How to use your ConnectiCare® Solo Point-of-Service Open Access Plan.
We’re glad you’re a member. And we always have time for your questions and concerns. Simply tell us what they are.
First, choose a primary care physician (PCP). Simply browse the Open Access Provider Directory. Can’t find your copy? Stop by our Web site at www.connecticare.com or call our Customer Service Center. 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.
Don’t leave home without your ConnectiCare ID card. It should live in your wallet. Show it whenever you visit a provider or fill a prescription. (Whether or not you’ve purchased a prescription drug benefit, you may still be eligible for a discount.)
As a member of our Point-of-Service Open Access Plan, no referral is necessary for any service you’re seeking. That includes professional help for mental health, and alcohol or drug problems. (Give us a few minutes and we’ll show you.)
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.
To maximize your benefits, always use our participating providers. Unless ... you have an emergency. 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 check the latest Open Access Provider Directory. Or, call our Customer Service Center. You can also visit our Web site (www.connecticare.com) for updates.
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.
Find out about pre-authorization. Certain procedures and drugs need our approval or “pre-authorization” before you go ahead with them. We list them in the ConnectiCare
Guidebook, but be aware that they’re subject to change. For the most up-to-date list, call our Customer Service Center.
For quick facts, take out your Benefit Summary. While it isn’t the last word on your plan (see your Policy for that), it’s a great overview of nitty-gritties like copays.
Know which hospitals are in our network. Hospital participation in our network changes from time to time, so be sure to check the latest Provider Directory. Or, call our Customer Service Center. You can also find updates on our Web site at www.connecticare.com.
When in doubt, call our Customer Service Center. ConnectiCare, Inc: 1-800-251-7722
