Commercial - Medical Management Programs
Bone Marrow and Organ Transplants
Bone marrow and organ transplants are covered when established
criteria for medical necessity are met. Covered organ transplants may include,
but are not limited to cornea, heart, heart-lung, kidney, liver, lung, pancreas,
pancreas-kidney and bone marrow transplants, depending on the member’s benefit
All requests for organ transplants, except corneal transplants,
require pre-authorization prior to any referral. Pre-authorize bone marrow or
organ transplant services with ConnectiCare as soon as the patient’s needs are
known, prior to any evaluative services.
Services are available at participating
facilities, including contracted Centers Of Excellence. To obtain a listing of
participating transplant facilities, call (860) 674-5860 or 1-800-562-6833.
Exception: Members covered under a ConnectiCare of Massachusetts, Inc. or
ConnectiCare of New York, Inc. plan may have access to out-of-network
Request services in writing from ConnectiCare’s Medical Operations
Department by FAXing us at:
(860) 674-5893 or 1-800-923-2852
What happens next?
• The case manager will request clinical documentation. Upon receipt, the
case manager will review the documentation with ConnectiCare’s medical director
to determine medical necessity and benefit
• The case manager or medical director may discuss
the determination with you by phone and will follow up with a written