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  How to Enroll with Connecticare Health Care Plans For help or assistance
  Call 1- 866- 508-0618

 

Connecticare Insurance can refuse to insure you based on your health application. Before you spend your time filling out an enrollment application, take a few minutes to call us. We can spot some health conditions you may have that Connecticare will reject. After talking with us, we then recommend you fill out all the forms and mail your application to us. We will review your forms for missing information and will help you get insurance with Connecticare. Our toll free phone number is: 1-866-508-0618. If the lines are busy, leave your name, phone number and a short message and we will get back to you shortly.

  Print the application forms here: View & Print Complete Enrollment Application
 
 
1. Complete and sign the application/change form (part 1). Be sure to select a primary care physician. This form is to choose your doctor. The easiest way is to call your doctor and get his PCP number.
 
2. Answer all questions on the Individual Health Statement (part 2). Be sure to answer the questions for all family members applying for coverage with Connecticare.
 
3. Complete and sign the Underwriting Authorization (part 3).
 
4. You do not have to submit your first month premium with your application. The effective date will be the 1st of the month following receipt of a complete application and acceptance by Connecticare. If you do not submit the premium, You may owe more than 1 month premium. We recommend sending 1 month premium with application.
 
Please make check payable to Connecticare.
 
 
 
If you want to pay Connecticare directly from your bank in the future, fill out the Electronic Funds Transfer Form.
 
If you would like us to call on your behalf and help you get health insurance, sign this form. This allows Connecticare to talk with us about your personal health information and to help you.
 
Part 1. Enrollment Application
 
 
Part 2. Individual Health Statement
 
 
Part 3. Underwriting Authorization
 
 
 
 
 
 
 
 
 
A. Optional: Electronic Funds Form
 
Optional: Broker Authorization Form
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
       

 

5. Send all the forms and paperwork to us:

    

Creative Health Insurance
230 Hartford Turnpike
Vernon, Ct 06066
 

There is no charge for using Creative Health Insurance. The price of health insurance in Connecticut is fixed by law - you cannot find a better price anywhere for the same product. The insurance companies will pay us commissions to help you find the best medical plan for you and your family.

Sometimes we are able to find you the plan you wanted at a lower price. This is not because we have special prices. We can do this because we specialize in health insurance here in Connecticut. We do not handle auto insurance, or financial products. We are not employees of an insurance company. We are here to help you with your health care needs. . . . Robin Thomas Dubord AAI

 
  Z 11-12-2009       Connecticare Health Insurance Menu