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| Go to ConnectiCare Menu |
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| Up Front Deductible Plans |
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| •HMO- up front plan: This plan allows you to see any medical doctor or provider inside the ConnectiCare network. This plan includes coverage for prescriptions. There are 2 plans, a $1500 or $2500 deductible plans. There are 6 prescription options for each. Below is 1 example and a link to more information and plans. |
| HMO Up Front $2500 Deductible Plan, with $1000 Prescriptions |
| Coverage |
You Pay |
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| Preventative Care |
Free or Copay |
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| Prescriptions $1000 |
10/20/35 |
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| All Other Medical Care-hospital, surgery, doctors, etc |
$2500 Yearly Deductible then see below |
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Monthly Costs |
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| Coverage |
You Pay |
Age |
Male |
Female |
2 Person |
Family |
Age |
| Doctor Copay |
$25 |
0-29 |
109.54 |
183.63 |
302.79 |
488.12 |
0-29 |
| Specialist Copay |
$35 |
30-34 |
144.13 |
205.41 |
307.27 |
547.79 |
30-34 |
| In Hospital Costs
per person |
$100 per day
$500 per year |
35-39 |
144.13 |
205.41 |
307.27 |
547.79 |
35-39 |
40-44 |
175.32 |
222.28 |
336.96 |
583.57 |
40-44 |
| Out Patient Surgery |
$100 per visit |
45-49 |
202.86 |
244.70 |
374.11 |
608.56 |
45-49 |
| Diagnostic Tests |
Free |
50-54 |
260.50 |
283.99 |
484.50 |
673.68 |
50-54 |
| Simple Xrays |
Free |
55-59 |
343.79 |
358.72 |
632.69 |
815.69 |
55-59 |
| Prescriptions $1000 |
10/20/35
| 60-64 |
453.33 |
428.14 |
802.88 |
961.74 |
60-64 |
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| Get more information on coverages and more HMO - Upfront Deductible plans |
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• POS – Up front plan: This optional plan allows you to visit any doctor in network(HMO), and allows you to go to doctors out of the network (POS). There are 3 plans 500, 1000, 2000 deductible plans.
Note: This plan allows for you to remove the prescription drug coverage to reduce the monthly cost even further. |
| POS - Up Front $2000 Deductible Plan, with No Prescription Coverage |
| Coverage |
You Pay |
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| Preventative Care |
Free or Copay |
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| Prescriptions $1000 |
10/20/35 |
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| All Other Medical Care-hospital, surgery, doctors, etc |
$2500 Yearly Deductible then see below |
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| Coverage |
You Pay |
Age |
Male |
Female |
2 Person |
Family |
Age |
| Doctor Copay |
$25 |
0-29 |
94.26 |
131.53 |
234.13 |
393.66 |
0-29 |
| Specialist Copay |
$35 |
30-34 |
124.12 |
150.28 |
237.94 |
444.72 |
30-34 |
| In Hospital Costs
per person |
$100 per day
$500 per year |
35-39 |
124.12 |
150.28 |
237.94 |
444.72 |
35-39 |
40-44 |
150.88 |
164.84 |
263.48 |
475.80 |
40-44 |
| Out Patient Surgery |
$100 per visit |
45-49 |
174.65 |
184.12 |
295.43 |
497.31 |
45-49 |
| Diagnostic Tests |
Free |
50-54 |
224.29 |
244.44 |
417.02 |
579.86 |
50-54 |
| Simple Xrays |
Free |
55-59 |
295.84 |
308.69 |
544.59 |
702.87 |
55-59 |
| Prescriptions $1000 |
10/20/35 |
60-64 |
390.13 |
368.56 |
690.99 |
827.76 |
60-64 |
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| Get more information on coverages and more POS -Upfront Deductible plans |
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| Go to top of page |
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