Arcadian Community Care Plus and Dual Plus Review

Arcadian Community Care Plus and Arcadian Community Care Dual Plus are two Medicare Advantage HMO plans offered by Arcadian Community Care.  Arcadian Community Care provides Medicare health and prescription drug coverage in Louisiana and two counties in California.  Arcadian Community Care recently has become part of Humana.  That may or may not be a good thing depending on how Humana changes the plan coverage.  Let’s take a look at how these two plans cover you.

Arcadian Community Care Plus (HMO)

  • Premium – $0/monthly
  • Maximum Out of Pocket – $4,950
  • Referral required for specialists
  • Hospital copay – $200/day Days 1-5
  • Doctors visits – $0 = Primary; $25 = Specialists
  • Outpatient Surgery – $250
  • Labs – $0
  • Diagnostic Procedures and Tests – $0
  • X-rays – 20%
  • Part D Deductible – $0
  • Part D Drugs – Tier 1 = $2; Tier 2 = $15; Tier 3 = $45; Tier 4 = $89; Tier 5 = 33%
  • Covers many generics through the coverage gap
  • Dental cleanings and x-rays covered
  • Routine hearing exam = $25; hearing covered up to $700
  • Eye exam and glasses covered up to $100

Arcadian Community Care Dual Plus (HMO-SNP)

  • Must have both Medicare and Medicaid
  • Premium – $0/monthly
  • Maximum Out of Pocket – $3,400
  • Referral required for specialists
  • All services offered at $0 copay depending on level of Medicaid assistance
  • Drugs will be $0 – $6.50 based on level of LIS
  • Dental cleanings and x-rays covered up to $1,000 for comprehensive dental benefits
  • Routine hearing exam = $10; hearing covered up to $1,200
  • Eye exam and glasses covered up to $150

The Arcadian Community Care Plus plan in California differs slightly in copays.  The above summary is for Louisiana only.  Remember that these plans are HMO’s and will require referrals, and use of network providers.  No out of network providers are covered.  You can verify if your provider is in network by visiting the plan’s website.  You can also compare plans by visiting medicare.gov.

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