2021 - ProCare Advantage (HMO I-SNP)
Get all the benefits and services covered under Original Medicare Parts A & B, plus Part D prescription drug coverage, and added health benefits and services.
HealthCare Benefit † | Plan Details |
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On-site Nurse Practitioner + customized care team
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Primary care physician (PCP) visits + preventive care
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Dental
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Vision
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Podiatry
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Prescription drugs
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Skilled Nursing
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Non-emergency Transportation
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$22.50*
Monthly Premium
People with limited incomes may qualify for Extra Help. Contact your plan representative to learn more.
†This list of benefits is in addition to Original Medicare. See Summary of Benefits for a complete list of benefits. All benefits listed above will begin on January 1, 2020. *$0 copay for these extra benefits, up to the annual limit.
Get all the benefits and services covered under Original Medicare Parts A & B, Plus Part D prescription drug coverage and added health benefits and services.
HealthCare Benefit †
- Regular, personalized, on-site visits
- Coordinates your clinical care
- Direct member access
$0 copay*
- $0 copay for in-room PCP visits at your community
- 20% coinsurance for PCP office visits
- $175 allowance for preventive dental services
- $0 copay* for routine eye exam
- $100 for eyewear every year
- $0 copay* for 4 routine foot care visits every year
- Prescription drug coverage
- Pharmacy coordination and monitoring
- No prior hospital stay required
- 24 one-way trips for healthcare services every year
$28.20*
Monthly Premium
People with limited incomes may qualify for Extra Help. Contact your plan representative to learn more.
†This list of benefits is in addition to Original Medicare. See Summary of Benefits for a complete list of benefits. All benefits listed above will begin on January 1, 2020.*$0 copay for these extra benefits, up to the annual limit.
ProCare Advantage is offered in the following participating communities:
(The participating communities are the same for plan year 2020 and 2021)
Dallas County

The Villa at Mountain View
2918 Duncanville Road,
Dallas, TX 75211
Windsor Gardens
2535 West Pleasant Run,
Lancaster, TX 75146
Crestview Court
224 W Pleasant Run Road,
Cedar Hill, TX 75104
The Manor at Seagoville
2416 Elizabeth Lane,
Seagoville, TX 75159
The Madison on Marsh
2245 Marsh Lane,
Carrollton, TX 75006
Palomino Place
3160 Gus Thomasson Road,
Mesquite, TX 75150
Harris County

Ashford Gardens
7210 Northline Drive,
Houston, TX 77076
The Broadmoor at Creekside Park
5665 Creekside Forest Drive,
The Woodlands, TX 77389
Solera at West Houston
2101 Greenhouse Road,
Houston, TX 77084
Jefferson County

Magnolia Manor
4400 Gulf Street,
Groves, TX 77619
Bonne Vie
8595 Medical Center Blvd.,
Port Arthur, TX 77619
Orange County

Oakwood Manor
225 South Main Street,
Vidor, TX 77662
Hardin County

Silsbee Convalescent Center
1105 West Highway 418,
Sulsbee, TX 77656
Brazoria County

The Colonnades at Reflection Bay
12001 Shadow Creek Park,
Pearland, TX 77584
Laurel Court
3830 Mustang Road,
Alvin, TX 77511
Denton County

Prairie Estates
1350 Main Street,
Frisco, TX 75033
Hollymead
4101 Long Prairie Road,
Flower Mound, TX 75028
Colin County

Carrara
4501 Tradition Trail,
Plano, TX 75093
The Belmont at Twin Creeks
999 Rantree Circle,
Allen, TX 75013
San Remo
3550 Shiloh Road,
Richardson, TX 75082
Bexar County

Sorrento
2739 Babcock Road,
San Antonio, TX 78229
Windemere
11106 Christus Hill,
San Antonio, TX 78251
Coronado at Stone Oak
19638 Stone Oak Parkway,
San Antonio, TX 78258
Tarrant County

The Harrison at Heritage
4600 Heritage Trace Parkway,
Ft. Worth, TX 76244
The Carlyle at Stonbridge Park
170 Stonebridge Lane,
Southlake, TX 76092
Fort Bend County

The Crescent
11353 Sugar Park Lane,
Sugar Land, TX 77478
Fort Bend HealthCare Center
3010 Bamore Road,
Rosenberg, TX 77471
What do I pay?
The amount you pay depends on the payment stage you are in when you fill your prescription. Your payment stage changes during the calendar year based on your total drug costs.
STAGE 1
Yearly deductible: $445 for all Part D prescription drugs
STAGE 2
Initial coverage
Once the yearly deductible is met, you pay 25% coinsurance for all drugs covered by this plan until your total yearly drug costs reach $4,130.
STAGE 3
Coverage Gap
After your total drug costs (including what our plan has paid and what you have paid) reach $4,130, you will pay no more than 25% coinsurance for generic drugs or 25% coinsurance for brand name drugs, for any drug tier during the coverage gap.
STAGE 4
Catastrophic coverage
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $6,550, you pay the greater of:
- 5% coinsurance, or
- $3.70 copayment for generic (including brand drugs treated as generic) and a $9.20 copayment for all other drugs.
If you take many medications for more than one chronic health condition you may be eligible to participate in the
Medication Therapy Management (MTM) program offered by the Centers for Medicare and Medicaid Services. Speak to a licensed ProCare plan representative for more details.
Cost-sharing may differ based on point-of-service (retail, Long Term Care (LTC)), home infusion, whether the pharmacy is in our standard network, or whether the prescription is a short-term (30-day supply) or long-term (90-day supply).