Frequently Asked Questions

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Frequently Asked Questions

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).

What are Medicare Advantage Plans?
Why should I choose a Medicare Advantage Plan over Original Medicare alone or with a Medicare Supplement Plan?
Why should I choose ConnectiCare?
Am I eligible to enroll in a ConnectiCare VIP Medicare Plan?
What Medicare Advantage Plans does ConnectiCare offer?
How do I decide which ConnectiCare VIP Medicare Plan best suits my needs?
When can I enroll in a ConnectiCare VIP Medicare Plan?
How do I enroll?
Will I have to pay a penalty if I don't sign up for Medicare Part B when I first become eligible?
How can I find out if my doctors are in ConnectiCare's network?
How can I find out if my prescription drugs are covered?
Where would I be able to purchase my prescription drugs?
Will I have worldwide coverage for emergency care?



What are Medicare Advantage Plans?

    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.
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Why should I choose a Medicare Advantage Plan over Original Medicare alone or with a Medicare Supplement Plan?

    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.
    Please Note: Monthly plan premiums, prescription drug and dental costs do not count towards the plan’s annual Maximum Out-of-Pocket Limit.
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Why should I choose ConnectiCare?

    ConnectiCare offers a wide range of Medicare Advantage Plans, each designed to carefully balance the coverage you need with the cost you can afford.

    • Plans that offer Medical and Prescription Drug Coverage all in one plan with no deductibles
    • Plans with National coverage
    • National Pharmacy Network
    • $0 copayments for Preventive and Wellness Services
    • Premiums starting at $0 in addition to your Medicare Part B monthly premium
    • Plans with the Healthways SilverSneakers® Fitness Program
    • Worldwide Emergency and Urgent Care
    • Financial Protection with each Plan’s Maximum Out-of-Pocket Limit
    • No referrals required
    • Vision Discount Program
    And, with each of our Plans comes something more – attentive, responsive and personal service you can expect only from a locally-based company like ConnectiCare. You can count on us to put your health first. Coverage, cost, plus caring service. We’re confident that we can help you find a ConnectiCare VIP Medicare Plan with the right balance for you.

    Click here to View our Plans.
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Am I eligible to enroll in a ConnectiCare VIP Medicare Plan?

    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.
    There are no pre-existing conditions, and physical exams are not required.

    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.
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What Medicare Advantage Plans does ConnectiCare offer?

    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.

    ConnectiCare VIP Prime (HMO) Plans offer you excellent choices for affordable coverage.
    • Access to our statewide network of doctors and hospitals, plus areas surrounding Connecticut – Massachusetts, Rhode Island, and New York
    • Premiums ranging from $0 to $137 in addition to your Part B monthly premium
    • Affordable copayment options
    • Prescription Drug Coverage with most Plans
    • SilverSneakers® Fitness Program with most Plans
    ConnectiCare VIP Option (HMO-POS) Plans are ideal if you would like national coverage or spend extended periods of time away from Connecticut.
    • Flexibility to seek national coverage from Medicare-approved doctors and hospitals.*
    • Premiums ranging from $39 to $208 in addition to your Part B monthly premium
    • Affordable copayment options
    • Prescription Drug Coverage with all Plans
    • SilverSneakers® Fitness Program with most Plans

    * 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.

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How do I decide which ConnectiCare VIP Medicare Plan best suits my needs?

    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:

    BUDGET

    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.

    Weighing Your Options graphic


    LIFESTYLE

    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.
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When can I enroll in a ConnectiCare VIP Medicare Plan?

    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.
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How do I enroll in a ConnectiCare VIP Medicare Plan?

    For your convenience, there are a number of ways to enroll in a ConnectiCare VIP Medicare Plan.
    • Online
    • By Phone
    • By Mail
    • In Person at an appointment or seminar
    Click here for details on all of these options and to enroll now!

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Will I have to pay a penalty if I don't sign up for Medicare Part B when I first become eligible?

    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.

    *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.

    Still Working?

    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:
    • 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.
    For more information on the Medicare Part B late enrollment penalty and/or Medicare Enrollment Periods, you can contact Medicare directly by calling 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048 or visit the official website at www.medicare.gov.

    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).

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How can I find out if my doctors are in ConnectiCare’s network?

    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.
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How can I find out if my prescription drugs are covered?

    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.
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Where would I be able to purchase my prescription drugs?

    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.

    Where you purchase your prescription drugs may affect the amount you pay out of your own pocket. Listed below are our network pharmacy options.

    Retail Pharmacies
    For your convenience, there are over 60,000 pharmacies in the ConnectiCare network, including many preferred chain pharmacies like Stop and Shop , Rite Aid, and Wal-Mart to name a few.

    • Preferred Pharmacy vs. Non-Preferred Pharmacy
      If you purchase your prescription drugs at one of our many Preferred Pharmacies, you may save more money than you would if you purchased the same medication at a Non-Preferred Network Pharmacy. We have an agreement with Preferred Network Pharmacies to provide prescription drugs at a reduced rate. As a result, we can pass along those savings to you in the form of a lower copayment.

    Home Delivery Pharmacy (Mail-Order) – Convenient and FREE standard shipping!
    • Prescriptions are sent right to your home, and standard shipping is FREE
    • Choice of payment options
    For a list of our participating pharmacies and additional information on our Home Delivery Pharmacy (Mail-Order), click here.
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Will I have coverage for emergency care when traveling outside the United States?

    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 Urgently Needed Care.
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H3528_14_4006_01 CMS Approved 11/5/2013
Last Update 10/1/2013