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Read more →CCA One Care (HMO D-SNP)
by Commonwealth Care Alliance, Inc.
2026 Medicare-Medicaid Dual Eligible D-SNP plan available in Massachusetts
Plan ID H1486-001-0
Additional coverage:
RxHearingVisionDental
Medicare-Medicaid Dual Eligible D-SNP HMO $0 premium
Monthly plan premium $0 / mo
Annual deductible $0 / yr
Max out-of-pocket · in-network $8,845 / yr
Drug deductible $615 / yr
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Plan Overview
CCA One Care (HMO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Massachusetts and offered by the health insurance company Commonwealth Care Alliance, Inc.. This plan's network type is HMO, which determines the in-network doctors who accept the plan and whether a referral is needed.
Plan Name CCA One Care (HMO D-SNP)
Insurance Carrier Commonwealth Care Alliance, Inc.
Plan Type Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)
Network Type HMO
Cost Summary
CCA One Care (HMO D-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $8,845. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.
Monthly Premium $0 / mo
Health portion of premium $0
Drug portion of premium $0
Annual Deductible $0 / yr
Max Out-of-Pocket · in-network $8,845 / yr
Primary doctor visit $0 copay
Specialist visit $0 copay
ER visit $0 copay
Ambulance $0 copay
Additional Benefits and Coverage
CCA One Care (HMO D-SNP) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. CCA One Care (HMO D-SNP) includes coverage for hearing, vision, dental.
Part D Prescription Drug Coverage Yes
Dental Yes
Vision Yes
Hearing Yes
Nationwide Coverage No
Other benefits
Fitness benefit Not covered
Over-the-counter drug benefits Limited coverage
In-home support services Not covered
Home & bathroom safety devices Not covered
Meals for short duration Limited coverage
Annual physical exams Limited coverage
Telehealth Limited coverage
Medical Benefits
Doctor Services
Primary doctor visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Specialist visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Tests, labs & imaging
Diagnostic tests & procedures In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Lab services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient x-rays In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Emergency care $0 copay
Urgent care $0 copay
Hospital Services
Inpatient hospital coverage Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
Outpatient hospital coverage In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Skilled nursing facility
Skilled nursing facility Tier 1
$0 per day for days 1-20
$217 per day for days 21-100
$0 per day for days 1-20
$217 per day for days 21-100
Preventive services
Preventive services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Therapy services
Occupational therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Physical therapy & speech & language therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Mental health services
Outpatient group therapy with a psychiatrist In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy with a psychiatrist In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient group therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Opioid treatment services
Opioid treatment services Covered
Other services
Durable medical equipment (like wheelchairs & oxygen) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prosthetics (like braces, artificial limbs) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Diabetes supplies In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prescription drugs (Part D benefits)
Drug tier standard retail · 1-month supply Initial coverage Catastrophic
Generic Drugs 25% coinsurance 0% coinsurance
Brand Name Drugs 25% coinsurance 0% coinsurance
Part B drugs
Chemotherapy drugs In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Other Part B drugs In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Extra Benefits
Hearing
Hearing exam Not covered
Fitting/evaluation Not covered
Hearing aids - prescription Not covered
Hearing aids - over the counter Not covered
Preventive dental
Oral exam Not covered
Cleaning Not covered
Fluoride treatment Not covered
Dental x-rays Not covered
Comprehensive dental
Restorative services Not covered
Endodontics Not covered
Periodontics Not covered
Prosthodontics, removable Not covered
Prosthodontics, fixed Not covered
Maxillofacial prosthetics Not covered
Implant services Not covered
Oral and maxillofacial surgery Not covered
Orthodontics Not covered
Adjunctive general services Not covered
Vision
Routine eye exam Not covered
Contact lenses Not covered
Eyeglasses (frames & lenses) Not covered
Eyeglass frames (only) Not covered
Eyeglass lenses (only) Not covered
Upgrades Not covered
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