Medicare in Connecticut
Key Takeaways
- Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). in Connecticut is an option at age 65. It features hospital (Part A) and medical (Part B) coverage with the option of adding drug (Part D) and supplemental (Medigap) coverage.
- Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Connecticut (Part C) replaces Original Medicare (Part A and B) but offers the same Part A and B benefits and coverages as Original Medicare. Along with Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision, and prescription drug coverage.
- Medicaid in Connecticut offers some similar coverages, but eligibility is based on need regardless of age. It is possible to be dual eligible for Medicare and Medicaid.
As the longtime home of legendary author Mark Twain, the state of Connecticut has been home to more than its share of fantastical stories.
But long story short, it’s not always easy to separate fact from fiction when it comes to Medicare.
If you’re searching for answers about Medicare in Connecticut, GoHealth has written the book.
Who Is Eligible for Medicare in CT?
If you’re a U.S. citizen and are age 65 or older, you qualify for Medicare in Connecticut. It’s as simple as that.
You’re also eligible regardless of your age if:
- You have end-stage renal disease or Lou Gehrig’s disease (also known as amyotrophic lateral sclerosis, or ALS).
- You have received 24 monthly payments of Social Security Disability Insurance or Railroad Board benefits.
Medicare is a federal program launched in 1965 to provide affordable healthcare for older Americans nearing retirement.
You can enroll in Part A (also known as hospital insurance), Part B (medical insurance), or both. Once enrolled in Part A and B (known collectively as Original Medicare), you have the option of switching to Medicare Advantage (also known as Part C) to replace the benefits of Parts A and B along with other benefits like dental and vision coverage.
If you decide to stay enrolled in Parts A and B, you have the option to add Part D to cover a portion of your prescription expenses. You may also choose to add Medigap, which is supplemental coverage that helps fill in the gaps in terms of out-of-pocket costs like copays and coinsurance. Medicare Advantage plans usually bundle Part A, B, and D coverage along with additional benefits.
Can I bundle multiple benefits into one plan?
How Do I Apply for Medicare in CT?
Your choices for applying for Medicare in CT include:
- Enrolling online with the Social Security Administration.
- Visiting a local Social Security office.
- Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).
What Is the Income Limit for Medicaid in Connecticut?
Each state has its own plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age. The state of Connecticut calls its Medicaid services HUSKY Health. Each program within HUSKY Health has its own income limits for eligibility.
Your Ideal Medicare Plan is out there.
Do Seniors Have to Pay for Medicare?
Seniors aren’t required to enroll in Medicare. But typically, it does make sense to enroll in Part A at age 65 because most people don’t have to pay for coverage, and sometimes it makes sense to enroll in Part B at age 65 to avoid having to pay more in the future.
- Part A of Original Medicare provides coverage for hospital stays and doesn’t require a monthly premium for anyone who has worked at least 10 years.
- Part B of Original Medicare provides coverage for medical expenses but does require a monthly premium. Some people don’t enroll at age 65 because they have similar insurance provided by an employer. In that case, you will have a Special Enrollment Period when your employer coverage ends. If you don’t enroll at 65 for some other reason, you likely will be responsible for a 10% late enrollment penalty for every 12 months you wait to enroll.
What Are the Different Medicare Plans Available?
Original Medicare is the same across the country, but you have the option to add a range of Part D and Medigap plans.
If you switch to Medicare Advantage, there are many plans to choose from.
- Some Medicare Advantage plans mirror Original Medicare but are more affordable.
- Some Medicare Advantage plans include options for dental, vision, and hearing coverage.
- Some Medicare Advantage plans offer assistance with transportation costs or over-the-counter needs.
- Some offer all of the above.
What Is the Best Medicare Advantage Plan in CT?
Medicare Advantage and Original Medicare have different coverage areas and costs. While Original Medicare can be used nationwide, Medicare Advantage is usually limited to a network of providers in your area. The limited network allows Medicare Advantage in Connecticut to often offer more affordable options.
The Centers for Medicare & Medicaid Services (CMS) has a Medicare Star Rating system that assigns a rating of one to five stars (five being the best) to individual Medicare Advantage plans. If you’re already on a Medicare Advantage plan and it’s not five-star, you are offered the opportunity to switch to a five-star plan each year.
While the rating system can shed light on Medicare Advantage plans’ performance, it’s not as easy as just picking the highest-rated plan. A GoHealth licensed insurance agent, without obligation, can help you compare plans and find the one that’s the right fit for you.
Your Ideal Medicare Plan is out there.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 641,167 people are enrolled in Medicare Part A and B in Connecticut. The total number of beneficiaries enrolled in Medicare Advantage increased from 295,182 to 324,226 year over year. Medicare Advantage participation in Connecticut went from 47.04% to 50.57% year over year. If you’d like to dive deeper into how Medicare in Connecticut breaks down across the state, we provide a glance at who is using Medicare and how.
641,167 Beneficiaries with Part A & Part B
324,226 Medicare Advantage Beneficiaries
50.57% Medicare Advantage Participation Rate
55.67% Female
44.33% Male
81.97% Non-Hispanic White
6.06% African American
6.02% Hispanic
5.95% Other/Unknown
28.68% Eligible for Medicaid
1.07 Average HCC Score
$12,706.08 Actual Per Capita Costs
18.63% Hospital Readmission Rate
29.69% % of Beneficiaries with an Emergency Department Visit
295,182 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
47.04% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
CHOICES - Medicare counseling
https://portal.ct.gov/aginganddisability/content-pages/programs/choices-connecticuts-program-for-health-insurance-assistance-outreach-information-and-referral-couns
What should I know about CHOICES?
Residents can get connected with their Area Agency on Aging for free, unbiased Medicare advice.
Senior Medicare Patrol
https://portal.ct.gov/aginganddisability/content-pages/programs/senior-medicare-patrol
What should I know about the Senior Medicare Patrol?
For Connecticut residents already on Medicare, this Department of Aging and Disability Services program provides support.
HUSKY Health
Phone lines open M-F, 8:30 a.m. to 6 p.m.
https://portal.ct.gov/husky
What should I know about HUSKY Health?
The state’s Medicaid program offers and oversees several financial assistance programs for Connecticut residents.
Department of Veterans Affairs
https://portal.ct.gov/dva/pages/office-of-advocacy-and-assistance/contact
What should I know about the Department of Veterans Affairs?
The state department’s Office of Advocacy and Assistance helps veterans with their health-related benefits.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Connecticut about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
Apply for Benefits. SSA.gov.- Social Security Office Locator. SSA.gov.
- Husky A & Husky B. CT.gov.
- Medicare costs at a glance. Medicare.gov.
- 5-star special enrolment period. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.