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Documents
Summary of Benefits Documents
2021 CarePartners of Connecticut HMO Plans Summary of Benefits
This document provides a summary of the coverage and costs associated with CarePartners of Connecticut HMO plans.
Prescription (Rx) and Pharmacy Documents
2021 CarePartners of Connecticut HMO Plans Formulary (List of Covered Drugs)
This document is a comprehensive formulary containing the prescription drugs covered by CarePartners of Connecticut individual HMO plans.
2021 CarePartners of Connecticut Prior Authorization Medical Necessity Guidelines
This document details the CarePartners of Connecticut Medical Necessity Guidelines. These guidelines are used by CarePartners of Connecticut to determine medical necessity and appropriateness of health care services for the purpose of determining coverage under the applicable health benefit plan.
2021 CarePartners of Connecticut Step Therapy Prior Authorization Medical Necessity Guidelines
This document details drugs that may require prior authorization or Step Therapy to be covered by CarePartners of Connecticut HMO plans. Prior Authorization means that your doctor, or prescriber, must first show that you have a medically necessary need for the drug before CarePartners of Connecticut will cover the drug cost. Step Therapy is a type of prior authorization that in most cases requires a less expensive drug, that has been proven effective for your condition, is prescribed before moving up a "step" to a more expensive drug.
CarePartners of Connecticut Transition Process
This document details what to do if your current prescription drugs are not included in the CarePartners of Connecticut formulary, or drug list, or are restricted in some way.
Part D Late Enrollment Penalty (LEP) Right to Review Reconsideration Notice
This document allows you to learn about your right to ask Medicare to review your Medicare Part D late enrollment penalty. Updated: 02/01/2021
Legal Documents
Notice of Non-Discrimination
CarePartners of Connecticut complies with applicable Federal civil rights laws and does not discriminate on the basiss of race, color, national origin, age, disability or sex.
Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed, and how you can get access to this information.
Appeals and Grievances Documents
CarePartners of Connecticut HMO Appeals and Grievances Document
This document explains how to submit a complaint to CarePartners of Connecticut in the form of an appeal or grievance.
Fraud, Waste, & Abuse
The document provides details around how CarePartners of Connecticut members can contact the CarePartners of Connecticut Fraud Hotline with questions, concerns and/or complaints related to possible wasteful, fraudulent, or abusive activity.
Plan Rating Documents
2021 CarePartners of Connecticut CareAdvantage HMO Medicare Star Ratings
This document details the Star Rating given to CarePartners of Connecticut CareAdvantage HMO plans. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov.
Provider Directories
2021 CarePartners of Connecticut HMO Provider and Pharmacy Directory
This directory provides a list of providers and pharmacies in the CarePartners of Connecticut HMO network. Updated: 5/12/2021
Evidence of Coverage Documents
2021 Evidence of Coverage | CarePartners of Connecticut CareAdvantage Preferred HMO
This document provides detailed coverage for the CarePartners of Connecticut CareAdvantage Preferred HMO plan. This information covers the 2021 calendar year, from January 1, 2021 through December 31, 2021.
2021 Evidence of Coverage | CarePartners of Connecticut CareAdvantage Premier HMO
This document provides detailed coverage for the CarePartners of Connecticut CareAdvantage Premier HMO plan. This information covers the 2021 calendar year, from January 1, 2021 through December 31, 2021.
2021 Evidence of Coverage | CarePartners of Connecticut CareAdvantage Prime HMO
This document provides detailed coverage for the CarePartners of Connecticut CareAdvantage Prime HMO plan. This information covers the 2021 calendar year, from January 1, 2021 through December 31, 2021.
Annual Notice of Change
2021 Annual Notice of Change | CarePartners of Connecticut CareAdvantage Preferred HMO
This documents details the year-over-year changes to the CarePartners of Connecticut Preferred Plan, from 2020 to 2021. It outlines how the costs and coverages for this plan have changed compared to the previous year.
2021 Annual Notice of Change | CarePartners of Connecticut CareAdvantage Premier HMO
This documents details the year-over-year changes to the CarePartners of Connecticut Premier Plan, from 2020 to 2021. It outlines how the costs and coverages for this plan have changed compared to the previous year.
2021 Annual Notice of Change | CarePartners of Connecticut CareAdvantage Prime HMO
This documents details the year-over-year changes to the CarePartners of Connecticut Prime Plan, from 2020 to 2021. It outlines how the costs and coverages for this plan have changed compared to the previous year.
Summary of Benefits Documents
2021 CarePartners of Connecticut PPO Plans Summary of Benefits
This document provides a summary of the coverage and costs associated with CarePartners of Connecticut PPO plans.
Prescription (Rx) and Pharmacy Documents
2021 CarePartners of Connecticut PPO Plans Formulary (List of Covered Drugs)
This document is a comprehensive formulary containing the prescription drugs covered by CarePartners of Connecticut individual PPO plans.
2021 CarePartners of Connecticut Prior Authorization Medical Necessity Guidelines
This document details the CarePartners of Connecticut Medical Necessity Guidelines. These guidelines are used by CarePartners of Connecticut to determine medical necessity and appropriateness of health care services for the purpose of determining coverage under the applicable health benefit plan.
2021 CarePartners of Connecticut Step Therapy Prior Authorization Medical Necessity Guidelines
This document details drugs that may require prior authorization or Step Therapy to be covered by CarePartners of Connecticut PPO plans. Prior Authorization means that your doctor, or prescriber, must first show that you have a medically necessary need for the drug before CarePartners of Connecticut will cover the drug cost. Step Therapy is a type of prior authorization that in most cases requires a less expensive drug, that has been proven effective for your condition, is prescribed before moving up a "step" to a more expensive drug.
CarePartners of Connecticut Transition Process
This document details what to do if your current prescription drugs are not included in the CarePartners of Connecticut formulary, or drug list, or are restricted in some way.
Part D Late Enrollment Penalty (LEP) Right to Review Reconsideration Notice
This document allows you to learn about your right to ask Medicare to review your Medicare Part D late enrollment penalty. Updated: 02/01/2021
Legal Documents
Notice of Non-Discrimination
CarePartners of Connecticut complies with applicable Federal civil rights laws and does not discriminate on the basiss of race, color, national origin, age, disability or sex.
Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed, and how you can get access to this information.
Appeals and Grievances Documents
CarePartners of Connecticut HMO Appeals and Grievances Document
This document explains how to submit a complaint to CarePartners of Connecticut in the form of an appeal or grievance.
Fraud, Waste, & Abuse
The document provides details around how CarePartners of Connecticut members can contact the CarePartners of Connecticut Fraud Hotline with questions, concerns and/or complaints related to possible wasteful, fraudulent, or abusive activity.
Plan Rating Documents
2021 CarePartners of Connecticut CareAdvantage PPO Medicare Star Ratings
This document details the Star Rating given to CarePartners of Connecticut CareAdvantage PPO plans. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov.
Provider Directories
2021 CarePartners of Connecticut PPO Provider and Pharmacy Directory
This directory provides a list of providers and pharmacies in the CarePartners of Connecticut PPO network. Updated: 5/12/2021
Evidence of Coverage Documents
2021 Evidence of Coverage | CarePartners of Connecticut CarePartners Access PPO
This document provides detailed coverage for the CarePartners of Connecticut CarePartners Access PPO plan. This information covers the 2021 calendar year, from January 1, 2021 through December 31, 2021.