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Plan Details

CommunityCare Catastrophic Select Plus

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.

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