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Documents
Summary of Benefits Documents
2019 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
2019 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.
2019 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.
2019 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 to a more expensive drug.
CarePartners of Connecticut HMO Transition Process
This document details what to do if your current prescription drugs are not included in the CarePartners of Connecticut HMO formulary, or drug list, or are restricted in some way.
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.
Evidence of Coverage Documents
2019 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 2019 calendar year, from January 1, 2019 through December 31, 2019.
2019 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 2019 calendar year, from January 1, 2019 through December 31, 2019.
2019 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 2019 calendar year, from January 1, 2019 through December 31, 2019.
Appeals and Grievances Documents (coming soon)
Provider Directories
2019 CarePartners of Connecticut HMO Provider Directory with Addendum
This directory provides a list of providers in the CarePartners of Connecticut network. Updated on: 2/28/19