ConnectiCare Flex Plan 3 (HMO-POS)

3.5 out of 5 stars
$41.00
Monthly Premium

ConnectiCare Flex Plan 3 (HMO-POS) is a HMO-POS plan offered by CONNECTICARE, INC.

Plan ID: H3528-011

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.

Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.

Learn more about Medicare Advantage plans such as ConnectiCare Flex Plan 3 (HMO-POS) - H3528-011 by CONNECTICARE, INC. as well as other Medicare Advantage plans available in your area.

$41.00
Monthly Premium

Connecticut Counties Served

HartfordLitchfieldMiddlesexTolland

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $185
Out of Pocket Max In-Network: $6750
Out-of-Network: 10000
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit


Doctor Office Visit:
Copayment for Primary Care Office Visit $5
Specialty Doctor Visit



Doctor Specialty Visit Services:
Coinsurance for Physician Specialist Office Visit $40%
Inpatient Hospital Care
In-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 additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services

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

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $15
Diabetes Supplies, Training, Nutrition Therapy and Monitoring


Diabetic Supplies and Services:
Coinsurance for Medicare-covered Diabetic Supplies 20%
Coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts 20%
Durable Medical Equipment (DME)

Durable Medical Equipment:
Coinsurance for Medicare-covered Durable Medical Equipment 10% to 20%
Prior Authorization Required for Durable Medical Equipment
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

Outpatient Diag Procs/Tests/Lab Services:
Copayment for Medicare-covered Diagnostic Procedures/Tests $25
Copayment for Medicare-covered Lab Services $0 to $15
Prior Authorization Required for Outpatient Diag Procs/Tests/Lab Services

Outpatient Diag/Therapeutic Rad Services:
Copayment for Medicare-covered Diagnostic Radiological Services $0 to $275
Coinsurance for Medicare-covered Therapeutic Radiological Services 20%
Copayment for Medicare-covered X-Ray Services $45

Prior Authorization Required for Pulmonary Rehabilitation Services
Home Health Care

Medicare Covered Home Health Services:
Coinsurance for Medicare Covered Home Health 40%
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


Medicare Covered Outpatient Hospital Services:
Coinsurance for Medicare Covered Outpatient Hospital Services 40%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 40%
Minimum amount for diagnostic colonoscopies in an outpatient 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%

Outpatient Substance Abuse Services:
Copayment for Medicare-covered Individual Sessions $40
Copayment for Medicare-covered Group Sessions $40
Prior Authorization Required for Outpatient Substance Abuse Services
Over-the-counter (OTC) 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%

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $50
Skilled Nursing Facility Care


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

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care

Medicare Covered Preventive Dental Services:
Coinsurance for Medicare Covered Preventive Dental 40%

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits


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 from in-network providers.

Coverage Cost
Hearing Benefits

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

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs


$0.00 copay for Medicare Covered Preventive Services:

Abdominal aortic aneurysm screening
Alcohol misuse screenings & counseling
Bone mass measurements (bone density)
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screening
Colorectal cancer screenings
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma tests
Hepatitis B (HBV) infection screening
Hepatitis C screening test
HIV screening
Lung cancer screening
Mammograms (screening)
Nutrition therapy services
Obesity screenings & counseling
One-time Welcome to Medicare preventive visit
Prostate cancer screenings(PSA)
Sexually transmitted infections screening & counseling
Shots:

  • COVID-19 shots

  • Flu shots

  • Hepatitis B shots

  • Pneumococcal shots

  • Tobacco use cessation

  • Yearly "Wellness" visit

Prescription Drug Costs and Coverage

The ConnectiCare Flex Plan 3 (HMO-POS) plan offers the following prescription drug coverage, with an annual drug deductible of $185 (excludes Tiers 1 and 6) per year.

Coverage Cost
Coverage & Cost
Annual Drug Deductible $185 (excludes Tiers 1 and 6)
Preferred Generic
  • Standard retail $1.00
  • Standard mail order $1.00
Select Care Drugs
  • Standard retail $0.00
  • Standard mail order $0.00
Annual Drug Deductible $185 (excludes Tiers 1 and 6)
Preferred Generic
  • Standard retail $2.00
  • Standard mail order $2.00
Select Care Drugs
  • Standard retail $0.00
  • Standard mail order $0.00
Annual Drug Deductible $185 (excludes Tiers 1 and 6)
Preferred Generic
  • Standard retail $2.00
  • Standard mail order $2.00
Select Care Drugs
  • Standard retail $0.00
  • Standard mail order $0.00
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