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Our Policies

Coverage Guidelines

Important policy information for medical management programs, preauthorization requirements, inpatient admissions, and more.

Go to Coverage Guidelines

Medical

Review policies on various medical treatments, emerging medical technologies, and preauthorization criteria.

Go to Medical

Pharmacy

See preauthorization criteria on prescription medications and much more.

Go to Pharmacy

Reimbursement Policies

Learn about billing and claims payment policies, evaluation and management services, and in-office lab and radiology codes.

Go to Reimbursement Policies

Payment Integrity Policies

Download the policies that support ConnectiCare’s payment integrity efforts.

Go to Payment Integrity Policies
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©2025 ConnectiCare. All Rights Reserved.

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.