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ConnectiCare Choice Dual (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for ConnectiCare Choice Dual (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on ConnectiCare Choice Dual (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
ConnectiCare Choice Dual (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by EmblemHealth, Inc. available for enrollment in 2025 to people living in State of Connecticut. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that ConnectiCare Choice Dual (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
ConnectiCare Choice Dual (HMO-POS D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about ConnectiCare Choice Dual (HMO-POS D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For ConnectiCare Choice Dual (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $8.80. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The ConnectiCare Choice Dual (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your monthly premium for Part D drugs will be $8.80. After the deductible is met, you will pay costs for drugs in each tier until your total drug costs reach $2000. Once you reach that amount, you enter the next coverage phase, and you will pay nothing for your Part D covered drugs.
Additional Benefits
The ConnectiCare Choice Dual (HMO-POS D-SNP) plan offers a variety of benefits with a focus on cost-sharing through coinsurance. Many services, including primary care, outpatient services, emergency services, preventive services, and diagnostic services, have a 20% coinsurance. The plan also provides coverage for hearing, vision, and dental services, with specific cost-sharing structures and annual maximums. Additional benefits include coverage for home health services with no copay, skilled nursing facility stays with a copay for days 21-100, and over-the-counter items up to $60 per month. There are also benefits for home infusion, ambulance, and medical equipment, but some services like transportation, cardiac rehabilitation, and certain types of hearing aids are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including both acute and psychiatric care, are covered, but additional days, non-Medicare-covered stays, and upgrades for both are not covered. Prior authorization is required, and the copay is determined by Medicare.
Outpatient Services See details
Outpatient Services include outpatient hospital services and observation services, both with a 20% coinsurance; ambulatory surgical center (ASC) services and outpatient substance abuse services are also covered, both with a 20% coinsurance. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by ConnectiCare Choice Dual (HMO-POS D-SNP), but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the ConnectiCare Choice Dual (HMO-POS D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and there is no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the ConnectiCare Choice Dual (HMO-POS D-SNP) plan. For Emergency Services and Urgently Needed Services, there is a 20% coinsurance and no copay. However, Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
ConnectiCare Choice Dual (HMO-POS D-SNP) covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services, all with a 20% coinsurance. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The ConnectiCare Choice Dual (HMO-POS D-SNP) plan covers various preventive services including Medicare-covered services, annual physical exams, health education, fitness benefits, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. This plan has a 20% coinsurance for Kidney Disease Education Services. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and several other services are not covered.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20%, and routine hearing exams and fitting/evaluation for hearing aids are covered once per year. Prescription hearing aids (all types) are covered with a maximum benefit of $2500 per year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, while eyewear, including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses, also have a 20% coinsurance and a combined maximum benefit of $500 per year; eyeglass frames and contact lenses are not unlimited.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Other dental services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services, each with a limit on the number of visits. Orthodontic services are covered up to a maximum of $3,000 every year. Restorative services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery are covered with prior authorization and visit limits, but maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered by the ConnectiCare Choice Dual (HMO-POS D-SNP) plan. For Medicare Part B Insulin Drugs, there is a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the ConnectiCare Choice Dual (HMO-POS D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with a 20% coinsurance for Medicare-covered devices and supplies, and Diabetic Equipment. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, and include no copay. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services all have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the ConnectiCare Choice Dual (HMO-POS D-SNP) plan, with no copay or coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
ConnectiCare Choice Dual (HMO-POS D-SNP) covers Cardiac Rehabilitation Services, but does not specify the cost sharing details. Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the ConnectiCare Choice Dual (HMO-POS D-SNP) plan. There is no copay for days 1-20, and a $214 copay per day for days 21-100.
Other Services See details
The ConnectiCare Choice Dual (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $60.00 every month, including Nicotine Replacement Therapy (NRT) and Naloxone coverage, but Acupuncture, Meal Benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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