Back to results
Medicare Advantage · HMOPOS
ConnectiCare
Plan year 2026
ConnectiCare Flex Plan 3 (HMO-POS) H3528-011
Monthly premium
$41
+ your Part B premium
Max out-of-pocket
$6,750
in-network annual cap
Primary care
$5
per visit copay
Specialist
$50
per visit
Your costs at a glanceIn-network, for the 2026 plan year
Rx deductible
$185
Inpatient hospital
Days 1-5: $495/day, Days 6-90: $0/day
no limit on covered hospital days
Inpatient mental health
$2,290
per stay
Outpatient surgery
$325
Emergency room
$130
Urgent care
$50
What's included, and what it's actually worth4 benefits included. Tap any card for the detail
Vision
$200/yr eyewear allowance ($50 exam copay)
Eyewear allowance$200/yr eyewear allowance
Routine eye exam$50 copay
This is a supplemental benefit with plan-specific limits. See plan documents for details.
OTC allowance
$50/quarter OTC allowance
Prepaid card$50/quarter OTC allowance
See more details about this plan
Doctor Visits: PCP$5 copay
Doctor Visits: Specialist$50 copay
Inpatient Hospital$495/day, days 1–5
Outpatient Surgery$325 copay
Mental Health$2,290 per stay
HearingHearing exam ($50 copay)
MealsMeal benefit
Your coverageCheck your coverageFrom the doctors and prescriptions you added
Your plan's drug tiers30-day retail · after any applicable deductible
Tier 1
$1
Preferred Generic
Tier 2
$10
Generic
Tier 3
25%
Preferred Brand· after deductible
Tier 4
27%
Non-Pref Brand· after deductible
Tier 5
30%
Specialty· after deductible
Tier 6
$0
Tier 6· after deductible
Our take
Things to know before you enroll
This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)
Plan documents
Summary of Benefits (PDF)
Download the plan's official Summary of Benefits document
Check Your Doctors
See if your doctors accept this plan
Documentos en español
Llame al (833)310-1182 (TTY: 711) para solicitar documentos en español