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Medicare Broker Toolkit

What Are You Looking For?

2025 Summary of Benefits

2025 Enrollment Application Forms

  • Medicare Advantage Enrollment Application

  • Medicare Advantage (D-SNP) Enrollment Application

  • Optional Supplemental Dental Benefit

    Dental plan upgrades are permitted through March 31st, 2025.

2025 Sales Brochures

2025 Plan Related Forms & Helpful Links

2025 Provider and Dental Directories

  • ConnectiCare Choice (HMO-POS) Plans, ConnectiCare Choice Dual (HMO-POS D-SNP) Plan, and ConnectiCare Flex (HMO-POS) Plans

  • ConnectiCare Passage Plan 1 (HMO-POS)

  • Dental Directory

    ConnectiCare Choice (HMO-POS) plans, ConnectiCare Choice Dual (HMO-POS D-SNP) plan, ConnectiCare Flex (HMO-POS) plans, and ConnectiCare Passage Plan 1 (HMO-POS)

2025 Pharmacy Directories and Formularies

  • Medicare Preferred Performance Pharmacy Directory

    ConnectiCare Choice Plan 1 (HMO-POS), ConnectiCare Choice Plan 3 (HMO-POS),ConnectiCare Passage Plan 1 (HMO-POS), ConnectiCare Flex Plan 2 (HMO-POS), ConnectiCare Flex Plan 3 (HMO-POS)

  • National Medicare Performance Pharmacy Directory

    ConnectiCare Choice Dual (HMO-POS D-SNP)

  • ConnectiCare 6 Tier Medicare Advantage Drug Formulary

  • ConnectiCare D-SNP Medicare Advantage Formulary

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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office.

Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary,or other plan documents for specific information about your benefits coverage.