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:

    • 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 has more than 30 years of experience in helping Connecticut residents find quality health care coverage. Our Medicare Advantage Plans are offered only in Connecticut, which means we focus 100% of our attention on the Medicare beneficiaries in our state.

    Easy access to care. You have the freedom to see your doctors without referrals. ConnectiCare has one of the largest statewide networks of doctors and hospitals—including every hospital in Connecticut with the exception of Connecticut Children’s Medical Center.

    An improved experience. We have longstanding, close relationships with the doctors and hospitals in our state to make your care work better for you.

    Savings. No deductibles for Medical and Prescription Drug Coverage. We bring together a large group of pharmacies and negotiate with many to lower your costs for prescription drugs.

    Get healthy and stay healthy. The Healthways SilverSneakers® Fitness Program is included with all of our Plans. And, should you need extra support for chronic or complex health issues, our dedicated Care Management team is here to help you.

    Peace of Mind. All Plans cover you when you travel with Worldwide Emergency and Urgent Care.

    Financial Protection. All Plans protect your finances with a Maximum Out-of-Pocket limit.

    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 $26 to $154 in addition to your Part B monthly premium
    • Affordable copayment options
    • Prescription Drug Coverage with most Plans
    • SilverSneakers® Fitness Program with all individual 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 $62 to $226 in addition to your Part B monthly premium
    • Affordable copayment options
    • Prescription Drug Coverage with all Plans
    • SilverSneakers® Fitness Program with all individual 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
    How often do you need to use medical services?
    Determine the better value for you by weighing higher premium costs and lower copayments against lower premium costs and higher copayments.

    Weighing Your Options graphic


    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 receive 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.

    ADDITIONAL SAVINGS
    Do you wear glasses or contacts?
    Our Vision Discount Program may be able to save you hundreds of dollars each year.

    Do you frequently fill prescriptions?
    Our Preferred Pharmacies and Home Delivery (Mail-Order) Pharmacy can offer both convenience and savings.

    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 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. Standard 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 Standard Network Pharmacy. There is 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!
    • Get prescriptions sent right to your home – standard shipping is FREE
    • Choose your payment option
    • Get confidential access to pharmacists 24/7
    • Receive refill prescriptions within 3-5 business days and new prescriptions within 14 calendar days
    • 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
    For more information on participating pharmacies and additional information on our Home Delivery Pharmacy (Mail-Order), visit the Find Your Pharmacy or Prescription Drugs section.
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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 and Urgent Care.
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H3528_15_4006_01 Pending CMS Approval
Last Update 10/01/2014