Learn About & Select A Health Plan
How to use your ConnectiCare® FlexPOS Deductible/Copayment/Coinsurance Plan
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First, choose a primary care physician (PCP). Simply browse our Provider
Directory. Can’t find your copy? Stop by our Web site at www.connecticare.com
or call ConnectiCare Member Services. Remember, your enrollment form needs to
include your doctor’s name and ID number. Who qualifies as a PCP? General
practitioners as well as doctors in family practice, pediatrics or internal
medicine are all considered PCPs. Since we consider obstetrician/gynecologists
as specialists, female members cannot select an ob/gyn as their PCP.
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Don’t leave home without your ConnectiCare ID card. It should be kept in your
wallet. Show it whenever you visit a provider and, if your plan includes a
prescription drug rider, whenever you fill a prescription. It’s also an
important indicator of your plan’s deductible and copayment information.
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As a member of our FlexPOS Plan, no referral is necessary for any service you
are seeking. We encourage you to select providers in our network. They’re
listed in our Provider Directory.
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If you’d like assistance finding a provider for mental health, alcohol or drug
problems, call 1-888-946-4658. Our Behavioral Health Program staff will be
happy to help you.
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To maximize your benefits, always use participating providers unless you have
an Emergency or need Urgent Care, or your situation is one of the limited
circumstances described in your Certificate of Coverage.. Be aware that
benefits are paid at a lower level when you use a non-participating provider.
And since physician participation changes from time to time, be sure to visit
our Web site at www.connecticare.com or call Member Services to confirm that
your provider is still a participating provider.
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If you use providers outside our network, rush us the claims. You must file
them within six months. But the sooner you file the less likely you are to
forget.
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Certain services, procedures and drugs need our approval or “pre-authorization”
before you go ahead with them. We list them in the ConnectiCare Guidebook
and in your Certificate of Coverage, but be aware that they’re subject to
change. For the most up-to-date list, call Member Services.
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For quick facts, take out your Benefit Summary. While it isn’t the last word on
your plan (see your Certificate of Coverage for that), it’s a great overview
of important information such as copayments, coinsurance and
deductibles.
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Remember, you have a plan deductible which applies to all services except preventive
care. See your Certificate of Coverage to see what is considered preventive
care. Once you’ve satisfied the plan deductible you then only pay applicable copayments and/or coinsurance.
We will send you an Explanation of Benefits (EOB) to help you track your
out-of-pocket expenses.
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Know which hospitals are in our network. Hospital participation in our network changes from time to time, so
be sure to visit our Web site at www.connecticare.com or call Member
Services to confirm that the hospital is still in our network.
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We’re glad you’re a member. And we always have time for your questions and
concerns. Simply tell us what they are. When in doubt, you can e-mail us at
www.connecticare.com, or call Member Services at 1-800-251-7722. We can save
you guesswork, trouble and money.
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