2019-2020 flu season information

Last year’s flu season was the longest in 10 years. We’re hoping that doesn’t happen again. All ConnectiCare members are covered for the flu vaccine. And here are the vaccine codes we cover:

For most members, there is no copayment, coinsurance or deductible if the only service that is provided during the visit is the administration of a flu shot. If there is an additional, separate reason billed for a visit, applicable copayment, coinsurance and deductible will apply.

If a member receives a flu vaccination from a non-participating provider, we cover the usual-and-customary amount. If a member pays out of pocket, he or she can provide a receipt to us along with a completed Out-of-Plan Reimbursement Form. Medicare members should use this Medicare Out-of-Plan Reimbursement Form.

Flu shot clinics at ConnectiCare centers
We’re also holding flu shot clinics – open to all – at ConnectiCare centers in Manchester and Waterbury on Saturday, Oct. 5. Walgreens will administer the shots. No registration needed, and most insurance plans accepted. Must be 18 or older to participate.

Manchester flu shot clinic | Waterbury flu shot clinic

A reminder about advising patients on Medicare plan enrollment

The Centers for Medicare & Medicaid Services (CMS) reminds health care providers that they should remain neutral when discussing Medicare and Part D plans with their patients. The Medicare annual election period (AEP) for 2020 starts Oct. 15, 2019 and ends Dec. 7, 2019.

Providers may:

Providers should not:

Providers who violate these regulations could face penalties up to and including termination of their contract with Medicare and Part D plans and plan sponsors.

If you have questions about discussing Medicare enrollment with your patients, please contact your network account manager.

Reimbursement policies for observation stay updated with FAQ section

Our observation reimbursement policies for commercial and Medicare Advantage plans now include a frequently-asked-questions section.

Here are the policies:

ConnectiCare commercial providers who are in network for certain EmblemHealth plans

Providers for our commercial plans can also treat certain EmblemHealth members. In 2017, EmblemHealth, our parent company in New York, expanded one of its networks to include ConnectiCare’s commercial HMO provider network in Connecticut.

Here are the EmblemHealth plans whose members can access the ConnectiCare HMO network:

EmblemHeath members with the above plans will have a member ID card with a ConnectiCare logo included, like the one illustrated below:

Front of EmblemHealth member ID card

Back of EmblemHealth member ID card

EmblemHealth members with the above plans can get medical care and services under their in-network benefits from ConnectiCare commercial providers. For these members, EmblemHealth’s policies and procedures apply. Go to emblemhealth.com/providers or call 1-866-447-9717 for details.

Please note, claims need to be submitted to Emblem but will be paid according to your ConnectiCare contract.