Key Takeaways
- ConnectiCare provides several types of Medicare Advantage plans in Connecticut, including HMO, Flex, and special needs plans, each with different coverage and cost levels.
- Most ConnectiCare Medicare Advantage plans include Part D prescription drug coverage, utilizing a formulary with tiered pricing based on the type of medication and pharmacy.
- These plans cover at least as much as Original Medicare, with some offering additional benefits like dental, vision, fitness programs, and allowances for over-the-counter medical items.
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 over 40 years and has a network that includes 100% of Connecticut hospitals.
The ConnectiCare network of healthcare professionals, including general practitioners and specialists, can be found throughout Connecticut and Western Massachusetts.
ConnectiCare healthcare professionals also practice in four New York counties: Westchester, Orange, Putnam, and Rockland.
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 Connecticut 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 $3,000 hearing aid allowance.
The ConnectiCare Passage plan is available in all eight Connecticut counties and includes prescription drug coverage.
ConnectiCare Flex
Like all HMOs with a Point of Service (POS) option, ConnectiCare Flex plans allow you to use out-of-network professionals throughout the United States.
There are two Flex plan levels, named Flex plan 2 and Flex plan 3. Both plans are available in all eight Connecticut counties.
Flex Plan 3 has a varying monthly premium based on the county in which 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.
ConnectiCare doesn’t offer any stand-alone Part D plans, but most ConnectiCare Medicare Advantage plans include Part D prescription drug coverage.
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 divided into tiers. These tiers include different types or categories of medications. Each tier may have different out-of-pocket costs, deductibles, and copays.
ConnectiCare’s formulary has up to six tiers. Copayments for medications on each tier vary based on whether 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 2025 costs for seven ConnectiCare Medicare Advantage plans in Bristol, CT:
| Location, plan | Monthly premium | Medical deductible | Dental coverage | Prescription drug coverage | Primary/specialist office visit |
|---|---|---|---|---|---|
| Bristol, CT: ConnectiCare Choice Plan 3 (HMO-POS) | $0 | $0 | Preventive and Comprehensive. Comprehensive included with a $2,000 annual limit. | yes | $0/$35 |
| Bristol, CT: ConnectiCare Passage Plan 1 (HMO-POS) | $0 | $0 | Preventive and Comprehensive. Comprehensive included with $2,000 annual limit. | yes | $0/$35 |
| Bristol, CT: ConnectiCare Flex Plan 3 (HMO-POS) | $29 per month | $0 | Preventive dental included. Comprehensive dental Optional Supplemental Benefits start at $27 per month. | yes | Primary care visit: • In-network: $5 • Out-of-network: 40% Specialist visit: • In-network: $50 • Out-of-network: 40% |
| Bristol, CT: ConnectiCare Choice Dual (HMO-POS D-SNP) | $0 | $0 | Preventive and Comprehensive. Comprehensive included with a $3,000 annual limit. | yes | $0/$0 |
| Bristol, CT: ConnectiCare Choice Plan 2 (HMO-POS) | $0 | $0 | Preventive and Comprehensive. Comprehensive included with a $3,000 annual limit. | no | $0/$10 |
| Bristol, CT: ConnectiCare Flex Plan 2 (HMO-POS) | $93 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) | $152 per month | $0 | Optional dental benefits start at $39 per month. | yes | $10/$30 |
Medicare Advantage (Part C) plans are bundled insurance plans that private Medicare-approved insurance companies administer. To buy a Medicare Advantage plan, you must first enroll in Original Medicare.
By law, Medicare Advantage plans must cover at least as much as Original Medicare, but many 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 Medicare Advantage plans are available in every location. Your state, county, and ZIP code determine the plans you are eligible to buy.
You can search and review available plans in your ZIP code using Medicare’s plan finder tool.
Medicare Advantage plans typically require that you visit healthcare professionals and facilities within their network. If you wish to keep your current doctors who accept Medicare assignment, check to see if they’re listed under the plan you’re considering before you enroll.
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 Medicare Advantage plans include prescription drug coverage.