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Our commitment is to provide you with the best health coverage possible. Compare your plan options side-by-side to find the one that fits your lifestyle and your budget. 

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CarePartners Plans Compare

CareAdvantage Preferred (HMO) $0.00/mo Enroll in this Plan CareAdvantage Prime (HMO) $29.00/mo Enroll in this Plan CareAdvantage Premier (HMO) $89.00/mo Enroll in this Plan

Plan Essentials
Plan Essentials Description
Deductible $0 $0 $0
Maximum Out of Pocket $6,700 $4,900 $3,700

Drugs and Drug Deductibles
Drugs Description Drug costs shown for Tier 1 and Tier 2 are reflective of Preferred Pharmacy pricing. Please use our Preferred Pharmacy Directory at carepartnersct.com/pharmacy to find a location near you. Drug costs shown for Tier 1 and Tier 2 are reflective of Preferred Pharmacy pricing. Please use our Preferred Pharmacy Directory at carepartnersct.com/pharmacy to find a location near you. Drug costs shown for Tier 1 and Tier 2 are reflective of Preferred Pharmacy pricing. Please use our Preferred Pharmacy Directory at carepartnersct.com/pharmacy to find a location near you.
Drug Deductible $0 $0 $0
Tier 1
Initial Coverage Stage $0 for 30 day retail supply; $0 for 90 day mail order supply $0 for 30 day retail supply; $0 for 90 day mail order supply $0 for 30 day preferred retail supply; $0 for 90 day mail order supply
During Coverage Gap Stage 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs
During Catastrophic Coverage Stage The greater of $3.60 generic, $8.95 brand or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of the cost
Tier 2
Initial Coverage Stage $10 for 30 day retail supply; $20 for 90 day mail order supply $10 for 30 day retail supply; $20 for 90 day mail order supply $10 for 30 day preferred retail supply; $20 for 90 day mail order supply
During Coverage Gap Stage 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs
During Catastrophic Coverage Stage The greater of $3.60 generic, $8.95 brand or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of the cost
Tier 3
Initial Coverage Stage $47 for 30 day retail supply; $94 for 90 day mail order supply $47 for 30 day retail supply; $94 for 90 day mail order supply $47 for 30 day retail supply; $94 for 90 day mail order supply
During Coverage Gap Stage 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs
During Catastrophic Coverage Stage The greater of $3.60 generic, $8.95 brand or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of the cost
Tier 4
Initial Coverage Stage $100 for 30 day retail supply; $200 for 90 day mail order supply $100 for 30 day retail supply; $200 for 90 day mail order supply $100 for 30 day retail supply; $200 for 90 day mail order supply
During Coverage Gap Stage 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs
During Catastrophic Coverage Stage The greater of $3.60 generic, $8.95 brand or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of the cost
Tier 5
Initial Coverage Stage 33% of cost 33% of cost 33% of cost
During Coverage Gap Stage 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs 25% of the cost of the brand name drugs; 25% of the cost of the generic drugs
During Catastrophic Coverage Stage The greater of $3.60 generic, $8.95 brand or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of cost The greater of $3.60 generic, $8.95 brand name or 5% of the cost
Tier 6
Vaccines $0 $0 $0

Routine Doctor Visits & Checkups
Routine Visits Description
Doctor Co-Pay $0 per visit $0 per visit $0 per visit
Cardiovascular Screening $0 per annual visit $0 per annual visit $0 per annual visit
Cancer Screening (Colorectal, Prostate, Breast) $0 per annual visit $0 per annual visit $0 per annual visit
Routine Vision Exam $15 per annual visit $15 per annual visit $15 per annual visit
Eyewear Benefit $150 annual allowance $150 annual allowance $150 annual allowance
Routine Hearing Exam $45 per annual visit $40 per annual visit $30 per annual visit

Specialty Visits, Surgery & Exams
Specialty Visits Description
Specialist Co-Pay $45 $40 $30
Physical/Occupational/Speech Therapy $40 $40 $30
Lab Services $0 - $5 $0 - $5 $0 - $5
X-rays $0 - $10 $0 - $10 $0 - $10
Diagnostic Procedures $0 - $30 $0 - $15 $0 - $10
Diagnostic Radiology Services $60 - $250 $60 - $250 $60 - $150
Outpatient Services $350 per day $275 per day $250 per day

Unforseen Care, Emergency Services & Hospital Stays
Unforeseen Care Description
Urgent Care $0 - $45 per visit $0 - $40 per visit $0 - $30 per visit
Ambulance Rides and Services $300 per day $250 per day $200 per day
Emergency Room Visits $90 per visit $90 per visit $90 per visit
Inpatient Hospital Coverage $475 per day for days 1-4; $0 per day for day 5 and beyond $375 per day for days 1-4; $0 per day for day 5 and beyond $250 per day for days 1-5; $0 per day for day 6 and beyond

Benefits
Embedded Dental Benefits $1,500 of dental coverage every year. $0 copy for preventive visits and services (e.g. cleanings, x-rays). 50% coinsurance on bridges, dentures, crowns and more. Access to thousands of dentists across the region. No waiting period. (Limited network under Dominion National) $750 dental benefit that includes coverage for preventive visits with $25 copay and 50% coinsurance after deductible for fillings, simple extractions, and more. (Limited network under Dominion National). $750 dental benefit that includes coverage for preventive visits with $25 copay and 50% coinsurance after deductible for fillings, simple extractions, and more. (Limited network under Dominion National)
CarePerks Health & Wellness Allowance $350 CarePerks health and wellness allowance. ($150 reimbursement towards weight management programs like WeightWatchers, Jenny Craig, and hospital-based programs. $200 wellness benefit good towards a fitness tracker once every 3 years, a membership at a qualified health club or fitness facility, yoga classes, memory fitness, nutritional programs and weight management programs). Not included. Not included.
SilverSneakers Membership You receive a SilverSneakers fitness membership at no additional cost giving you access to 16,000+ gyms nationwide, trained instructors, classes and health and nutrition tips with exercise videos. You receive SilverSneakers fitness membership at no additional cost giving you access to 16,000+ gyms nationwide, trained instructors, classes and health and nutrition tips with exercise videos. You receive SilverSneakers fitness membership at no additional cost giving you access to 16,000+ gyms nationwide, trained instructors, classes and health and nutrition tips with exercise videos.
Over-The-Counter (OTC) Bonus Not included. $40 every calendar quarter for the purchase of covered over-the-counter (OTC) items such as bandages and toothbrushes. $40 every calendar quarter for the purchase of covered over-the-counter (OTC) items such as bandages and toothbrushes.
Hearing Aid Benefit $250 Standard Level
$475 Superior Level
$650 Advanced Level
$850 Advanced Plus Level
$1,150 Premier Level 		$250 Standard Level
$475 Superior Level
$650 Advanced Level
$850 Advanced Level
$1,150 Premier Level 		$250 Standard Level
$475 Superior Level
$650 Advanced Level
$850 Advanced Plus Level
$1,150 Premier Level
Weight Management Programs See “CarePerks Health & Wellness Allowance” above. $150 Reimbursement. You are reimbursed up to $150 towards programs fees related to weight management programs like WeightWatchers, Jenny Craig, and hospital based programs. $150 Reimbursement. You are reimbursed up to $150 towards program fees related to weight management programs like WeightWatchers, Jenny Craig, and hospital based programs.
Wellness Allowance See “CarePerks Health & Wellness Allowance” above. Not included. Not included.
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