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Medicare in Connecticut

Keep reading for answers to all your questions about Medicare in Connecticut

Reviewed by: Malinda Cannon, Licensed Insurance Agent. Written by: Bryan Strickland.

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:

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. [1]
  • Visiting a local Social Security office. [2]
  • 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, which starts three months before the month of your 65th birthday.

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. [3]

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. [4] 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 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. [5]

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 616,249 people are enrolled in Medicare in Connecticut. The total number of beneficiaries enrolled in Medicare Advantage in Connecticut is 266,526. The previous year, 194,726 enrolled in Medicare Advantage. Medicare Advantage participation in Connecticut went from 32.19% to 43.25% 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.

Outline of Connecticut
616,249
Beneficiaries with Part A & Part B
266,526
Medicare Advantage Beneficiaries
43.25%
Medicare Advantage Participation Rate
56.07%
% Female
43.93%
% Male
1.06
Average HCC Score
$12,636.19
Actual Per Capita Costs
29.98%
% Eligible for Medicaid
35.04%
% of Beneficiaries with an Emergency Department Visit
18.80%
Hospital Readmission Rate
81.97%
% Non-Hispanic White
6.61%
% African American
6.19%
% Hispanic
5.23%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

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 $12,636.19 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:

CHOICES - Medicare counseling

1-800-994-9924

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

1-800-537-2549

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

1-877-284-8759
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

1-866-928-8387

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 an insurance agent that is licensed in Connecticut about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in CT, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA 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

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.

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New to Medicare Guide

Helpful information to get you started with enrolling in Medicare.

Medicare Beneficiary Guide

For those currently enrolled in Medicare.

Medicare Plans Guide

Costs, coverage and enrollment details for each Medicare plan.

Low Income & Medicare Guide

For individuals with a qualifying income status.

A Caregiver’s Guide

For those helping a loved one with Medicare.