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ConnectiCare Choice Plan 1 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for ConnectiCare Choice Plan 1 (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 1 (HMO-POS) in 2026, please refer to our full plan details page.
ConnectiCare Choice Plan 1 (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 Choice Plan 1 (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 Choice Plan 1 (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 1 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $162.00. 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 $200.00 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 $4150.00 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 Plan 1 (HMO-POS) features an annual prescription drug deductible of $200. Under this plan, Tier 6 select care drugs are highly affordable with no copay for one-, two-, or three-month supplies filled at standard pharmacies or via mail order. Tier 1 preferred generics carry a $1.00 copay for a one-month supply, while Tier 2 generic medications require a $15.00 copay. For brand-name and specialty medications, the plan transitions to coinsurance cost-sharing through standard pharmacy and mail-order services. Tier 3 preferred brands require a 25% coinsurance, Tier 4 non-preferred drugs require a 27% coinsurance, and Tier 5 specialty drugs carry a 30% coinsurance for a one-month supply. These straightforward copays and coinsurance rates help you easily project your annual healthcare costs.
Additional Benefits
The ConnectiCare Choice Plan 1 (HMO-POS) offers comprehensive medical coverage with no copay or coinsurance for primary care visits, home health services, and annual preventive physicals. For specialist visits, urgent care, and Medicare-covered dental services, you will pay a $30 copay. Inpatient hospital stays feature no coinsurance but require a $345 daily copay for the first five days, with no copay for additional days. Emergency room visits carry a $140 copay, while routine vision and hearing exams are available with a $30 copay. It is important to note that this plan does not cover routine dental cleanings, eyeglasses, hearing aids, or over-the-counter items. Additionally, medical equipment and dialysis services require a coinsurance of up to 20 percent with no copay.
Inpatient Hospital See details
ConnectiCare Choice Plan 1 (HMO-POS) covers inpatient acute hospital stays with no coinsurance, requiring a $345 daily copay for days 1 to 5 and no copay for days 6 and beyond. Inpatient psychiatric care is also covered with no coinsurance and a $2,545 copay per stay, though hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
ConnectiCare Choice Plan 1 (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $200 copay for outpatient hospital services and a $295 copay per stay for observation services. Ambulatory surgical center services and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $30 copay and no coinsurance.
Partial Hospitalization See details
ConnectiCare Choice Plan 1 (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 Choice Plan 1 (HMO-POS) covers ground ambulance services with a $295 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. While some transportation services are covered, transport to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by ConnectiCare Choice Plan 1 (HMO-POS) with a $140 copay and no coinsurance, which is waived if you are admitted to the hospital within one day. Urgently needed services require a $30 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with no copay and no coinsurance.
Primary Care See details
ConnectiCare Choice Plan 1 (HMO-POS) provides primary care physician services with no copay and no coinsurance, while specialist, therapy, psychiatric, and opioid treatment services require a $30 copay and no coinsurance. Telehealth benefits range from no copay to a $30 copay with no coinsurance, though podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Preventive services are covered by ConnectiCare Choice Plan 1 (HMO-POS) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive services are partially covered, offering fitness benefits, health education, and remote access technologies, while sub-services like in-home safety assessments, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by ConnectiCare Choice Plan 1 (HMO-POS), offering one routine hearing exam per year with a $30 copay, no coinsurance, and no deductible. Hearing aid fittings and evaluations, prescription hearing aids, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
ConnectiCare Choice Plan 1 (HMO-POS) covers one routine eye exam every year with a $30 copay and no coinsurance, while other eye exam services are not covered. For eyewear, some services are covered with no copay and no coinsurance, but contact lenses, eyeglasses, lenses, frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by ConnectiCare Choice Plan 1 (HMO-POS), with covered Medicare dental services requiring a $30 copay and no coinsurance. While orthodontic, restorative, and surgical dental services are covered, preventive and diagnostic sub-services—including oral exams, cleanings, x-rays, and fluoride treatments—are not covered.
Home Infusion bundled Services See details
ConnectiCare Choice Plan 1 (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the ConnectiCare Choice Plan 1 (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
ConnectiCare Choice Plan 1 (HMO-POS) covers medical equipment with no copay, though coinsurance applies to all covered items. Durable medical equipment requires a 10% to 20% coinsurance, while prosthetic devices, medical supplies, and diabetic equipment carry a 20% coinsurance.
Diagnostic and Radiological Services See details
ConnectiCare Choice Plan 1 (HMO-POS) covers diagnostic services with no coinsurance, featuring a $25 copay for tests and no copay for lab services. Radiological services are also covered, featuring a $35 copay for X-rays, a minimum 20% coinsurance for therapeutic services, and a $0 minimum copay for diagnostic radiology, with prior authorization required.
Home Health Services See details
Home Health Services are covered by ConnectiCare Choice Plan 1 (HMO-POS) with no copay and no coinsurance. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by ConnectiCare Choice Plan 1 (HMO-POS) with no coinsurance and require prior authorization, though in practice only some services are covered. Standard cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $60 copay), pulmonary rehabilitation (with a $20 copay), and SET for PAD services (with a $30 copay) are not covered.
Skilled Nursing Facility (SNF) See details
ConnectiCare Choice Plan 1 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $214 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not needed, the benefit is only partially covered as days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
ConnectiCare Choice Plan 1 (HMO-POS) does not cover Other Services, as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage.
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