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2018 Plan Documents

The materials listed below contain information about our 2018 ConnectiCare Medicare Advantage Plans.

Document
Description
2018
About ConnectiCare
2018 Plan Rating
H3528_18_1090_01 Accepted 10/16/2017

Star rating of ConnectiCare's 2018 Medicare Advantage Plans.

Enrollment
2018 Long Enrollment Form
H3528_18_1070_01 Approved 09/01/2017 
2018 Formulario de solicitud de inscripcion
H3528_18_1070_01 Aprobado el 09/01/2017 

Enrollment form for new 2018 ConnectiCare Medicare Advantage Members.
En Español

2018 Short Enrollment Form
H3528_18_1070_02 Approved 09/01/2017

Enrollment form for renewing 2018 ConnectiCare Medicare Advantage Members.

Summary of Benefits
2018 Passage Plan
H3528_18_1099_02 Accepted 09/05/2017

Description of benefits provided with the 2018 ConnectiCare Medicare Advantage Passage Plan.

2018 Flex Plans
H3528_18_1099_03 Accepted 09/05/2017

Description of benefits provided with the 2018 ConnectiCare Medicare Advantage Flex Plans.

2018 Choice Plans
H3528_18_1099_01 Accepted 09/05/2017

Description of benefits provided with the 2018 ConnectiCare Medicare Advantage Choice Plans.

Evidence of Coverage
2018 Passage Plan
H3528_18_1127_010 File & Use 08/25/2017

ConnectiCare's Medicare Advantage Passage Plan 1 details including medical and prescription drug coverage and plan costs.

2018 Flex Plan 1, HMO-POS
H3528_18_1127_006 File & Use 08/25/2017

ConnectiCare's Medicare Advantage Flex Plan 1 details including medical and prescription drug coverage and plan costs.

2018 Flex Plan 2, HMO-POS
H3528_18_1127_012 File & Use 08/25/2017

ConnectiCare's Medicare Advantage Flex Plan 2 details including medical and prescription drug coverage and plan costs.

2018 Flex Plan 3, HMO-POS
H3528_18_1127_011 File & Use 08/25/2017

ConnectiCare's Medicare Advantage Flex Plan 3 details including medical and prescription drug coverage and plan costs.

2018 Choice Plan 1, HMO
H3528_18_1127_013 File & Use 08/25/2017

ConnectiCare's Medicare Advantage Choice Plan 1 details including medical and prescription drug coverage and plan costs.

2018 Choice Plan 2, HMO
H3528_18_1127_003 File & Use 08/25/2017

ConnectiCare's Medicare Advantage Choice Plan 2 details including medical coverage and plan costs.

Downloadable Provider Directories
Passage Volume 1
H3528_18_1080_03_NM

Passage Plan Provider Directory - Volume 1

Passage Volume 2
H3528_18_1080_03_NM

Passage Plan Provider Directory - Volume 2

Choice & Flex Plans Volume 1
H3528_18_1080_05_NM

Choice & Flex Plans Provider Directory - Volume 1

Choice & Flex Plans Volume 2
H3528_18_1080_06_NM

Choice & Flex Plans Provider Directory - Volume 2

Extras

Free interpreter service in multiple languages to answer any questions regarding your health or drug plan.

For members who wish to have their premium payments directly debited from their bank account.

2018 LIS Premium Sheet
H3528_18_10001_06_NM

Premium reference sheet for members receiving Extra Help to help pay for their prescription drug costs.

ConnectiCare Medicare Advantage Guide
H3528_18_4041_07 Accepted 09/11/2017

Guide of ConnectiCare's Medicare Advantage Plans, helping you choose a ConnectiCare Medicare Advantage plan for 2018.








H3528_18_4006_01r5 Approved 01/02/2018
Last Update: 09/04/2018

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