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ConnectiCare Flex Plan 3 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for ConnectiCare Flex Plan 3 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on ConnectiCare Flex Plan 3 (HMO-POS) in 2026, please refer to our full plan details page.
ConnectiCare Flex Plan 3 (HMO-POS) is a HMO-POS plan offered by Molina Healthcare, 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 2026.
It's important to know that ConnectiCare Flex Plan 3 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about ConnectiCare Flex Plan 3 (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 Flex Plan 3 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.00. 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.
This plan has a $185.00 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 $10000.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $6750.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 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 Flex Plan 3 (HMO-POS) features an annual prescription drug deductible of $185. For Tier 1 preferred generic drugs, you will pay a $1.00 copay for a one-month supply and a $2.00 copay for a two- or three-month supply through standard pharmacies or mail order. Tier 2 generic drugs require a $10.00 copay for one month and $20.00 for longer fills, while Tier 6 select care drugs are covered with no copay. Brand-name and specialty medications are subject to coinsurance rather than flat copays. Tier 3 preferred brands require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 27% coinsurance. Tier 5 specialty drugs are covered with a 30% coinsurance for a one-month supply through standard pharmacies and mail order.
Additional Benefits
The ConnectiCare Flex Plan 3 (HMO-POS) offers affordable access to everyday medical care with no copay for preventive services, a $5 copay for primary care visits, and a $50 copay for specialists. If you require hospital care, inpatient stays require a $495 daily copay for days one through five with no copay for additional days, while emergency room visits carry a $130 copay. Outpatient services feature no coinsurance, with copays ranging from no copay up to $325 depending on the service. For additional wellness benefits, this plan provides routine dental cleanings and up to $200 annually for eyewear with no copay, as well as routine vision and hearing exams for a $50 copay. Skilled nursing facility care is covered with no copay for the first 20 days, and members get a $50 allowance every three months for over-the-counter items with no copay. Please note that comprehensive dental treatments, hearing aids, and transportation services are not covered under this plan.
Inpatient Hospital See details
ConnectiCare Flex Plan 3 (HMO-POS) partially covers inpatient hospital services with no coinsurance, excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. Covered acute stays require a $495 daily copay for days 1 through 5 and no copay for days 6 and beyond, while psychiatric stays require a $2,290 copay per stay.
Outpatient Services See details
ConnectiCare Flex Plan 3 (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $325 copay for outpatient hospital services and a $325 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
ConnectiCare Flex Plan 3 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
ConnectiCare Flex Plan 3 (HMO-POS) covers ambulance services with prior authorization, requiring a $325 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
ConnectiCare Flex Plan 3 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within one day. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 limit with no copay and no coinsurance.
Primary Care See details
ConnectiCare Flex Plan 3 (HMO-POS) offers primary care physician visits for a $5.00 copay and specialist visits for a $50.00 copay, both with no coinsurance. Therapy, mental health, and telehealth services are also covered with copays ranging from $5.00 to $50.00 and no coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
ConnectiCare Flex Plan 3 (HMO-POS) offers preventive services with no copay and no coinsurance, though the benefit is only partially covered. Covered services include annual physical exams, kidney disease education, fitness benefits, and glaucoma screenings, while excluded sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, telemonitoring, home/bathroom safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by ConnectiCare Flex Plan 3 (HMO-POS), which provides one routine hearing exam every year with a $50 copay and no coinsurance. Fitting and evaluation services, prescription hearing aids, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
ConnectiCare Flex Plan 3 (HMO-POS) vision services are partially covered, offering one annual routine eye exam with a $50 copay and no coinsurance, while other eye exams are not covered. Eyewear is covered with no copay and no coinsurance up to a $200 yearly maximum, though upgrades are not covered.
Dental Services See details
ConnectiCare Flex Plan 3 (HMO-POS) partially covers dental services, offering Medicare-covered dental care for a $50 copay and no coinsurance, and preventive services like exams, cleanings, and x-rays with no copay and no coinsurance. However, comprehensive treatments such as restorative services, endodontics, periodontics, prosthodontics, implants, orthodontics, and oral surgery are not covered.
Home Infusion bundled Services See details
ConnectiCare Flex Plan 3 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Related Medicare Part B chemotherapy, radiation, and other drugs require no copay and a 0% to 20% coinsurance, while covered Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
ConnectiCare Flex Plan 3 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
ConnectiCare Flex Plan 3 (HMO-POS) covers durable medical equipment, prosthetics, and diabetic equipment with no copays, though coinsurance and prior authorization may apply. Durable medical equipment requires a 10% to 20% coinsurance, while prosthetic devices, medical supplies, and diabetic equipment and supplies carry a 20% coinsurance.
Diagnostic and Radiological Services See details
ConnectiCare Flex Plan 3 (HMO-POS) covers diagnostic and radiological services with prior authorization, offering lab services and diagnostic radiological services with no copay and no coinsurance. Diagnostic tests and procedures require a $25 copay with no coinsurance, while outpatient x-rays carry a $45 copay plus coinsurance, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by ConnectiCare Flex Plan 3 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the ConnectiCare Flex Plan 3 (HMO-POS), meaning members must pay the full cost for all related sub-services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy.
Skilled Nursing Facility (SNF) See details
ConnectiCare Flex Plan 3 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $214 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
ConnectiCare Flex Plan 3 (HMO-POS) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance up to a maximum of $50 every three months. Acupuncture and meal benefits are not covered under this plan.
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