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15 th year with the State of Oklahoma Locally owned and operated

15 th year with the State of Oklahoma Locally owned and operated Local customer service and claims processing 100% HMO medical plan No deductible or coinsurance Self-refer to most specialists for initial visits Member Reassurance Program. Health Plan Outline No deductibles

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15 th year with the State of Oklahoma Locally owned and operated

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  1. 15th year with the State of Oklahoma • Locally owned and operated • Local customer service and claims processing • 100% HMO medical plan • No deductible or coinsurance • Self-refer to most specialists for initial visits • Member Reassurance Program

  2. Health Plan Outline • No deductibles • Out-of-pocket maximum - $2,500 or $3,000 (ind.) $5,000 or $6,000 (family) • Office visit copays - $30/$40 or $35/$50 • Hospital outpatient visit - $250 or $300 • Hospital inpatient admission - $350 or $500 • Diagnostic lab & X-ray - No additional copay • Emergency care - $150 or $200

  3. Pharmacy Benefits Outline • Pharmacy copays - $0/$5/$30/$60 or $0/$10/$40/$65 • Mail order – 90-day supply for 3 copays • $0 Copay Program – anti-depressants, blood pressure reducing agents, cholesterol reducing agents, acid/ulcer medications, anti-inflammatory medications • Days Supply Per Copay – 30 days • Quantity Limits – See Rx plan for details

  4. To locate CommunityCare contracted providers & pharmacies: • Please access our Web site: www.ccok.com • Select “Find a Provider” on the CommunityCare home page • Select “State, Education and Local Government Employees” to begin your search • Printed directories available upon request

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