ConnectiCare provides Medicare Advantage plans throughout Connecticut. Coverage is similar to Medicare parts A and B, with some extras like prescription drugs, dental, and vision care.
ConnectiCare is a managed care company and a subsidiary of EmblemHealth, a New York-based healthcare insurer. The company offers Medicare Advantage (Part C) plans to Connecticut residents.
ConnectiCare has been serving state residents for more than 40 years, with 100% of Connecticut hospitals in its network.
The ConnectiCare network of healthcare professionals, including general practitioners and specialists, can be found throughout the entire state of Connecticut and in western Massachusetts. ConnectiCare healthcare professionals also practice in four New York counties, including Westchester, Orange, Putnam, and Rockland.
This article reviews the Medicare Advantage plans from ConnectiCare, including what they cover and how much they cost.
ConnectiCare offers four types of Medicare Advantage plans. The following sections provide overviews of what each type offers.
ConnectiCare HMO plans
ConnectiCare Choice
Like all Health Maintenance Organization (HMO) plans, ConnectiCare Choice plans pay for only the medical care you receive from in-network healthcare professionals, pharmacies, and hospitals.
There are three Choice plan levels, indicated by numbers 1, 2, and 3. Each level has different costs and provides varying degrees of coverage. All three plans are available in all eight counties.
Plan 1 and Plan 3 include Medicare Part D prescription drug coverage. Plan 2 does not.
ConnectiCare Passage
There’s only one ConnectiCare Passage plan. What sets this plan apart is its $500 hearing aid allowance.
The ConnectiCare Passage plan is available in all eight Connecticut counties and includes prescription drug coverage.
ConnectiCare Flex
Like all HMOs that include a Point of Service (POS) option, ConnectiCare Flex plans give you the ability to use out-of-network professionals throughout the United States.
There are three Flex plan levels, indicated by numbers 1, 2, and 3. All three plans are available in all eight Connecticut counties.
Flex Plan 3 has a varying monthly premium based on the county where you live.
ConnectiCare special needs plans
ConnectiCare Choice Duals
This Dual Eligible Special Needs Plan (D-SNP) is available for Connecticut residents who are eligible for Medicare and the Connecticut Medicaid program, known as HUSKY Health.
It’s available in all eight Connecticut counties and includes prescription drug coverage.
As discussed above, most ConnectiCare Advantage plans include Medicare Part D prescription drug coverage. ConnectiCare doesn’t sell any stand-alone Part D plans. It’s worth noting that if you join a PPO Advantage plan that doesn’t offer drug coverage, you can’t join a separate Medicare drug plan.
You must use ConnectiCare in-network pharmacies to get the most coverage for your prescription medications.
Like all Medicare plans that provide prescription drug coverage, ConnectiCare HMO and HMO-POS plans have a formulary.
A formulary is a list of covered prescription drugs that are divided into tiers. These tiers include different types or categories of medications. Each tier has different out-of-pocket costs, deductibles, and copays.
ConnectiCare’s formulary includes five tiers. Copays for medications on each tier vary based on whether or not you use a standard or preferred pharmacy, with preferred pharmacies being less expensive.
ConnectiCare Medicare Advantage plans are available only to residents of Connecticut. You must also be eligible to enroll in Medicare.
These plans are available in all eight Connecticut counties.
ConnectiCare Medicare Advantage plans are required to cover at least as much as Original Medicare (Part A and Part B).
Some of these services include:
- in-patient hospital care
- hospice care
- limited skilled nursing facility care
- limited home healthcare
- emergency ambulance services
- durable medical equipment
- outpatient preventive and medically necessary services
- screenings for conditions like diabetes, cardiovascular disease, certain types of cancer, depression, and substance use disorder
- flu and pneumonia shots
Some ConnectiCare plans provide additional coverage for:
- preventive or comprehensive dental care
- prescription drugs
- vision care and an eyewear allowance
- fitness programs
- Teladoc services
- emergency services required outside of the United States
- SilverSneakers program
- an allowance for over-the-counter medical items
The copays, deductibles, and premiums for ConnectiCare plans may vary from county to county. The table below provides sample 2024 costs for eight ConnectiCare Medicare Advantage plans in Bristol, Connecticut:
| Location, plan | Monthly premium | Medical deductible | Dental coverage | Prescription drug coverage | Primary/specialist office visit |
|---|---|---|---|---|---|
| Bristol, CT: ConnectiCare Choice Plan 3 (HMO-POS) | $0 | $195 (only on certain benefits) | Preventive dental included. Comprehensive dental optional benefits start at $25 per month. | yes | $0/$35 |
| Bristol, CT: ConnectiCare Passage Plan 1 (HMO-POS) | $0 | $0 | Optional dental benefits start at $39 per month. | yes | $0/$35 |
| Bristol, CT: ConnectiCare Flex Plan 3 (HMO-POS) | $30 per month | $0 | Preventive dental coverage included. Comprehensive dental optional benefits start at $25 per month. | yes | Primary care visit: in-network: $5, out-of-network: 35% Specialist visit: in-network: $50, out-of-network: 35% |
| Bristol, CT: ConnectiCare Choice Dual (HMO-POS D-SNP) | $0 | $0 | Preventive and comprehensivedental care included with $3,000 annual limit. | yes | $0/$0 |
| Bristol, CT: ConnectiCare Choice Dual Vista (HMO-POS D-SNP) | $0 | $0 | Preventive and comprehensivedental care included with $2,000 annual limit. | yes | $0/$0 |
| Bristol, CT: ConnectiCare Choice Plan 2 (HMO-POS) | $0 | $0 | Preventive and comprehensivedental care included with $3,000 annual limit. | no | $0/$10 |
| Bristol, CT: ConnectiCare Flex Plan 2 (HMO-POS) | $115 per month | $0 | Optional dental benefits start at $39 per month. | yes | Primary care visit: in-network: $15, out-of-network: $50 Specialist visit: in-network: $35, out-of-network: $50 |
| Bristol, CT: ConnectiCare Choice Plan 1(HMO-POS) | $160 per month | $0 | Optional dental benefits start at $39 per month. | yes | $10/$30 |
Medicare Advantage (Part C) plans are optional insurance plans you may choose to purchase from a private insurance company. To buy a Part C plan, you must first enroll in Original Medicare.
By law, Part C plans are required to cover at least as much as Original Medicare. Many Part C plans, including some ConnectiCare plans, also cover extras that Original Medicare doesn’t. These extras may include:
- prescription drug coverage
- vision coverage
- dental coverage
Not all Part C plans are available in every location. Your state, county, and ZIP code determine what plans you are eligible to buy. You can search and review the Part C plans available in your ZIP code using Medicare’s plan finder tool.
Part C plans typically require that you see healthcare professionals within their network. If you wish to keep your current doctors who accept Medicare assignments, check to see if they’re listed under the plan you’re considering before you sign up.
ConnectiCare offers Medicare Advantage plans to Connecticut residents. The plans are available in all eight counties in Connecticut.
ConnectiCare’s plans vary in terms of copays, deductibles, and covered services. Some, but not all, ConnectiCare Part C plans include prescription drug coverage.