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Connecticut Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other additional benefits Original Medicare doesn’t cover.

Learn more about Connecticut Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price. 

Enrollment may be limited to certain times of the year. See why you may be able to enroll today.

Compare plans today.

Speak with a licensed insurance agent

1-800-557-6059
|
TTY 711, 24/7

Basic Costs and Coverage

CoverageDetails
Monthly plan premium$49.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$185.00
Out-of-pocket maximum$6,750.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$2,100.00
Primary care doctor visit

Doctor Office Visit Services:
Coinsurance for Primary Care Office Visit 40%

Specialty doctor visit

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $50

Inpatient hospital careIn-Network:

Acute Hospital Services:
$495 per day for days 1 to 5
$0 per day for days 6 to 90
Prior Authorization Required for Acute Hospital Services
Urgent care
Urgent Care:
Copayment for Urgent Care $50

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $0
Maximum Plan Benefit of $50,000
Emergency room visit
Emergency Care:
Copayment for Emergency Care $130

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $0
Copayment for Worldwide Emergency Transportation $0
Maximum Plan Benefit of $50,000
Ambulance transportation

Ambulance Services:
Copayment for Ambulance Services - Ground $325
Coinsurance for Ambulance Services - Air 20%
Prior authorization may be required.

Health Care Services and Medical Supplies

ConnectiCare Flex Plan 3 (HMO-POS) covers a range of additional benefits. Learn more about ConnectiCare Flex Plan 3 (HMO-POS) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic services

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $15

Diabetes supplies, training, nutrition therapy and monitoring

Medicare Covered Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies 40%
Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 40%

Durable medical equipment (DME)

Medicare Covered Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 40%
Minimum coinsurance applies to HIT drug component services provided in the home. Maximum coinsurance applies to HIT drug component services provided in all other locations and all other DME.

Diagnostic tests, lab and radiology services, and X-rays

Medicare Covered Diagnostic Procedures/Tests Services:
Coinsurance for Medicare Covered Diagnostic Procedures/Tests 40%
Coinsurance for Medicare Covered Lab Services 40%
Coinsurance for Medicare Covered Diagnostic Radiological Services 40%
Coinsurance for Medicare Covered Therapeutic Radiological Services 40%
Coinsurance for Medicare Covered Outpatient X-Ray Services 40%

Prior authorization may be required

Home health care

Home Health Services:
Copayment for Medicare-covered Home Health Services $0
Prior Authorization Required for Home Health Services

Mental health inpatient care

Psychiatric Hospital Services:
Copayment for Psychiatric Hospital Services per Stay $2290
Prior Authorization Required for Psychiatric Hospital Services
190-day limitation is combined for In-Network and Out-of-Network services

Mental health outpatient care

Medicare Covered Mental Health Services:
Coinsurance for Medicare Covered Individual Sessions 40%
Coinsurance for Medicare Covered Group Sessions 40%

Prior authorization may be required.

Outpatient services/surgery

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0 to $325
Prior Authorization Required for Outpatient Hospital Services
Minimum amount for diagnostic colonoscopies in an outpatient setting. Maximum amount for all other services.

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $325

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0 to $200
Prior Authorization Required for Ambulatory Surgical Center Services
Minimum amount for diagnostic colonoscopies in an ASC setting. Maximum amount for all other services.

Outpatient substance abuse care

Medicare Covered Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual Sessions 40%
Coinsurance for Medicare Covered Group Sessions 40%

Prior authorization may be required

Over-the-counter items

Over-The-Counter (OTC) Items:
Copayment for Over-The-Counter (OTC) Items $0

  • Maximum plan benefit of $50 every three months for Over-The-Counter (OTC) Items

  • Available through catalog purchase only


Podiatry services

Medicare Covered Podiatry Services:
Coinsurance for Medicare Covered Podiatry Services 40%

Skilled Nursing Facility (SNF) care

Skilled Nursing Facility Services:
Coinsurance for Skilled Nursing Facility per Stay 40%

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Dental care

Medicare Covered Preventive Dental:
Copayment for Office Visit $50

Non-Medicare Covered Preventive Dental:
Copayment for Non-medicare preventive $0
Copayment for Oral exams $0

  • Maximum 1 visit every six months

Copayment for Dental x-rays $0

  • Maximum 1 visit (Please see Evidence of Coverage for details)

Copayment for Other diagnostic services $0
Copayment for Prophylaxis $0

  • Maximum 1 visit every six months

Copayment for Fluoride treatment $0

  • Maximum 1 visit every six months

Copayment for Other preventive services $0

  • Maximum 1 visit every six months

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage

CoverageDetails
Vision care

Eye Exams:
Copayment for Medicare Covered Benefits $50
Copayment for Routine Eye Exams $0

  • Maximum 1 Routine Eye Exams every year


Eyewear:
Copayment for Medicare-Covered Benefits $0
Copayment for Contact Lenses $0
Copayment for Eyeglasses (lenses and frames) $0
Copayment for Eyeglass Lenses $0
Copayment for Eyeglass Frames $0
Maximum Plan Benefit of $200 every year

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Hearing care

Medicare Covered Hearing Exams Services:
Coinsurance for Medicare Covered Hearing Exams 40%

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Preventive services and health/wellness education programs

Medicare Covered Medicare-covered Preventive Services:
Copayment for Medicare Covered Medicare-covered Preventive Services $0

Prescription Drug Costs and Coverage

The ConnectiCare Flex Plan 3 (HMO-POS) offers prescription drug coverage, with an annual drug deductible of $185.00 (excludes Tiers 1 and 6)

Coverage & Cost
Coverage
Cost
Annual drug deductible$185.00 (excludes Tiers 1 and 6)
Tier 1
  • Standard retail $1.00
  • Standard mail order $1.00
Tier 6
  • Standard retail $0.00
  • Standard mail order $0.00
Annual drug deductible$185.00 (excludes Tiers 1 and 6)
Tier 1
  • Standard retail $2.00
  • Standard mail order $2.00
Tier 6
  • Standard retail $0.00
  • Standard mail order $0.00
Annual drug deductible$185.00 (excludes Tiers 1 and 6)
Tier 1
  • Standard retail $2.00
  • Standard mail order $2.00
Tier 6
  • Standard retail $0.00
  • Standard mail order $0.00

When reviewing Connecticut Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

You may be able to find plans in your part of Connecticut that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Plan Documents

Links to plan documents

Connecticut Counties Served

We offer plans from Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Healthspring, Wellcare, or Kaiser Permanente.

Back to plans in Connecticut

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