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ConnectiCare Choice Plan 2 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for ConnectiCare Choice Plan 2 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on ConnectiCare Choice Plan 2 (HMO-POS) in 2025, please refer to our full plan details page.
ConnectiCare Choice Plan 2 (HMO-POS) is a HMO-POS 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 Plan 2 (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about ConnectiCare Choice Plan 2 (HMO-POS).
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 Plan 2 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6000.00 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
Prescription drugs are not covered by ConnectiCare Choice Plan 2 (HMO-POS).
Additional Benefits
The ConnectiCare Choice Plan 2 (HMO-POS) offers a range of benefits with varying costs. Hospital stays have a copay, and outpatient services often have copays, such as $10 for mental health and specialist visits. This plan includes coverage for primary care, preventive services with no copay for many services, hearing, vision, and dental services, with specific copays, coinsurance, and maximum benefit amounts. Additional benefits include coverage for ambulance services, emergency services, and home health services with no copay. The plan also covers durable medical equipment, diagnostic and radiological services, and skilled nursing facilities, each with different copays or coinsurance. This plan offers benefits like over-the-counter items, with a monthly maximum benefit.
Inpatient Hospital See details
Inpatient Hospital benefits under the ConnectiCare Choice Plan 2 (HMO-POS) include Inpatient Hospital-Acute, with a copay of $295 for days 1-6 and no copay for days 7-90, and Inpatient Hospital Psychiatric, with a copay of $2290. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $200, Observation Services with a $200 copay, Ambulatory Surgical Center (ASC) Services with no copay, and Outpatient Substance Abuse Services with a copay of $10 for both individual and group sessions. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the ConnectiCare Choice Plan 2 (HMO-POS), with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $50 copay, while air ambulance services have a 20% coinsurance. 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 Plan 2 (HMO-POS). Emergency Services have a $100 copay, Urgently Needed Services have a $10 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $100 copay.
Primary Care See details
The ConnectiCare Choice Plan 2 (HMO-POS) covers primary care physician services, chiropractic services (with a $20 copay), occupational therapy, physician specialist services (with a $10 copay), mental health specialty services (with a $10 copay for individual and group sessions), physical therapy and speech-language pathology services (with a $10 copay), additional telehealth benefits (with a $0-$10 copay), and opioid treatment program services (with a $10 copay). Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The ConnectiCare Choice Plan 2 (HMO-POS) covers preventive services, including no copay for Medicare-covered preventive services, annual physical exams, health education, fitness benefits, enhanced disease management, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit; however, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services include hearing exams with a $10 copay, fitting/evaluation for hearing aids, and prescription hearing aids with a maximum plan benefit of $3000 every three years. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with a $10 copay. Eyewear is covered up to a combined maximum of $750 every year, and includes coverage for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Upgrades are not covered.
Dental Services See details
The ConnectiCare Choice Plan 2 (HMO-POS) covers dental services, including Medicare dental services with a $10 copay, and other dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered, each with one visit every six months. Orthodontic services have a $100 deductible and a maximum benefit of $3,000 per year, while restorative services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery require prior authorization and have a 50% coinsurance. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the ConnectiCare Choice Plan 2 (HMO-POS), with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0-20% coinsurance, and Prosthetics/Medical Supplies - Non-Medicare benefit with no coinsurance and no copay. Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a $25 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $175, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the ConnectiCare Choice Plan 2 (HMO-POS) with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and the copay information is available in the plan documents.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the ConnectiCare Choice Plan 2 (HMO-POS). There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items, with a maximum benefit of $50.00 every month, and acupuncture, meal benefit, Dual Eligible SNPs, 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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