Welcome to Connect to Care by CMSP

Starting December 1, 2020, the Connect to Care Program by CMSP expands access to primary care and preventive services to eligible uninsured adult residents of one of CMSP’s 35 counties. The mission of the program is to improve health outcomes and enable contracting Community Health Centers to enroll new members.

Providers: Click here to view or download a copy of the Connect to Care Provider Operational Manual for program information including claims submission. Providers must be contracted with CMSP to be paid for Connect to Care covered services. For information about becoming a CMSP contracted Provider, please call (888) 614-0846.

Members: Click here to view or download a copy of the Connect to Care Member Guide for more program information.

Who is Eligible: Uninsured adult (21-64 years old) residents of CMSP counties in the income range of over 138% FPL (Federal Poverty Line) and up to 300% FPL.

How to Enroll: Participating Community Health Centers will register eligible participants for a six-month eligibility period though a secure registration/enrollment portal. For enrollment support and questions, please contact the Connect to Care Enrollment Help Desk at (800) 548-5880.

ID cards: Eligible members will receive an ID card with a Member Guide in the mail AMM, Connect to Care Administrator, following their enrollment approval.

What’s Covered : Approved Outpatient Primary and Preventative Services delivered by a CMSP Contracted Provider. Inpatient and Emergency Services are not covered under the Connect to Care program. For more detailed information on covered services, click here or call (888) 614-0846.

Covered Services
Primary care or specialist office visits Screenings for HIV, HPV, Hepatitis B & C, STI Screenings
Routine screening laboratory testing Screening for depression, alcohol misuse, obesity counseling (performed by a physician)
Prescription medications with a $5 copay per prescription (up to $500 per claim and $1500 maximum benefit limit) Preventative health screenings
Various in-office minor medical procedures EKG, Osteoporosis, DEXA Scan
Specified X-rays of head, neck, chest, trunk, upper and lower extremities Colorectal cancer screening
Adult immunizations Tobacco use counseling and intervention (performed by a physician)

Pharmacy Benefits and Claims: Connect to Care pharmacy claims are process by MedImpact (PCN/Group No. 50145). For more information, please call MedImpact at (800) 788-2949. For a copy of the Connect to Care drug formulary, please visit Connecttocare@cmspcounties.org.

Not Covered
Emergency Services Inpatient Services
Acupuncture, including podiatry-related acupuncture services Methadone maintenance services
Breast and cervical cancer treatment services when covered by other coverage Optometry services and eye appliances
Chiropractic care Public transportation, such as airplane, bus, car or taxi rides
Cosmetic procedures Pregnancy-related and infertility services
Dental services Services by a Psychologist, LCSW, MFT or substance use disorder counselor
Family planning services when covered by another coverage (F-PACT) Any medical service not provided by a contracted CMSP Connect to Care provider

Any Other Questions: Please call Connect to Care Customer Service at (888) 614-0846