Frequently Asked Questions
Click the “+” symbol next to a category to view answers to frequently asked questions on that topic. If you don’t find what you need, call Customer Service at:
1-855-HLTHYCT (1-855-458-4928)
Monday – Friday 8:00 a.m. to 6:00 p.m. EST
* Effective February 1, 2017 the hours will be : Monday – Friday 8:00 a.m. to 5:00 p.m. EST
If HCT is non-profit, what happens to the money you make from member premiums?
Unlike for-profit insurance companies, HCT does not have shareholders who benefit when the company makes money. Instead, profits go back to improving programs and services – or keeping premiums low – for you.
What is a health insurance CO-OP?
It is a Consumer Operated and Oriented Plan. HCT started with a loan granted to the Connecticut State Medical Society and its independent physician organization. As a CO-OP, members play an important role in the future of the company. They can vote, or run for seats on the Board of Directors.
How long has HCT been in business?
We sold our first plans in October 2013 and began covering members in January 2014. Our members include people who have bought insurance on their own and others who have coverage through their employer.
Are you the exchange?
Even though our names are similar, we’re not the exchange. The exchange is Access Health CT. We’re a health plan offering healthcare plans on the exchange.
Do you only sell to individuals?
No, we have plans for individuals, small groups (2-50 employees) and large groups (51+ employees). In fact, we may have a plan that’s right for you!
Do you sell plans on the Connecticut Health Insurance Exchange, Access Health CT?
Yes. We sell plans both on and off the exchange.
How many doctors are in your network?
Our network is now over 19,000 providers statewide (including all Connecticut hospitals) and over 750,000 nationwide.
What is an IRS form 1095-A and how do I use it?
Access Health CT sends the 1095-A tax forms, so all questions regarding them should be directed to Access Health CT, the state’s official health insurance marketplace. More information is available in the Tax Info tab in the Learn More section on Access Health CT’s website at http://learn.accesshealthct.com/tax-info. If you have 1095-A questions, please call Access Health CT at 1-860-757-6800 or 1-855-909-2428 or email them at 1095.accesshealth@ct.gov.
When will I receive my first invoice?
You should receive your first invoice in the mail five to seven business days after we process your application. During times of very high volume, such as the beginning of the year, it may take longer for you to receive your invoice. To see how much you owe, please login to our secure online bill payment system. The amount of your first invoice should appear on that page approximately two business days after we process your application. You can also get premium information by calling Member Services at 1-855-208-1641.
After my initial invoice, when will I receive invoices each month and when are my payments due?
You can expect to receive your invoice by the middle of each month. Invoice payments are due by the first of the month. For example, you’ll receive your April invoice by the middle of March and it is due April 1.
How can I pay my HealthyCT bill?
You can pay your HealthyCT premium by mail or online. Information on both options is always available at http://healthyct.org/payments.
Mailing your Payments if enrolled through AccessHealthCT
If you enrolled into a HealthyCT plan through AccessHealthCT, please do not send your payment to AccessHealthCT. Once you receive your first invoice, the payments must be mailed to:
HealthyCT Inc – Member
Dept. 46
PO Box 280
Hartford, CT 06141-0280
Please write your member ID on the check or money order in the memo section.
Or you can register and enroll in our online bill pay site to make your payments.
Online Bill Pay – Reminders
- Password Reset – Please be aware that your online payment password will reset every 90 days.
- Registration Confirmation E-mail – Please remember to check “Junk Mail” or “Spam” if you not receiving a confirmation E-mail after completing the registration process.
What are the online bill pay requirements?
You can use a PC, mobile device or tablet to access the online bill pay system.
How long does it take for an online payment to be processed?
When you pay your monthly bill using our secure online bill pay system before 8:00 p.m. EST, your payment will be reflected in our system one full business day later. For example, if you pay your bill online on a Friday at 12:00 p.m. EST, it will be reflected in our system by 12:00 p.m. EST on Monday, provided neither day is a holiday. If you pay your bill online on a Friday at 5:30 p.m. EST, it will be reflected in our system by 12:00 p.m. on Tuesday, provided neither day is a holiday. This also applies to auto-payments that are scheduled in the online bill pay system for a future date.
What is a “surprise bill”?
(A) “Surprise bill” means a bill for health care services, other than emergency services, received by an insured for services rendered by an out-of-network health care provider, where such services were rendered by such out-of-network provider at an in-network facility, during a service or procedure performed by an in-network provider or during a service or procedure previously approved or authorized by the health carrier and the insured did not knowingly elect to obtain such services from such out-of-network provider.
(B) “Surprise bill” does not include a bill for health care services received by an insured when an in-network health care provider was available to render such services and the insured knowingly elected to obtain such services from another health care provider who was out-of-network.
In other words, it’s considered a “surprise bill” if you were charged for services (other than emergency services) from an out-of-network provider that you did not knowingly choose to receive such services from:
• At in-network facility,
• During a service or procedure an in-network provider performed,
or
• During a service or procedure HealthyCT previously approved or authorized
For example, you deliver your baby at an in-network hospital but receive a bill from an out-of-network anesthesiologist.
It is not considered a “surprise bill” if you knowingly chose to receive services from an out-of-network provider when an in-network provider was available.
I’ve enrolled. What happens next?
Once HealthyCT receives your completed application and enters your information into the member database, we will send your member ID cards and a welcome kit in two separate mailings. Please allow about seven business days for your ID card to arrive and ten business days for your welcome kit. During times of very high volume, such as the beginning of the year, it may take longer for materials to arrive. To get a temporary ID card, please see section six of this FAQ document. Please note, we must receive your premium payment before you can begin accessing services and using your HealthyCT ID card.
How do I make a change to my enrollment documents?
If you enrolled through Access Health CT, all enrollment or demographic changes (such as name and address) need to go through them. Access Health CT will send updates to HealthyCT electronically to process. Please contact Access Health CT at 1-855-909-2428.
For changes to plans purchased directly through HealthyCT, please complete this form or call the number for Member Services on the back of your ID card. For plans purchased through an insurance broker or your employer, please call them directly.
Where can I view my plan documents?
You can view and print Certificate of Coverage, Schedule of Benefits and Summary of Benefits documents on our website.
Please visit the following link and click on the name of your current plan: http://www.healthyct.org/our-plans. Documents are available as PDFs on those pages.
How can I check to see if my doctor is in the HealthyCT network?
- Go to healthyct.org
- Select “Find a Doctor” or click on the stethoscope image in the top right of the front page.
- Need help? Refer to the Provider Directory, or call Member Services using the phone # listed on the back of your ID Card or 1-855-HLTHYCT.
- Once the provider directory page opens, choose an option from the “What are you looking for?” menu on the left side. To locate a network provider outside of Connecticut, select “Out-of-State Providers” from that left hand column menu and click “OK” when the next screen opens.
- Enter the provider information requested in Steps 2 and 3, and then click “Search.” The results of your search will display on the next page.
How can I request that a doctor be added to the HealthyCT network?
If you do not see your doctor listed after following the steps outlined in the previous FAQ, we’d be happy to reach out to them for you. To send a request:
- On the provider search results page, click on the text where it says “Provider Not Found” This will open the online provider request form.
- Complete the form and click “Submit.”
- You can also contact our Customer Service Department at 1-855-208-1641; they can collect your provider data and submit it to our Provider Relations Department, who can then reach out to the physician on your behalf.
- It is always helpful if you contact your provider to let them know you are interested in their participation with HealthyCT – they may be in process of joining already!
When will I receive my ID card?
You should receive your ID card around seven business days after your application has been processed. That’s the time it takes to enter your information into the member database and to produce and mail the card. During times of very high volume, such as the beginning of the year, it may take longer for you to receive your card. In the meantime, you can print out a temporary ID card. Please see the instructions in the FAQ below.
How can I print a temporary ID card?
After we’ve entered your information into the member database, you can print a temporary ID card by logging in here. You’ll need your HealthyCT member number in order to do this. If you do not have an ID card yet, your member number can be found on your invoice or you can call Member Services at 1-855-HLTHYCT (1-855-458-4928). Once you’ve logged in, select “Request ID Card” from the menu in the top left, under the HealthyCT logo. Then follow the instructions on the next page to print your temporary ID card.
When will I receive my Welcome Kit and plan documents?
Please allow about ten business days, after you submit your application, for your Welcome Kit to arrive. During times of very high volume, such as the beginning of the year, it may take longer for you to receive your welcome kit. In the meantime, you can view and print a copy of your plan documents. Please refer back to Section 4: Enrollment/Coverage, “Where can I view my plan documents?” for instructions on how to do this.
How can I find out which prescriptions my plan covers?
HealthyCT’s partner, OptumRx, manages your pharmacy benefits and offers an online tool you can use to look up coverage and other information about specific drugs. To access your prescriptions and prescription benefits, go to www.mycatamaranrx.com or contact OptumRx directly at 1-855-577-6549.
What information should the pharmacy use when filling any prescription?
When filling your prescription, a pharmacy must use the following information, found on your HealthyCT ID card:
- Member Number: Your unique member number
- BIN Number: 610011
- PCN: IRX
- RX Group Number: HCT
Can I fill my prescriptions at a local pharmacy or do I have to use a mail order service?
You don’t have to “break up” with your local pharmacist! We support local businesses, including independent pharmacies. If you prefer using your local pharmacy, you can buy one-month or 90-day supplies of the medicines you need and the copay will be the same as mail order. Click here for more about mail order pharmacy.