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Benefits

As a member of Commonwealth Care Connection, you must use plan providers to get all of the health care services and supplies that are covered by the Commonwealth Care Connection. You will also be assigned a Care Manager to work with your PCP. Your Care Manager will assist your PCP in coordinating medical and support service needs that you require. You will know your Care Manage well as he/she will work closely with you to provide care coordination services that will be designed specifically to meet your needs so that you can remain as healthy and independent as possible.

Services and Care You May Receive:

*For more detailed information on the services mentioned below, please reference CCC’s Evidence of Coverage.

  • Emergent/Urgent Care
  • Outpatient Health Services
  • Inpatient Hospital Care
  • Skilled Nursing Facility, Inpatient Rehabilitative Care
  • Outpatient Surgery
  • Home Health Care
  • Diagnostic Dental, Vision and Hearing Care
  • Specialists, Specialty Care
  • Diabetes Self Monitoring, Training and Supplies
  • Prescriptions and Pharmacy Benefits
  • Preventative Care and Screenings (including immunizations, bone mass measurements, colorectal screenings, mammography screenings, pap smears, pelvic exams, clinical breast exams, prostate cancer screening exams, cardiovascular screening blood tests, and diabetes self-monitoring training and supplies
  • Prosthetic devices & related supplies
  • Various Medical Equipment (wheelchair, cane, walker etc.)
  • Medical Nutrition Therapy
  • Podiatry Services
  • Inpatient/Outpatient Mental Health Care
  • Outpatient Substance Abuse Services
  • And any additional services recommended by your PCP or PCT

Urgent, Emergency Care

In an emergency, you should get care immediately. You do NOT have to contact your PCP or get permission from your Care Manager in an emergency. You can dial 911 for immediate help by phone, or go directly to the nearest emergency room, hospital, or urgent care center.

Out-of-Area Care

If you need care when you are outside of the service area, your coverage is very limited. The only services we cover when you are outside of our service area are care for a medical emergency, urgently needed care, renal dialysis, and care that your PCP and/or Care Manager has approved in advance. If you have questions about what medical care is covered when you travel, please call Member Services at 1-800-311-9529 (TTY users please dial 1-866-322-7357).