2020 Benefit Changes
The following changes are effective on or after January 1, 2020, upon the plan’s effective or renewal date:
Referral Requirement
- Removed referral requirement for services rendered by in-network providers
Note: PCPs must continue to issue referrals for CarePartners of Connecticut members to see an out-of-network provider or specialist.
Great Dental Benefit
- Replaced preventive dental allowance with embedded benefits offered through Dominion National
- $1,500 annual maximum benefit on Preferred plan services covering preventive, restorative and comprehensive services; cost shares may apply
- $750 annual maximum benefit on Prime and Premier plans covering preventive and restorative services; member cost shares may apply
- Optional buy-up available for Prime and Premier members for additional $16 per month to reduce cost share on restorative services and add 50% coverage for comprehensive services
- No waiting period
Improved Rx Coverage
- Removed deductibles from all plans
- Introduced a preferred pharmacy network with $0 copay on Tier 1 drugs
- Introduced a vaccine tier to cover common vaccines at $0
New Wellness Allowance (Part of the CarePerks Benefit Package)
New $200 per year Wellness Allowance available toward the purchase of a fitness tracker, membership fees to a qualified fitness facility, participation in instructional fitness classes and more. Allowance is part of the CarePerks package that also includes the separate $150 per year Weight Management Program allowance
New Over-the-Counter (OTC) Bonus
- Introduced a $40 per calendar quarter OTC bonus on the Prime and Premier plans
- Available toward purchase of Medicare-approved items
Other Changes
- Added new tier for premier-level hearing aids through Hearing Care Solutions
- Lowered routine eye exam copay to $15
- Added full membership to BrainHQ memory fitness training at no cost to the member
- Removed additional copay from labs, tests and X-rays when rendered as part of an office visit. Members will only pay the office copay, not the additional copay for the service.
- Lowered copay of ultrasounds to $60
- Introduced a 20% coinsurance on dialysis services
Note: This is a summary of changes. Before services are rendered, providers are reminded to check member benefits and cost-share amounts using CarePartners of Connecticut’s secure Provider website or other self-service channels, even for members seen on a regular basis.