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Medicare Advantage · HMOPOS
ConnectiCare
Plan year 2026
ConnectiCare Flex Plan 2 (HMO-POS) H3528-015
Monthly premium
$119
+ your Part B premium
Max out-of-pocket
$6,750
in-network annual cap
Primary care
$15
per visit copay
Specialist
$35
per visit
Your costs at a glanceIn-network, for the 2026 plan year
Rx deductible
$200
Inpatient hospital
Days 1-4: $375/day, Days 5-90: $0/day
no limit on covered hospital days
Inpatient mental health
$2,290
per stay
Outpatient surgery
$250
Emergency room
$130
Urgent care
$35
What's included, and what it's actually worth3 benefits included. Tap any card for the detail
Vision
Routine vision benefit ($35 exam copay)
DetailsRoutine vision benefit
Routine eye exam$35 copay
This is a supplemental benefit with plan-specific limits. See plan documents for details.
Hearing
Hearing exam ($35 copay)
DetailsHearing exam ($35 copay)
This is a supplemental benefit with plan-specific limits. See plan documents for details.
Meals
Meal benefit
See more details about this plan
Doctor Visits: PCP$15 copay
Doctor Visits: Specialist$35 copay
Inpatient Hospital$375/day, days 1–4
Outpatient Surgery$250 copay
Mental Health$2,290 per stay
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
28%
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
Evidence of Coverage (PDF)
Complete plan details and rules
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