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FAQ

Enrollment

For ConnectiCare HMO and HMO-POS Medicare Advantage plans, you are eligible to enroll 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 (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.


For the ConnectiCare Choice Dual (HMO D-SNP) plan, you are eligible to enroll if:

  • You are entitled to Medicare Part A;

  • You are entitled to Medicare Part B;

  • You are enrolled in the Connecticut Medicaid Program (HUSKY); and

  • You live in ConnectiCare’s service area (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.

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. See our plans.

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.

Annual Election Period for 2020 Coverage: October 15, 2019 – December 7, 2019

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.

Open Enrollment Period: January 1, 2020 – March 31, 2020

There is an additional, annual Open Enrollment Period (OEP) that takes place from January 1st through March 31st. The OEP allows individuals enrolled in a Medicare Advantage plan, including newly Medicare Advantage-eligible individuals, to make a one-time election to go to another Medicare Advantage plan or Original Medicare. Individuals using the OEP to make a change may make a coordinating change to add or drop Part D coverage.

For NEW Medicare beneficiaries who are entitled to Parts A and B and have already enrolled in a Medicare Advantage plan during their initial coverage election period: You may make a change as noted above before the last day of the third month of your Part A and Part B entitlement. This would not apply to those who delay Part B enrollment.

Special Enrollment Period for D-SNP plans

If you are eligible, you can also join a D-SNP plan or switch to another D-SNP plan, like ConnectiCare Choice Dual (HMO D-SNP), just once during each of the first three calendar quarters of the year:

  • January – March 2020

  • April – June 2020

  • July – September 2020

Your coverage will be effective on the first day of the following month.

Special Enrollment Period for all Medicare Advantage plans:

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 contact us.

How to enroll in a ConnectiCare Medicare Advantage plan will depend on which one you’re choosing.

Please refer to our “How to enroll” section of our website for details.

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.

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. All our plans include coverage for emergency and urgent care.

  • With ConnectiCare HMO and HMO-POS plans, you are covered for these services worldwide.1
  • With ConnectiCare Choice Dual (HMO D-SNP), you are only covered for these services within the United States.

For more information, refer to the Summary of Benefits or Evidence of Coverage. To see plan documents, click here.

1 Subject to limitations.

General Information

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, include extra benefits and services like routine care and wellness programs. Some even include dental coverage.

You can also get Medicare Part D prescription drug coverage from a Medicare Advantage plan. This is called a Medicare Advantage Prescription Drug plan, or MAPD. ConnectiCare offers seven MAPD plans.

Medicare Advantage plans may save you money, offer added benefits and services, and keep all of your coverage in a single health plan.

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

With a Medicare Advantage plan, you get:

  • Convenience: All of your coverage from a single health plan.

  • Benefits: Access to additional benefits, such as routine care and wellness programs. Some plans even include dental.

  • Financial protection: All plans have an annual maximum out-of-pocket limit for covered medical expenses. Amounts vary by plan.

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

If you don't sign up for Medicare Part B (Medical Insurance) during your Initial Election Coverage 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 Election Coverage 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 (24 hours a day/7 days a week) or visit the official website at www.medicare.gov.

Or, you can also speak with a ConnectiCare representative. Find numbers and hours of service.

ConnectiCare Passage Plan 1 (HMO)

Click here to find PCPs who accept Passage Plan 1 (HMO) members. Then, contact the PCP you choose to register as a new patient. Please make sure to tell us the name of your PCP by logging into our website or contacting us.

You can see another PCP and pay the same copay as long as the PCP accepts ConnectiCare Passage Plan 1 (HMO) members. Click here to confirm the PCP accepts ConnectiCare Passage Plan 1 members.

You choose your PCP. You can change the PCP assigned to you as long as the provider is in your plan's network.  You just need to let us know.  Under your Passage Plan 1 (HMO), you can change your PCP in three ways: 

Then, contact the PCP you select to register as a new patient.

You have three ways to do it under your ConnectiCare Passage Plan 1 (HMO):

If you have chosen ConnectiCare Passage Plan 1 (HMO), you need a PCP who accepts members of this plan. Click here to find a ConnectiCare Passage Plan 1 PCP. There are hundreds of PCPs who accept ConnectiCare Passage Plan 1 members. We do want to caution you: your plan will not cover visits to PCPs who don’t accept Passage Plan 1 members.

Prescription drugs

You can find out if your prescription drugs are covered by clicking here to view the ConnectiCare Medicare Advantage formulary for our HMO and HMO-POS plans or to view the ConnectiCare Choice Dual (HMO D-SNP) formulary.

A formulary is the list of prescription drugs covered by ConnectiCare under your plan. Except in limited circumstances, your prescription drugs must be included in our formulary to be covered.

As a ConnectiCare member, you’ll have the flexibility to purchase your covered prescriptions from our extensive network of pharmacies.There are more than 60,000 participating retail pharmacies, including “standard” pharmacies and “preferred” pharmacies where you may pay less for your prescriptions.

Preferred pharmacies include, but are not limited to:

  • Costco
  • Rite Aid
  • Sam’s Club
  • Stop & Shop
  • Stop & Shop
  • Walgreens
  • Walmart

You can also get the medications you take regularly mailed to you by Express Scripts Pharmacy, the company that manages this service for us.



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Last Update 10/1/2019

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