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CarePartners Plans Compare
CarePartners Access (PPO) $0/mo Enroll in this Plan | CareAdvantage Preferred (HMO) $0.00/mo Enroll in this Plan | CareAdvantage Prime (HMO) $30.00/mo Enroll in this Plan | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Plan Essentials |
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Plan Essentials Description | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Deductible | $1,000 combined in- and out-of-network | $0 | $0 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Maximum Out of Pocket | $7,550 combined in- and out-of-network | $7,550 | $5,900 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Drugs and Drug Deductibles |
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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 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 drugs | 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
During Catastrophic Coverage Stage | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand name or 5% of cost | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Tier 2 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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 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 drugs | 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
During Catastrophic Coverage Stage | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand name or 5% of 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 drugs | 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
During Catastrophic Coverage Stage | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand name or 5% of 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 drugs | 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
During Catastrophic Coverage Stage | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand name or 5% of cost | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Tier 5 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Initial Coverage Stage | 33% of cost for 30 day retail or mail order supply | 33% of cost for 30 day retail supply | 33% of cost for 30 day retail 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 drugs | 25% of the cost of the brand name drugs; 25% of the cost of the generic name drugs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
During Catastrophic Coverage Stage | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand or 5% of cost | The greater of $3.70 generic, $9.20 brand name or 5% of cost | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Tier 6 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Vaccines | $0 | $0 | $0 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Routine Doctor Visits & Checkups |
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Routine Visits Description | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
PCP Co-Pay | INN: $0; OON: $20 per visit after deductible | $0 per visit | $0 per visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Telehealth | Medicare-covered services plus additional telehealth services. Additional telehealth services include but are not limited to: primary care physician services, specialist services, individual sessions for mental health and psychiatric services, opioid treatment program services, observation services, and individual sessions for outpatient substance abuse. Applicable office visit costshare applies for non-opioid treatment program telehealth services. Opioid treatment program services cost-share applies to telehealth services rendered as part of an opioid treatment program services episode. | Medicare-covered services plus additional telehealth services. Additional telehealth services include but are not limited to: primary care physician services, specialist services, individual sessions for mental health and psychiatric services, opioid treatment program services, observation services, and individual sessions for outpatient substance abuse. Applicable office visit costshare applies for non-opioid treatment program telehealth services. Opioid treatment program services cost-share applies to telehealth services rendered as part of an opioid treatment program services episode. | Medicare-covered services plus additional telehealth services. Additional telehealth services include but are not limited to: primary care physician services, specialist services, individual sessions for mental health and psychiatric services, opioid treatment program services, observation services, and individual sessions for outpatient substance abuse. Applicable office visit costshare applies for non-opioid treatment program telehealth services. Opioid treatment program services cost-share applies to telehealth services rendered as part of an opioid treatment program services episode. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cardiovascular Screening | INN: $0; OON: 30% | $0 per annual visit | $0 per annual visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cancer Screening (Colorectal, Prostate, Breast) | INN: $0; OON: 30% | $0 per annual visit | $0 per annual visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Routine Vision Exam | INN: $0; OON: 30% after deductible | $15 per annual visit | $15 per annual visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Eyewear Benefit | $150 allowance per calendar year | $150 annual allowance through EyeMed | $150 annual allowance through EyeMed | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Routine Hearing Exam | INN: $0; OON: $50 per visit after deductible | $45 per annual visit | $40 per annual visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Specialty Visits, Surgery & Exams |
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Specialty Visits Description | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Specialist Co-Pay | INN: $45 per visit; OON: $50 per visit after deductible | $45 per visit | $40 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Physical/Occupational/Speech Therapy | INN: $40 per visit; OON: 30% after deductible | $40 per visit | $40 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Lab Services | INN: $0; OON: 30% after deductible | FIT Tests: $0; Others: $5 per day | FIT Tests: $0; Others: $5 per day | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
X-rays | INN: $10 per day; OON: 30% after deductible | $10 per day | $10 per day | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnostic Tests | INN: $40 per day; OON: 30% after deductible | $30 per day | $15 per day | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnostic Radiology Services | INN: Ultrasound: $60 per day; Others: $250 per day; OON: 30% after deductible | Ultrasound: $60 per day; Others: $250 per day | Ultrasound: $60 per day; Others: $250 per day | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Outpatient Services | INN: Colonoscopies: $0; Others: $250 per day after deductible; OON: 30% after deductible | Colonoscopy: $0; Others: $350 per day | Colonoscopies: $0; Others: $275 per day | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Unforeseen Care, Emergency Services & Hospital Stays |
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Unforeseen Care Description | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Urgent Care | $45 per visit | PCP: $0; Specialist: $45 per visit | PCP: $0; Specialist: $40 per visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Ambulance Rides and Services | INN: $325 per one-way trip; OON: $325 per one-way trip after deductible | $300 per day | $250 per day | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Emergency Room Visits | $90 per visit | $90 per visit | $90 per visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Inpatient Hospital Coverage | INN: $795 per stay after deductible; OON: 30% per stay after deductible | $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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Benefits |
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Embedded Dental Benefits | $1,000 yearly maximum. $0 for preventive services such as cleanings and oral exams, 50% coinsurance for restorative services such as fillings and simple extractions, and 50% coinsurance for major services such as dentures, bridges, and crowns. No waiting period. | $1,500 yearly maximum. $0 for preventive services such as cleanings and oral exams, 50% coinsurance for restorative services such as fillings and simple extractions, and 50% coinsurance for major services such as dentures, bridges, and crowns. $100 deductible on restorative and major services. No waiting period. | $750 yearly maximum. $25 copay for preventive services such as cleaning and oral exams, and 50% coinsurance for restorative services such as fillings and simple extractions. $100 deductible on restorative services. No waiting period. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
CarePerks Health & Wellness Allowance | Not Covered. | $325 CarePerks health and wellness allowance. ($150 reimbursement towards weight management programs like WeightWatchers, Jenny Craig, and hospital-based programs. $175 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 and nutritional programs). | Not included. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
SilverSneakers Membership | INN: 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. OON: You pay $0 for at-home exercise kits. | 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. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Over-The-Counter (OTC) Bonus | $50 per calendar quarter to use towards covered OTC items. No rollover of unused calendar quarter balance. See Evidence of Coverage (EOC) for more information. | $25 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 Plus Level $1,150 Premier Level |
$250 Standard Level $475 Superior Level $650 Advanced Level $850 Advanced Level $1,150 Premier Level |
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Weight Management Programs | Not Covered. | 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. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Wellness Allowance | Not Covered. | See “CarePerks Health & Wellness Allowance” above. | Not included. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Acupuncture | INN: $10 per visit; OON: $50 per visit after deductible | $10 per visit | $10 per visit | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Embedded Dental Benefits |
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Individual Annual Deductible |
$0 |
$100 on Class 2 and 3 Services |
$100 on Class 2 Services ($100 on Class 2 and 3 Services with CarePartners of Connecticut Dental Option). |
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Calendar Year Maximum |
The plan pays up to the calendar year maximum of $1,000. |
The plan pays up to the calendar year maximum of $1,500. |
The plan pays up to the calendar year maximum of $750 ($1,000 with CarePartners of Connecticut Dental Option). |
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Periodic Oral Evaluation |
$0 copay; Once every 36 months (includes the initial dental history and charting of teeth). |
$0 copay; Once every 36 months (includes the initial dental history and charting of teeth). |
$25 copay; Once every 36 months (includes the initial dental history and charting of teeth). |
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Comprehensive Oral Exam |
$0 copay; Two per year (when oral conditions indicate need). |
$0 copay; Two per year (when oral conditions indicate need). |
$25 copay; Two per year. (when oral conditions indicate need). |
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Intra Oral Bitewing X-ray (X-ray of Crowns of Teeth) |
50% coinsurance; Once every 60 months. |
50% coinsurance after deductible; Once every 60 months. |
50% coinsurance after deductible; Once every 60 months. (20% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Intra Oral X-ray - Entire Mouth (Panoramic & Full Mouth) |
50% coinsurance; As needed. |
50% coinsurance after deductible; As needed. |
50% coinsurance after deductible; As needed. (20% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Single Tooth X-ray Images |
50% coinsurance; Once every 24 months per surface per tooth. |
50% coinsurance after deductible; Once every 24 months per surface per tooth. |
50% coinsurance after deductible; Once every 24 months per surface per tooth. (20% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Silver Filling and White Fillings (Front Teeth) |
50% coinsurance; Once every 6 months (following active periodontal therapy, not to be combined with regular cleanings). |
50% coinsurance after deductible; Once every 6 months (following active periodontal therapy, not to be combined with regular cleanings). |
50% coinsurance after deductible; Once every 6 months (following active periodontal therapy, not to be combined with regular cleanings). (20% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Periodontal Cleaning |
50% coinsurance; Once per tooth. |
50% coinsurance after deductible; Once per tooth. |
50% coinsurance after deductible; Once per tooth. (20% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Simple Extractions |
50% coinsurance; Once per tooth. |
50% coinsurance after deductible; Once per tooth. |
Not covered. (50% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Surgical Extractions |
50% coinsurance; Once per tooth. |
50% coinsurance after deductible; Once per tooth. |
Not covered. (50% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Bridge or Denture Repair |
50% coinsurance; Once every 24 months per bridge or denture. |
50% coinsurance after deductible; Once every 24 months per bridge or denture. |
Not covered. (50% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Dentures (Complete or Partial) |
50% coinsurance; Once per arch within 84 months. |
50% coinsurance after deductible. Once per arch within 84 months. |
Not covered. (50% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Crowns and Onlays (Initial Placement) |
50% coinsurance; Once within 84 months per tooth (when teeth cannot be restored with regular filings due to fracture or decay). |
50% coinsurance after deductible; Once within 84 months per tooth (when teeth cannot be restored with regular filings due to fracture or decay). |
Not covered. (50% coinsurance after deductible with CarePartners of Connecticut Dental Option). |
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Enroll in this Plan | Enroll in this Plan |