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/TDD 1-800-842-9710).

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 in a ConnectiCare VIP Medicare Plan?

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

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

If I enroll in a ConnectiCare plan with Prescription Drug Coverage, where can I purchase my prescription drugs?

Will I have 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:

    As a Medicare Advantage plan member you’ll continue to receive regular Medicare-covered services (Part A Hospital Insurance and Part B Medical Insurance). You will also have access to additional benefits, such as routine services and wellness programs, that neither Medicare Supplement plans nor the Original Medicare plan provides.

    In addition, 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 has more than 30 years of experience providing quality health care coverage. Today, more people in Connecticut choose us over any other Medicare Advantage Plan.* Here are some of the reasons why:

    • No referrals to see your doctors
    • No deductibles for Medical and Prescription Drug Coverage
    • Access to one of the largest statewide networks of doctors and hospitals - including EVERY hospital in the state**
    • Plan options that give you the flexibility to get medical care nationally from Medicare-approved doctors and hospitals
    • Peace of mind knowing that ConnectiCare has close, longstanding relationships with the doctors and hospitals in Connecticut
    • Preventive services covered 100%, plus the Healthways SilverSneakers® Fitness program at no additional cost beyond the monthly plan premium
    • Savings on prescriptions with our Mail Order Pharmacy
    • Worldwide emergency and urgently needed services
    • Financial protection with each plan’s maximum out-of-pocket limit
    • Option to add dental coverage
    • Local, caring and personal service from a locally-based company.
    *Source: Centers for Medicare & Medicaid Services (CMS) Monthly Summary Report
    (Data as of August, 2015)

    ** With the exception of CT Children’s Medical Center

    Click here to See 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.


    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. These plans are ideal if you plan on getting all of your medical services from doctors and hospitals in our broad statewide network, except for emergency care and urgently needed services.

    • Access to our statewide network of doctors and hospitals, plus areas surrounding Connecticut – Massachusetts, Rhode Island, and New York
    • Premiums ranging from $0 to $170 in addition to your Part B monthly premium
    • Affordable copayment options
    • Prescription Drug Coverage with most Plans
    • SilverSneakers® Fitness Program with all plans


    ConnectiCare VIP Option (HMO-POS) Plans are ideal if you want flexibility to get care outside our network - perhaps if you spend extended periods of time away from Connecticut.

    • Flexibility to get care nationally from Medicare-approved doctors and hospitals.
    • Premiums ranging from $95 to $240 in addition to your Part B monthly premium
    • Prescription Drug Coverage with all Plans
    • SilverSneakers® Fitness Program with all plans

    Click here to See our Plans.

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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
    How often do you need to use medical services?
    If you choose a plan with a higher monthly premium, you’ll have lower copayments/coinsurance for most services. If you choose a plan with a lower monthly premium, you’ll have higher copayments/coinsurance for most services.

    Lifestyle
    Do you want the option to seek medical services outside our network? Do you spend extended periods of time away from home?

    Consider our VIP Option (HMO-POS) Plans. These plans offer the flexibility to get care nationally from Medicare-approved doctors and hospitals.

    Prescription Drug Coverage
    Do you need coverage for your prescriptions?
    All Plans include Prescription Drug Coverage, except the VIP Prime 4 (HMO) Plan. 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.

    Dental Needs
    Will you need dental care?
    Our optional Dental Plan offers you a great value. You'll get both preventive and comprehensive services for an additional low monthly premium.

    Click here to See 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?

    There are a number of convenient ways to enroll in a ConnectiCare VIP Medicare Plan.

    Online
    You can enroll right on this website. Click on the “How to Enroll” tab. Enrolling online is convenient and secure. You can also view our online seminar to learn more about our plans.

    By phone
    Call toll-free at 1-877-224-8220 (TTY/TDD 1-800-842-9710). Representatives are available to take applications by phone Monday – Friday from 8 a.m. – 6 p.m. EST.

    In person
    Call toll-free at 1-877-224-8220 (TTY/TDD 1-800-842-9710) to:

    • Arrange a personal consultation at a convenient time and location
    • Reserve a seat at one of our informational seminars in your area.
    Representatives are available to take your call seven days a week from 8 a.m. – 8 p.m. EST.

    By mail
    Mail a completed Enrollment Request Form to:
      ConnectiCare
      Attention: VIP Medicare Enrollment
      P.O. Box 4001
      Farmington, CT 06034-4001

    You can download an Enrollment Request Form right on this website. Just click on the “How to Enroll” tab. Click here to access the How to Enroll section of this website.

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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 so there's no need to use the paper directory. Additionally, the search tool provides a quick and easy way to locate medical providers by distance, specialty, spoken language, hospital affiliation and more! To find your doctor, click here.
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How can I find out if my prescription drugs are covered by ConnectiCare?

    You can find out if your prescription drugs are covered by clicking here to view the ConnectiCare VIP Medicare Formulary.

    Our Formulary is a list of Part D prescription drugs. Except in limited circumstances, your prescription drugs must be included in our Formulary to be covered.
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If I enroll in a ConnectiCare plan with Prescription Drug Coverage, where can I 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.

    As a ConnectiCare member, you’ll have the flexibility to purchase your covered prescriptions from our extensive network of pharmacies, using the options listed below.

    Where you purchase your prescription drugs may affect the amount you pay out of your own pocket.

    Retail pharmacies
    Purchase your covered prescriptions at any of our participating retail pharmacies. There are more than 60,000 pharmacies in the ConnectiCare network, including many national chain pharmacies like CVS, Rite Aid and Walgreens.

    Mail Order Pharmacy
    • Get prescriptions sent right to your home – standard shipping is FREE
    • 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
    • Get confidential access to pharmacists 24/7
    • Have the option to schedule your prescriptions for auto refill and auto delivery
    • Receive refill prescriptions within 3-5 business days and new prescriptions within 14 calendar days
    For more information on participating pharmacies and additional information on our Mail Order Pharmacy, click here.
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Will I have coverage for emergency care?

    Yes. It’s important 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 all of our plans include coverage for worldwide emergency care and urgently needed services.
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H3528_16_4006_01 CMS Approved 10/27/2015
Last Update 10/01/2015