ConnectiCare


ConnectiCare, Inc. & Affiliates is a managed-care company based in Farmington, Conn., and a member of the HIP (Health Insurance Plan of New York) Family of Health Plans. Serving more than 240,000 members, ConnectiCare has a participating provider network that includes Connecticut, Western Massachusetts and Orange, Putnam, Rockland and Westchester counties in New York.

With ConnectiCare SOLO, health insurance doesn’t have to be confusing or scary. Their individual health plans are backed by the same outstanding service that has made ConnectiCare a sought-after health plan for years. Below is the different plans from ConnectiCare.

How SOLO is Different

Plans You Can Understand

Ever think some insurance companies are trying to make things confusing? It’s like they’re working to make their plans too complicated to understand, rather than focusing on keeping you well.

ConnectiCare SOLO is taking the opposite approach. We believe that health plans work best when people know what they’re getting. That’s why you’ll always get a straight answer from us, straight from our Connecticut headquarters.

Benefits of ConnectiCare SOLO:

  • Open Access – No need to seek a referral  before visiting a specialist
  • Industry-leading Service – Highest member satisfaction score in Connecticut1
  • TouchPoints Program for Staying Healthy – Plus guidance and support to get there
  • Local Customer Service – Direct from our Farmington, CT headquarters
  • Quality Coverage – “Excellent” accreditation from NCQA2
  • Wide Choice – Selection of plans at different coverage levels
  • Extensive Provider Network – Choose from more than 20,000 health care professionals.

POS Hospital Deductible Plans

The POS Hospital Deductible Plans apply a deductible only to services that are provided by a hospital or an outpatient facility, either for inpatient or outpatient Ambulatory Services. Copayments apply for most other services provided by doctors and other healthcare providers in our extensive network, who are known as in-network providers.

There is a separate plan deductible for the contract year that applies when you use out-of-network providers that involve providers outside of the ConnectiCare network, or out-of-network providers. The plan deductible does not apply when you use in-network providers.

Key Benefits:

  • Freedom to choose in-network providers and out-of-network providers
  • Choice of 3 prescription drug coverage options: $1,000 contract year maximum, a $5,000 contract year maximum or a $200 deductible. You may also choose not to elect prescription drug coverage.
  • Copayments for most in-network services

These plans are now compliant with the new Health Care Reform law, in which preventive care is not subject to member cost-share.

POS Upfront Deductible Plans

In a Point-of-Service Upfront Deductible Plan, most health care services you receive apply to a plan deductible, even when you are using an in-network provider. Once this contract year
plan deductible is met, we pay for the services subject to a copayment or coinsurance amount that is paid by you.

Key Benefits of POS Upfront Deductible Plans:

  • The higher the upfront deductible, the lower the plan premium will be
  • Upfront deductible helps with budgeting for medical expenses
  • Separate in-network contract year plan deductibles for individual and family
  • Separate out-of-network contract year plan deductible for individual and family

These plans are now compliant with the new Health Care Reform law, in which preventive care is not subject to member cost-share.

POS High-Deductible Health Plans (Compatible with Health Savings Account)

Our High-Deductible Health Plans (HDHP) are a good choice if you are comfortable with greater cost-sharing in exchange for a lower monthly plan premium.

With an HDHP , you are required to meet an upfront deductible for the contract year. The deductible amount varies according to the plan you choose. In general, the higher the upfront deductible, the lower the monthly plan premium. Once the deductible is met, covered services will be subject to a Copayment or coinsurance.

If you are attracted to the premium savings of a ConnectiCare SOLO High-Deductible Health Plan (HDHP), you may wish to combine it with a Health Savings Account (HSA). (Do not open the HSA until your application to a ConnectiCare SOLO HDHP is approved.) HSAs offer tax advantages that make it easier to set aside money for meeting the health plan deductible. Click here to learn more about the advantages of an HSA.

Key Benefits:

  • Low premiums
  • Plan begins to provide benefits after you reach the contract year plan deductible
  • Visit participating providers to receive the greatest level of benefits
  • Visit the doctor of your choice out-of-network for a higher cost-share
  • An HSA solution offers a tax-advantaged way for meeting the plan deductible

Qualified Medical Expenses

The savings in an HSA can be used for any IRS-qualified medical expenses, including some that are not covered by the ConnectiCare SOLO plan. These expenses include over-the-counter drugs, eyeglasses, dental services, prescriptions and other medical supplies. For a partial list of qualified and non-qualified expenses, please refer to IRS Publication 502.

HMO High-Deductible Health Plan (Compatible with Health Savings Account)

This high-deductible health plan allows you to see any participating specialist without first obtaining a referral from your PCP. You must meet a contract-year individual plan deductible or contract-year family plan deductible before the plan begins to provide benefits. If you are attracted to the premium savings of a ConnectiCare SOLO High-Deductible Health Plan (HDHP), you may wish to combine it with a Health Savings Account (HSA). (Do not open the HSA until your application to a ConnectiCare SOLO HDHP is approved.) HSAs offer tax advantages that make it easier to set aside money for meeting the health plan deductible.

HMO HSA Compatible Plan

With the HMO HSA-Compatible Plan, there is no member cost-share after the contract year plan deductible.

Key Benefits:

  • No member cost after plan deductible
  • The only plan that includes maternity coverage
  • An HSA solution offers a tax-advantaged way for meeting the plan deductible

Individual Dental Plan

Oral Health And Overall Health

Your oral health says a lot about your overall health. Regular dental checkups are necessary to maintain your good health and the good health of your family. The human mouth teems with bacteria, most of which is normally kept in check by daily brushing and flossing. When harmful bacteria grows out of control, it causes tooth decay, gum disease and other problems. During a preventive exam or dental checkup, dentists can detect much more than cavities and broken fillings. Dentists spot oral characteristics of certain medical conditions – from osteoporosis and diabetes to heart and kidney disease – before they become serious and costly to treat.

Take care of your oral health to help maintain your overall health. A ConnectiCare Dental plan can help you do that.