How to use your ConnectiCare Point-of-Service Open Access Plan.
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 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.
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.
As a member of our Point-of-Service Open Access 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.
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 participating providers unless you
have an Emergency, need Urgent care or your situation is one of the limited circumstances
described in your Membership Agreement. 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.
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.
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.
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 like copays.
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.
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.
