary care physician is responsible for the oversight of your care. Your primary care physician will coordinate the care you receive and is responsible for facilitating the referral process when you need to see specialists. If you obtain routine care from out-of-plan providers neither Medicare nor Spokane Community Care will be responsible for the costs. Members must use network pharmacies to access your prescription drug benefits, except under non-routine circumstances when you cannot reasonably use network pharmacies. You will be required to pay the difference between what we would pay for a prescription filled at an in-network pharmacy and what the out-of-network pharmacy charged for your prescriptions.
Spokane Community Care is provided by Arcadian Health Plan, Inc., a Coordinated Care Plan with Medicare Advantage contract. Spokane Community Care’s contract with CMS is renewed annually and the availability of coverage beyond the end of the current or specified contract year is not guaranteed. Benefits, formulary, pharmacy network , premium and/or co-payments/co-insurance may change on January 1, 2007. Please contact Spokane Community Care for details.
Members may enroll in a Plan only during specific times of the year. You cannot enroll in this plan if your current or former employer helps pay for your drugs. Spokane Community Care’s Medicare Prescription Drug Benefit is only available to members of the MA-PD Plan. If you are already enrolled in a MA-PD Plan, you must receive the Medicare Prescription Drug Benefit through that Plan. Beneficiaries may be enrolled in only one Part D Plan at a time. If you are enrolled in an MA Plan, you may not enroll in a PDP, unless you are a member of a Private Fee-for-Service MA Plan (PFFS) that does not provide Medicare prescription drug coverage, a Medical Savings Account MA Plan (MSA), or a 1876 Cost Plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party. Medicare beneficiaries may enroll in Spokane Community Care through the Centers for Medicare and Medicaid Services Online Enrollment Center, located at www.medicare.gov.
If you qualify for extra help with your Medicare Prescription Drug Plan costs, your premium and drug costs will be lower. When you join Spokane Community Care, Medicare will tell us how much extra help you are receiving. Then, we will let you know the amount you will pay. If you aren’t receiving any extra help, you can see if you qualify …