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AbilityCare (HMO SNP)

AbilityCare (HMO SNP)

Understanding AbilityCare

If you need free help interpreting the information in this video, visit our Translation and Alternative Formats page or contact Member Services for the program you are enrolled in.

For a printed copy of the brochure or benefits sheet contact Member Services.

AbilityCare Coverage and Eligibility

AbilityCare is a Medicare Advantage Special Needs BasicCare (SNBC) program for people with disabilities who live in our 12-county service area. AbilityCare is designed to help people with disabilities access the health care, medications, and support services they need. There are no additional costs to join AbilityCare.

To be eligible for AbilityCare you must:

  • Be certified disabled by the Social Security Administration or State Medical Review Team (SMRT);
  • Be at least 18 and under the age of 65 at the time of enrollment;
  • Be eligible for Medical Assistance;
  • Have Medicare Parts A and B;
  • Live in our service area (see service area map) .

AbilityCare eligibility is determined by a financial worker in your county.

AbilityCare provides Medicare Part A (hospital), Part B (medical), Part D (prescription drug), and Medical Assistance coverage.

You do not pay a separate monthly plan premium for AbilityCare. You must continue to pay your Medicare Part B premium (unless your Part B premium is paid for you by Medical Assistance (Medicaid) or another third party).

AbilityCare Features:

  • A large network of providers where members can receive care without referrals
  • A Community Care Connector located in the county who helps members get the services and supports they need
  • Nurse24 nurse advice line and online support, available 24/7
  • Care Coordination services

HIV Screening

Did you know that annual screening for Human Immunodeficiency Virus (HIV) is a covered benefit for South Country Health Alliance members? Call Member Services for specific benefit information. If you are at risk, be safe and get tested!

Not a Member Yet?

There are many more benefits to being an AbilityCare member, and the best part is, there is no extra cost to you! See How to Enroll for more information. Or, if you wish to speak with someone about your enrollment questions, please call the number below. We are happy to help!

Enrollment Questions and Assistance

Call: 1-866-567-7242
TTY: 1-800-627-3529 or 711
Calls to both numbers are free.
April – September: Monday to Friday, 8 a.m. to 8 p.m.
October – March: 7 days a week, 8 a.m. to 8 p.m.


You may end your membership in our plan at any time. Ending your membership in our plan may be voluntary (your own choice) or involuntary (not your own choice). For more information, see Chapter 10 in the Evidence of Coverage (under Member Materials to the right).

Member Rights and Responsibilities

For Member Rights and Responsibilities, see Chapter 8 in the Evidence of Coverage (under Member Materials to the right).


H5703_3773, Approved

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AbilityCare Member Materials 
Enrollment FormPDFComing Soon
Evidence of CoveragePDFPDF
Annual Notice of ChangesPDFPDF
Summary of BenefitsPDFPDF
Pre-Enrollment ChecklistPDFComing Soon
List of Covered Drugs (Formulary)PDFPDF
Formulary UpdatesPDFComing Soon
Provider and Pharmacy DirectoryWeb PageWeb Page
Medicare Star RatingsPDFPDF
LIS Premium Summary ChartPDFComing Soon
CMS Best Available Evidence CoverageWeb PageWeb Page
Covered Diabetic Testing SuppliesPDFPDF
A list of AbilityCare Member materials for download.