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Registration

  • Personal Info

  • Create Secure Login

  • Terms & Conditions

  • Complete Registration

Step 1 of 4:

Personal Info


= Required

Welcome to ConnectiCare! To get off on the right foot, register for a member website account.


Before you begin, we recommend that you have your Member ID card available. Then, follow these tips:

  • - Enter your first and last name exactly as it appears on your Member ID card
  • - Enter your complete birth date in the following format: MM/DD/YYYY.  Please make sure that you’ve entered the correct year before proceeding.
  • - Also, enter your Member ID exactly as it appears on your Member ID card. Make sure that you include all 11 digits and do not include any spaces or dashes (example: XXXXXXXXXXX).

It is very important that you enter your information correctly.  Please take the time to double check your entries before moving to the next step.

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* I understand that the phone number I provide may be used by ConnectiCare or any of its contracted parties to contact me about my account, my health benefit plan or related programs, or services provided to me.
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