Frequently Asked Questions

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Frequently Asked Questions

Listed below are answers to our most commonly asked questions. If you still have questions or need more information, call us toll-free at 1-877-224-8221, seven days a week from 8 a.m. – 8 p.m. (TTY 1-800-842-9710).

What are Medicare Advantage Plans?

Why should I choose a Medicare Advantage Plan over Original Medicare alone or with a Medicare Supplement Plan?

Why should I choose ConnectiCare?

Am I eligible to enroll in a ConnectiCare Medicare Advantage Plan?

What Medicare Advantage Plans does ConnectiCare offer?

What type of plan is Passage Plan 1 (HMO)?

How do I decide which ConnectiCare Plan best suits my needs?

When can I enroll in a ConnectiCare Medicare Advantage Plan?

How do I enroll in a ConnectiCare Medicare Advantage Plan?

Will I have to pay a penalty if I don't sign up for Medicare Part B when I first become eligible?

How can I find out if my doctors are in ConnectiCare's network?

How can I find out if my prescription drugs are covered?

Where can I purchase my prescription drugs?

Will I have coverage for emergency care?



What are Medicare Advantage plans?

Medicare Advantage plans (Medicare Part C) are health plans approved by Medicare and run by private insurance companies, like ConnectiCare. They include your Part A (hospital insurance), your Part B (medical insurance) and in many cases, your Part D Prescription Drug Coverage. They can also include extra benefits and services like routine care and wellness programs.

They’re an attractive option for your Medicare coverage because they may save you money, offer added benefits and services, and keep all of your coverage in a single health plan.

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Why should I choose a Medicare Advantage plan over Original Medicare alone or with a Medicare Supplement Plan?

Compared to Original Medicare alone or with a Medicare Supplement plan, Medicare Advantage plans can be a simpler option:

  • Convenience: All of your coverage from a single health plan.
  • Prescriptions: Part D Prescription Drug Coverage included in most plans.
  • Benefits: Access to additional benefits, such as routine care and wellness programs You can also get optional benefits like dental.
  • Financial protection: Included in all plans with the annual maximum out-of-pocket limit for covered medical expenses.

Please Note: Monthly plan premiums, prescription drug and dental costs do not count towards the plan’s annual maximum out-of-pocket limit.

The chart below displays your Medicare plan options at work.

Medicare Advantage

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Why should I choose ConnectiCare?

ConnectiCare offers a range of plan options, giving you the benefits you need at a price that works. Our Medicare Advantage Plans work for many of your Connecticut neighbors – for three years straight, ConnectiCare has the largest Medicare Advantage membership in the state!* Here are some of the reasons why:

  • Six Plans offered statewide, including our NEW Passage Plan 1 (HMO)
  • Five Plans with Prescription Drug Coverage that give you savings on prescriptions with our preferred pharmacies and mail order services
  • Three Plans that give you the flexibility to get care nationally, outside our network

And, with ALL Plans, you'll enjoy:

  • NO deductibles
  • Coverage for worldwide emergency and urgent care
  • SilverSneakers® Fitness program
  • Many no-cost preventive services, including your annual physical exam
  • Access to our broad networks, including thousands of doctors, pharmacies and EVERY hospital in the state**
  • Financial protection with each plan’s maximum out-of-pocket limit
  • Option to add dental coverage

No matter which plan you choose, you can count on ConnectiCare to give you the personal service and easy access that sets us apart from other health plans.

*Source: Centers for Medicare & Medicaid Services (CMS) Monthly Summary Report (Data as of September, 2016)

** With the exception of CT Children’s Medical Center

Click here to See our Plans.

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Am I eligible to enroll in a ConnectiCare Medicare Advantage Plan?

You are eligible to enroll in a ConnectiCare Medicare Advantage Plan if:

  • You qualify for Medicare Part A;
  • You are enrolled in and continue to pay Medicare Part B; and
  • You reside in ConnectiCare's service area which is the entire state of Connecticut.

Except under certain limited circumstances, the Centers for Medicare & Medicaid Services (CMS) does not allow Medicare Advantage plans to enroll Medicare beneficiaries that have End-Stage Renal Disease.

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What Medicare Advantage Plans does ConnectiCare offer?

ConnectiCare offers a variety of Medicare Advantage plans to meet the different needs of many individuals. So there's sure to be a ConnectiCare Plan that’s right for you.

NEW Passage Plan 1 (HMO) can give you a better value and a simple pathway to the services you need. Just select a primary care doctor in the Passage network and let him or her guide your care. If you need to see a specialist, your PCP can refer you to one.

Your current PCP may be in the Passage network! Click here to use our Find a Doctor search tool. Or, call us and we’ll look it up for you!

Three Flex Plans that give you the most flexibility. They are Point-of-Service Plans that give you affordable cost shares for in-network services PLUS the flexibility to get care nationally, outside our network.

Choice Plans let you manage your care your way with access to thousands of doctors in our network plus EVERY hospital in the state, with the exception of Connecticut Children’s Medical Center.

Click here to shop & compare Plans

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What type of plan is Passage Plan 1 (HMO)?

Passage Plan 1 is an HMO Plan which means you will need to get your medical care from doctors and hospitals in the Passage network, except for emergency and urgent care. To enroll in Passage Plan 1, you will need to select a primary care doctor (PCP) from the hundreds available in the Passage network.

With Passage, your PCP will help guide your care. If you need to see a specialist, your PCP will refer you to one. The Passage network includes a wide choice of specialists, labs, pharmacies and EVERY hospital in the state, with the exception of Connecticut Children’s Medical Center. You will only need a referral to see a specialist; no referral is needed to see other providers, like labs.

Passage Plan 1

If your primary care doctor is in the Passage network, or if you’re looking for a new primary care doctor, this Plan may be the best fit for you.

Click here to see our Passage Provider Directory
Or, if you need help, give us a call and we’ll look it up for you.

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How do I decide which ConnectiCare Plan best suits my needs?

To help you decide which ConnectiCare Plan is best for you, take a look at the examples below:

Click here to shop & compare Plans.

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When can I enroll in a ConnectiCare Medicare Advantage Plan?

You may only enroll in a ConnectiCare Medicare Advantage Plan during specific times of the year. Here are some important enrollment dates:

Initial Coverage Election Period

You can enroll when you first become eligible for Medicare (three months before the month you turn age 65 until three months after the month you turn age 65). If you did not elect Medicare Part B when you were first eligible, you can still enroll in a Medicare Advantage plan. You will have a three-month period to enroll, which begins three months before your Medicare Part B effective date. You will not be able to enroll after your Medicare Part B effective date.

If you receive Medicare benefits due to a disability, you can join from three months before to three months after your 25th month of disability.

Please Note: You must qualify for Medicare Part A and be enrolled in and continue to pay for Medicare Part B to be eligible.

Annual Election Period for 2017 Coverage: October 15, 2016 – December 7, 2016

If you are eligible for Medicare, you can enroll in or switch plans during the Annual Election Period. For example, you can switch from Original Medicare to a Medicare Advantage plan (like a ConnectiCare Medicare Advantage Plan). Your coverage will be effective on January 1, 2017.

Special Enrollment Period

In certain situations, you may be able to join, switch or drop a Medicare Advantage plan at other times during the year. Some of these situations include:

  • If you move out of your plan's service area
  • If you have both Medicare and Medicaid
  • If you qualify for Extra Help paying for your Part D Prescription Drugs
  • If you live in an institution (such as a nursing home)
  • If you lose your employer coverage

For more information on enrollment periods, please call us toll-free at 1-877-224-8221, seven days a week from 8 a.m. - 8 p.m. (TTY 1-800-842-9710).

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How do I enroll in a ConnectiCare Medicare Advantage Plan?

There are a number of convenient ways to enroll in a ConnectiCare Medicare Advantage Plan.

  

Online

Enrolling online is convenient and secure.

Click here to enroll online

Enroll by Phone icon  

By Phone


Call toll-free at 1-877-224-8221 (TTY 1-800-842-9710). Representatives are available to take Enrollment Request Forms by phone Monday – Friday from 8 a.m. – 6 p.m. EST.

  

In person

Call toll-free at 1-877-224-8221 (TTY 1-800-842-9710) to:

  • Arrange a personal consultation at a convenient time and location, including the NEW ConnectiCare retail center: 1487 Pleasant Valley Road, Manchester, CT 06042
  • Reserve a seat at one of our free informational seminars in your area that occur from October 14, 2016 – December 7, 2016. Click here to find a seminar

Representatives are available to take your call seven days a week from 8 a.m. – 8 p.m. EST.

  

By mail

Mail a completed Enrollment Request Form to:

ConnectiCare
Attention: Medicare Advantage Enrollment
P.O. Box 4001
Farmington, CT 06034-4001

Click here to access the "How to Enroll" section of this website.

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Will I have to pay a penalty if I don't sign up for Medicare Part B when I first become eligible?

If you don't sign up for Medicare Part B (Medical Insurance) during your Initial Enrollment Period*, a 10% penalty may be added to the Part B premium for each 12-month period you could have had Part B but didn’t take it, unless you qualify for the Part B Special Enrollment Period. The late enrollment penalty continues for as long as you have Part B.

*Your Initial Enrollment Period is the seven-month "window" around your 65th birthday. It includes the three months before your birth month, your birth month, and the three months after your birth month.

Still Working?

If you’re covered under a group health plan based on current employment (yours or your spouse’s), you qualify for a Special Enrollment Period. You can sign up for Part A and/or Part B:

  • Any time you have current employer insurance (COBRA and retiree insurance don’t count as current employer insurance); or
  • During the 8-month period that begins the month after employment or your group coverage ends, whichever comes first.

For more information on the Medicare Part B late enrollment penalty and/or Medicare Enrollment Periods, you can contact Medicare directly by calling 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048 or visit the official website at www.medicare.gov.

Or, you can also speak with a ConnectiCare representative by calling toll-free at 1-877-224-8221, seven days a week from 8 a.m. – 8 p.m. (TTY 1-800-842-9710).

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How can I find out if my doctors are in ConnectiCare’s network?

You can use our convenient Find a Doctor search tool, located right on this website. This online directory is updated daily so you’ll get the most up-to-date information. To find your doctor, click here.

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How can I find out if my prescription drugs are covered by ConnectiCare?

You can find out if your prescription drugs are covered by clicking here to view the ConnectiCare Medicare Advantage Formulary.

Our Formulary is a list of covered Part D prescription drugs. Except in limited circumstances, your prescription drugs must be included in our Formulary to be covered.

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If I enroll in a ConnectiCare Plan with Prescription Drug Coverage, where can I purchase my prescription drugs?

As a ConnectiCare member, you’ll have the flexibility to purchase your covered prescriptions from our extensive network of pharmacies. Where you purchase your prescription drugs may affect the amount you pay out of your own pocket.

Retail pharmacies

Purchase your covered prescriptions at any of our participating retail pharmacies. There are more than 60,000 pharmacies in the ConnectiCare network, including many national chain pharmacies.

Many of our retail pharmacies are "preferred pharmacies", like Walgreens, where you can save on your prescriptions. For example, you'll save $5 each and every time you fill a 30-day prescription for most drugs. Those savings can really add up!

Mail Order Pharmacy

If you take medications on a regular basis, our Mail Order Pharmacy is a cost-saving and convenient option.

  • Get prescriptions sent right to your home – standard shipping is FREE
  • Save money! You'll pay less for a 90-day supply of most drugs than you would for a 90-day supply of the same drug at a retail pharmacy.
  • Have the option to schedule your prescriptions for auto refill and auto delivery
  • Get confidential access to pharmacists 24/7
  • Receive refill prescriptions within 3-5 business days and new prescriptions within 10 business days

For a list of our participating pharmacies and additional information on our Mail Order Pharmacy, click here.

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Will I have coverage for emergency care?

Yes. It's important to know that your health plan will be there for you if you have a medical emergency or urgent care situation, especially when you travel. That's why all of our plans include coverage for worldwide emergency and urgent care.

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H3528_17_4006_01r1 CMS Approved 10/19/2016
Last Update 10/15/2016