Medicare in Connecticut
Key Takeaways
Original Medicare 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 Advantage 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.
But what exactly is Medicare in Connecticut?
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 in Connecticut (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 in Connecticut bundles Parts A, B, and D.
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).
If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you have to apply. Your first chance to sign up is during your Initial Enrollment Period (IEP), which starts three months before the month you turn 65.
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.
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?
In the case of Original Medicare in Connecticut, there’s only one plan — Parts A and B, which does open the option to add Part D and Medigap coverage from private insurance companies.
In the case of Medicare Advantage in Connecticut — also known as Part C — there are many plans.
- 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.
Original Medicare is simple. Medicare Advantage offers a variety that can be overwhelming. Still, it’s simple for a dedicated GoHealth licensed insurance agent to review your situation and figure out what Medicare Advantage plan is the right fit for your specific situation.
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.
Medicare in Connecticut by the Numbers
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.
Medicare
Connecticut
641,167 Beneficiaries with Part A & Part B
324,226 Medicare Advantage Beneficiaries
50.57% Meducare 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% Meducare Advantage Participation Rate, Previous Year
See more +
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.
Connecticut Medicare Resources & Contacts
Beneficiaries spend an average of $13,202.27 each year on Medicare in Connecticut. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Connecticut-based resources, like these, may be able to help:
Nationwide Resources
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.
Medicare guide
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare guide
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare guide
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Medicare guide
Low Income and Medicare Guide
For individuals with a qualifying income status
Medicare guide
A Caregiver’s Guide
For individuals with a qualifying income status
