Plan Details

98905OK0130024-00

Plan Year:

2023

CommunityCare's Fundamental Plan is defined by federal regulation as a "catastrophic plan." As defined by the Affordable Care Act (ACA), a catastrophic plan covers essential health benefits, but only after out-of-pocket cost sharing reaches a high deductible that equals the level of the ACA's required out-of-pocket maximum. Catastrophic plans do not qualify as creditable coverage.

Individual Deductible:	$9,100
Individual Out of Pocket Maximum:	$9,100
Office Visit Copay:	$35^†
Preferred Generics:	$0^*
Preferred Brand Name:	$0^*
Non-Preferred Brand Name:	$0^*
Individual Rx Deductible:	Integrated
Preferred Specialty:	$0^*
Non-Preferred Specialty:	$0^*
Specialist Copay:	$0^*
Coinsurance:	0%^*

^†First 3 primary care visits have a $35 co-payment and are not subject to the deductible.

^*Subject to the deductible.

Benefit Details

Directories

Additional Information

Essential Benefits

All health plans in the exchanges are required to provide a minimum set of benefits which are termed essential benefits. These benefits include:

Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health services
Substance use disorder services
Prescription drug coverage
Rehabilitative and habilitative services and devices
Preventative and wellness services
Pediatric Services

Plan Details

CommunityCare Catastrophic Select Plus

Benefit Details

Directories

Additional Information

Essential Benefits