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Summary of Benefits Documents
2025 CarePartners of Connecticut HMO Plans Summary of Benefits
This document provides a summary of the coverage and costs associated with CarePartners of Connecticut PPO plans.
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View Document called 2025 CarePartners of Connecticut HMO Plans Summary of BenefitsPrescription (Rx) and Pharmacy Documents
2025 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 HMO plan.
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View Document called 2025 CarePartners of Connecticut HMO Plans Formulary (List of Covered Drugs)2025 CarePartners of Connecticut Prior Authorization Medical Necessity Guidelines (HMO/PPO)
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.
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View Document called 2025 CarePartners of Connecticut Prior Authorization Medical Necessity Guidelines (HMO/PPO)2025 CarePartners of Connecticut Step Therapy Prior Authorization Medical Necessity Guidelines (HMO/PPO)
This document details drugs that may require prior authorization or Step Therapy to be covered by CarePartners of Connecticut HMO and Access (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.
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View Document called 2025 CarePartners of Connecticut Step Therapy Prior Authorization Medical Necessity Guidelines (HMO/PPO)CarePartners of Connecticut Network Pharmacy Search
Use the link below to determine if a pharmacy is within the preferred pharmacy network.
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View Document called CarePartners of Connecticut Network Pharmacy SearchCarePartners of Connecticut Transition Plan 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.
View Document called CarePartners of Connecticut Transition Plan ProcessMedicare Prescription Payment Plan Fact Sheet
This fact sheet outlines information regarding the Medicare Prescription Payment Plan which is a new payment option in the prescription drug law that works with your current drug coverage to help you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January-December). Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can use this payment option. All plans offer this payment option and participation is voluntary. This payment option might help you manage your expenses, but it doesn’t save you money or lower your drug costs.
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View Document called Medicare Prescription Payment Plan Fact SheetPart 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.
View Form called Part D Late Enrollment Penalty (LEP) Right to Review Reconsideration NoticeDental Coverage Documents
2025 Dominion National Utilization Review Guidelines
Dominion National’s Utilization Review (UR) Guidelines explain the criteria used to review pre-treatment estimates, pre-authorization requests and/or claims, whenever clinical review is performed. The Guidelines were formulated based on generally accepted dental standards and information gathered from practicing dentists, dental schools, insurance companies, as well as other dental related organizations.
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View Document called 2025 Dominion National Utilization Review GuidelinesLegal 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.
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View Document called Notice of Non-DiscriminationNotice 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.
View Document called Notice of Privacy PracticesAppeals and Grievances Documents
CarePartners of Connecticut Appeals and Grievances Document
This document explains how to submit a complaint to CarePartners of Connecticut in the form of an appeal or grievance.
View Document called CarePartners of Connecticut Appeals and Grievances DocumentFraud, 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.
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View Document called Fraud, Waste & AbusePlan Rating Documents
2025 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.
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View Document called 2025 CarePartners of Connecticut CareAdvantage HMO Medicare Star RatingsProvider Directories
CarePartners of Connecticut HMO Member Directory
These directories provide a full list of providers and pharmacies in the CarePartners of Connecticut network. These directories are updated daily and are current as of the date located in the footer on each page.
View Document called CarePartners of Connecticut HMO Member DirectoryEvidence of Coverage Documents
2025 Evidence of Coverage | CarePartners of Connecticut CareAdvantage Preferred HMO
This document provides detailed coverage for the CarePartners of Connecticut CareAdvantage Preferred HMO plan.
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View Document called 2025 Evidence of Coverage | CarePartners of Connecticut CareAdvantage Preferred HMOAnnual Notice of Change
2025 Annual Notice of Change | CarePartners of Connecticut CareAdvantage Preferred HMO
This document provides detailed coverage for the CarePartners of Connecticut CareAdvantage Preferred HMO plan.
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View Document called 2025 Annual Notice of Change | CarePartners of Connecticut CareAdvantage Preferred HMOPPO
Summary of Benefits Documents
2025 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.
Last Updated:
View Document called 2025 CarePartners of Connecticut PPO Plans Summary of BenefitsPrescription (Rx) and Pharmacy Documents
2025 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 PPO plan.
Last Updated:
View Document called 2025 CarePartners of Connecticut PPO Plans Formulary (List of Covered Drugs)2025 CarePartners of Connecticut Prior Authorization Medical Necessity Guidelines (HMO/PPO)
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.
Last Updated:
View Document called 2025 CarePartners of Connecticut Prior Authorization Medical Necessity Guidelines (HMO/PPO)2025 CarePartners of Connecticut Step Therapy Prior Authorization Medical Necessity Guidelines (HMO/PPO)
This document details drugs that may require prior authorization or Step Therapy to be covered by CarePartners of Connecticut HMO and Access (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.
Last Updated:
View Document called 2025 CarePartners of Connecticut Step Therapy Prior Authorization Medical Necessity Guidelines (HMO/PPO)CarePartners of Connecticut Network Pharmacy Search
Use the link below to determine if a pharmacy is within the preferred pharmacy network.
Last Updated:
View Document called CarePartners of Connecticut Network Pharmacy SearchCarePartners of Connecticut Transition Plan 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.
View Document called CarePartners of Connecticut Transition Plan ProcessMedicare Prescription Payment Plan Fact Sheet
This fact sheet outlines information regarding the Medicare Prescription Payment Plan which is a new payment option in the prescription drug law that works with your current drug coverage to help you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January-December). Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can use this payment option. All plans offer this payment option and participation is voluntary. This payment option might help you manage your expenses, but it doesn’t save you money or lower your drug costs.
Last Updated:
View Document called Medicare Prescription Payment Plan Fact SheetPart 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.
View Form called Part D Late Enrollment Penalty (LEP) Right to Review Reconsideration NoticeLegal 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.
Last Updated:
View Document called Notice of Non-DiscriminationNotice 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.
View Document called Notice of Privacy PracticesAppeals and Grievances Documents
CarePartners of Connecticut Appeals and Grievances Document
This document explains how to submit a complaint to CarePartners of Connecticut in the form of an appeal or grievance.
View Document called CarePartners of Connecticut Appeals and Grievances DocumentFraud, 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.
Last Updated:
View Document called Fraud, Waste & AbusePlan Rating Documents
2025 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.
Last Updated:
View Document called 2025 CarePartners of Connecticut CareAdvantage PPO Medicare Star RatingsProvider Directories
CarePartners of Connecticut PPO Member Directory
These directories provide a full list of providers and pharmacies in the CarePartners of Connecticut network. These directories are updated daily and are current as of the date located in the footer on each page.
View Document called CarePartners of Connecticut PPO Member DirectoryEvidence of Coverage Documents
2025 Evidence of Coverage | CarePartners of Connecticut Carepartners Access PPO
This document provides detailed coverage for the CarePartners of Connecticut CarePartners Access PPO plan.
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View Document called 2025 Evidence of Coverage | CarePartners of Connecticut Carepartners Access PPOAnnual Notice of Change
2025 Annual Notice of Change | CarePartners of Connecticut CarePartners Access PPO
This document provides detailed coverage for the CarePartners of Connecticut CareAdvantage Access PPO plan.
Last Updated:
View Document called 2025 Annual Notice of Change | CarePartners of Connecticut CarePartners Access PPO