Frequently Asked Questions for Members
Listed below are answers to our most commonly asked questions. If you still have questions or need more information, call us toll-free at 1-877-224-8221, seven days a week from 8 a.m. – 8 p.m. (TTY/TDD1-800-842-9710).
Medicare Advantage plans are health plans approved by Medicare and run by private companies, like ConnectiCare. They are part of the Medicare Program and are sometimes called Medicare Part C.
Medicare Advantage plans include both Part A Hospital Insurance and Part B Medical Insurance. And, they generally offer extra benefits beyond Original Medicare, such as routine care and wellness programs. Many Medicare Advantage plans also include Part D Prescription Drug Coverage.
Inherent in their name, Medicare Advantage plans can offer many advantages – cost savings, added benefits and services, and the convenience of having one health plan with one monthly premium.
The Advantages of a Medicare Advantage Plan:
- Medicare Advantage plans are available with affordable monthly premiums starting at $0, in addition to your Medicare Part B premium.
- As a Medicare Advantage plan member you’ll continue to receive regular Medicare-covered services (Part A Hospital Insurance and Part B Medical Insurance). In addition, you will also have access to additional benefits and services, such as routine care and wellness programs, that neither Medicare Supplement plans nor the Original Medicare plan provides.
- Prescription Drug Coverage is often included in a Medicare Advantage plan. Original Medicare and Medicare Supplement plans do not include Prescription Drug Coverage.
- Medicare Advantage plans offer the convenience of getting comprehensive coverage from a single health plan with one monthly premium.
- Unlike Original Medicare and Medicare Supplement plans, Medicare Advantage plans offer you financial protection through each plan’s annual Maximum Out-of-Pocket Limit. This limit is the most you would have to pay in copayments/coinsurance out of your own pocket for covered medical expenses within each calendar year. If you were to reach your plan’s annual limit, the plan will pay 100% of your covered medical expenses for the remainder of the calendar year. You can feel secure knowing that you are protected against unforeseen catastrophic medical costs.
ConnectiCare offers a wide range of Medicare Advantage Plans, each designed to carefully balance the coverage you need with the cost you can afford.
- Premiums starting at $0 in addition to your Medicare Part B monthly premium
- Plans that offer Medical and Prescription Drug Coverage all in one plan with no deductibles
- Plans with National coverage
- National Pharmacy Network – including CVS, Rite Aid, Walgreens, and more
- $0 copayments for Preventive and Wellness Services
- Plans with the Healthways SilverSneakers® Fitness Program
- Worldwide Emergency and Nationwide Urgent Care
- Financial Protection with each Plan’s Maximum Out-of-Pocket Limit
- No referrals required
- Vision Discount Program
Click here to View our Plans.
You are eligible to enroll in a ConnectiCare VIP Medicare Advantage Plan if:
- You qualify for Medicare Part A; and
- You are enrolled in and continue to pay Medicare Part B; and
- You reside in Connecticut.
Except under certain limited circumstances, the Centers for Medicare & Medicaid Services (CMS) does not allow Medicare Advantage plans to enroll Medicare beneficiaries that have End-Stage Renal Disease.
ConnectiCare offers a variety of Medicare Advantage Plans to meet the different needs of many individuals. So there’s sure to be a ConnectiCare Plan that’s right for you.
- Access to our statewide network of doctors and hospitals, plus areas surrounding Connecticut – Massachusetts, Rhode Island, and New York
- Premiums ranging from $0 to $134 in addition to your Part B monthly premium
- Affordable copayment options
- Prescription Drug Coverage with most Plans
- Flexibility to seek national coverage from Medicare-approved doctors and hospitals.*
- Premiums ranging from $24 to $204
- Affordable copayment options
- Prescription Drug Coverage with all Plans
ConnectiCare VIP Prime (HMO) Plans offer you excellent choices for affordable coverage.
* National coverage is available for certain services including, but not limited to, Preventive Screenings and Immunizations, Doctor Office Visits, Lab Services, X-rays, Ambulatory Surgical Center Services, Ambulance Services, Inpatient and Outpatient Hospital Care, and Physical Therapy.
ConnectiCare offers a range of Medicare Advantage Plans that suit a variety of lifestyles and budgets. Before you review our Plan options, here are a few things to consider:
Consider how often you need to see your doctor. Weighing higher premium costs and lower copayments against lower premium costs and higher copayments may help you determine the better value for you.
Are you comfortable with a Plan that requires you to get services from doctors and hospitals in our statewide network? If so, you may want to consider one of our VIP Prime Plans.
Or, do you want the flexibility to seek medical services outside our network? Perhaps you spend extended periods of time away from home? If so, you may want to look at our VIP Option Plans.
PRESCRIPTION DRUG COVERAGE
Do you want coverage for your prescription drugs? All of our Plans include Prescription Drug Coverage, except VIP Prime 4. If you have creditable Prescription Drug Coverage from a previous employer, or from the Veterans Administration (VA), our Prime 4 Plan may be a good option for you.
Click here to View our Plans.
When you can enroll depends on the time of the year it is, and when you are eligible for Medicare Part A or B. Additionally, there are special circumstances that allow you to enroll at any time of the year. For a summary of the Medicare enrollment dates that will help you understand when you can enroll, click here.
For your convenience, there are a number of ways to enroll in a ConnectiCare VIP Medicare Plan.
- By Phone
- By Mail
- In Person at an appointment or seminar
If you don’t sign up for Medicare Part B (Medical Insurance) during your Initial Enrollment Period*, a 10% penalty may be added to the Part B premium for each 12-month period you could have had Part B but didn’t take it, unless you qualify for the Part B Special Enrollment Period. The late enrollment penalty continues for as long as you have Part B.
- Any time you have current employer insurance (COBRA and retiree insurance don’t count as current employer insurance); or
- During the 8-month period that begins the month after employment or your group coverage ends, whichever comes first.
*Your Initial Enrollment Period is the seven-month "window" around your 65th birthday. It includes the three months before your birth month, your birth month, and the three months after your birth month.
If you’re covered under a group health plan based on current employment (yours or your spouse’s), you qualify for a Special Enrollment Period. You can sign up for Part A and/or Part B:
Or, you can also speak with a ConnectiCare representative by calling toll-free at 1-877-224-6221, seven days a week from 8 a.m. – 8 p.m. (TTY/TDD1-800-842-9710).
You can use our convenient "Find a Doctor" tool, located right on this website. This online directory is updated daily rather than annually like the paper directory. To find your doctor, click here.
You can find out if your prescription drugs are covered by clicking here to view the ConnectiCare Formulary.
Our Formulary is a list of Part D prescription drugs (generic and brand). Except in limited circumstances, your prescription drugs must be included in our Formulary to be covered.
Making sure you have the prescription drugs you need is important. Our Plans with Prescription Drug Coverage give you the flexibility to purchase your covered prescriptions from our extensive network of pharmacies.
- Prescriptions are sent right to your home, and standard shipping is FREE
- Choice of payment options
- Schedule your prescriptions for auto refill
- Confidential access to pharmacists 24/7
- Save money! You’ll pay less for a 90-day supply of most drugs than you would for a 90-day supply of the same drug at a retail pharmacy.
Where you purchase your prescription drugs may affect the amount you pay out of your own pocket. Listed below are our network pharmacy options.
For your convenience, there are over 60,000 pharmacies in the ConnectiCare network, including many national chain pharmacies like CVS, Rite Aid, and Walgreens, to name a few.
Home Delivery Pharmacy (Mail-Order) – Convenient and FREE standard shipping!
Yes. At ConnectiCare, we understand how important it is to know that your health plan will be there for you if you have a medical emergency or urgent care situation, especially when you travel. That’s why every Plan we offer includes Worldwide Emergency Care and Nationwide Urgent Care.
H3528_13_4006_01 CMS Approved 11/09/2012
Last Update 10/1/2012