About the member portal
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.
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.
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.
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.1
1 Subject to limitations
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.
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.
Initial Coverage Election PeriodYou 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 2018 Coverage: October 15, 2017 – December 7, 2017
Annual Election Period for 2019 Coverage: October 15, 2018 – December 7, 2018
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.
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 contact us.
There are a number of convenient ways to enroll in a ConnectiCare Medicare Advantage Plan.
Enrolling online is convenient and secure.
Click here to enroll online
Find numbers and service hours when you can reach a ConnectiCare representative.
- Arrange a personal consultation at a convenient time and location, including our ConnectiCare centers in Manchester, Bridgeport and Newington. Go to visitconnecticare.com to make an appointment and find directions to our centers.
Mail a completed Enrollment Request Form to:
Attention: Medicare Advantage Enrollment
P.O. Box 4001
Farmington, CT 06034-4001
Click here to access the "How to Enroll" section of this website.
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.
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.
ConnectiCare offers a range of plan options, giving you the benefits you need at a price that works. 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.
* With the exception of CT Children’s Medical Center
Click here to See our Plans.
Passage Plan 1 (HMO)
Yes, except for Connecticut Children’s Medical Center. Connecticut Children’s Medical Center doesn’t accept ConnectiCare Medicare Advantage Passage plans.
You’ll want to tell the specialist’s office when you make an appointment that you are in a plan that requires a PCP referral. The specialist can call us or check our website to confirm that your referral is valid.
You contact your PCP, who will decide if you should come into the office for a visit or consult by phone. Your PCP will tell you what specialist(s) to see and send referral(s) to ConnectiCare electronically. Your PCP should also tell you the date your referral(s) expire.
PCPs who accept Passage members have the authority to make referrals. They notify us so we can process claims. ConnectiCare doesn’t need to review or approve your PCP’s referrals.
Your PCP will decide how long your referral will last and tell you.
The specialist will bill you the fee based on the rates established by the Centers for Medicare & Medicaid Services.
With your Passage plan, it is the specialist office visit that requires a referral from your PCP. To find out your costs for other services, you can look at your Evidence of Coverage.
- Online – If you have a ConnectiCare plan today, log into our website and change your PCP.
- In person – Drop by one of our ConnectiCare centers. Find locations and hours at visitconnecticare.com. Or,
- By phone – Find numbers and hours of service.
Then, contact the PCP you select to register as a new patient. Make your annual checkup appointment at the same time.
Your PCP will notify us about the referral. But before you go to the specialist, make sure the referral has been sent to us. If the specialist has a question, his or her office can contact your PCP’s office.
Contact your PCP and tell him or her about what your ob/gyn recommended. Your PCP will decide what specialist you should see and submit a referral to ConnectiCare.
Passage plans don’t require you to have a referral to go to a facility, such as an urgent-care center, an emergency room, a radiology facility or a hospital. If you’re ever in doubt about the status of a referral, give us a call.
It depends. If your PCP orders lab work, for example, you may have to pay for it. Your Evidence of Coverage has all the details. Prescription medicines aren’t covered by the PCP copay, either. You can find a link to your Evidence of Coverage in the "My coverage" section of your Care Dashboard.
If you have a Passage plan, it says you need your PCP’s referral to see a specialist. You and your PCP can discuss the best specialist(s) for you. If you see a specialist without a referral, you will have to pay the full cost of the visit. If you had a Passage plan last year, you need to get specialist referrals again this year from your PCP.
If you have chosen a Passage plan, you need a PCP who accepts patients with your plan. Click here to find a Passage PCP. There are hundreds of PCPs who accept ConnectiCare Passage members. We do want to caution you: your plan will not cover visits to PCPs who don’t accept Passage plans.
No, you don’t need a referral for lab work. Check your Evidence of Coverage that we mailed to you to see what you may need to spend on lab work. You can find a link to your Evidence of Coverage in the "My coverage" section of your Care Dashboard.
Yes, you do. You should contact your PCP for another referral to see the second specialist.
Not all PCPs have urgent-care facilities. If yours does, then you will pay your urgent-care copay for your visit.
You don’t need referrals to emergency rooms and urgent-care centers.
Yes, specialist visits will each have a copay as long as you have a valid PCP referral. If the specialist performs other services – diagnostic tests or procedures – those may be subject to other copayments or coinsurance. Your Evidence of Coverage has all the details. We mailed you a copy. You can find a link to your Evidence of Coverage in the “My coverage” section of your Care Dashboard.
No. Your PCP will send the referral electronically to ConnectiCare. That way, we have a record of the referral when we receive a claim from the specialist you visit.
Your member identification (ID) card has the message that your plan requires PCP referrals to specialists. We have let specialists know how to check for referrals. If they have questions, they can log into our website for providers to check on the status of referrals.
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 pharmaciesPurchase 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, like Rite Aid, Walgreens and more.
Many of our retail pharmacies are “preferred pharmacies,” like Walgreens, where you can save on your prescriptions. For example, you'll save at least $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.
No, you will need to register with a new username and password to access the new Medicare Advantage website.
You must be enrolled in a Medicare plan, and you will need to have your member ID handy. Your member ID is the 11-digit number displayed on your ID card. Answer a few questions on our online registration form, choose a username and password, confirm your email, and you’re done!
If you have been locked out, please wait approximately 30 minutes before trying to login again.
H3528_18_4006_01 Approved 2/27/2018
Last Update 01/26/2018