How to use your ConnectiCare HMO Open Access High-Deductible Health 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 whenever you fill a
prescription. It’s also an important indicator of your plan’s information.
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As a member of our HMO Open Access Plan, no referral is necessary for any
service you are seeking so long as you select a provider in our network.
Participating providers are listed in our Provider Directory.
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Our network includes providers that provide professional help for mental health
and alcohol or drug problems. If you’d like assistance finding a participating
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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Always use our participating providers, including hospitals, unless you have an
Emergency or need Urgent Care, or your situation is one of the other limited
circumstances described in your Membership Agreement. 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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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 Membership Agreement, 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 Membership Agreement for that), it’s a great overview of
important information.
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Remember, you have a plan deductible that applies to all services except
preventive care. See your Membership Agreement to see what is considered
preventive care. Once you’ve satisfied the plan deductible, you then pay any
applicable copayment 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.