Medicare is health insurance that’s provided through the federal government. It’s available to people who are age 65 or older or to people of any age who meet certain criteria.
Medicare plans in Connecticut fall into four categories:
- Part A and Part B, which make up original Medicare
- Part C, also known as Medicare Advantage
- Part D, which is prescription drug coverage
- Medigap, which are supplemental insurance plans
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Connecticut for the 2021 plan year:
- A total of 690,397 residents of Connecticut are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in Connecticut compared to last year — from $22.72 in 2020 to $21.42 in 2021.
- There are 47 Medicare Advantage plans available in Connecticut for 2021, compared to 41 plans in 2020.
- All Connecticut residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in Connecticut for 2021.
Different parts of Medicare cover different services, so it’s important to understand each one in order to determine which is best for you.
Original Medicare includes Part A and Part B coverage. It’s available to anyone eligible for Medicare. Each part covers different services.
Part A covers hospital or inpatient care, including:
- care when you are admitted to a hospital
- hospice care
- limited coverage of skilled nursing facility care
- limited home healthcare
Part B covers outpatient and preventive care, including:
- doctor’s appointments
- screenings or diagnostic tests
- preventive care, such as vaccines and annual wellness checks
- qualifying durable medical equipment
Medicare Advantage in Connecticut
Private insurance companies contract with Medicare to bundle all the coverage under original Medicare into Medicare Advantage (Part C) plans. Many of these plans also include prescription drug coverage, as well as additional coverage for things like vision, dental, or hearing.
To get a Medicare Advantage plan, you must first enroll in original Medicare (parts A and B). Then, you can select from available Medicare Advantage plans in your area by comparing costs and coverage options.
The following insurance carriers offer Medicare Advantage plans in Connecticut:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- CarePartners of Connecticut
Your choice of plans will vary depending on where you live in Connecticut, as not all plans are available in every area.
Medicare supplement plans in Connecticut
If you need help paying for your costs under original Medicare, a supplemental insurance policy (Medigap plan) can help. There are 10 different Medigap plans that cover various combinations of deductibles, coinsurance, and copays.
Many companies offer Medigap plans in Connecticut. In 2021, some of the companies offering Medigap plans throughout the state include:
But you can’t enroll in both Medigap and Medicare Advantage. You must choose one or the other if you want this additional coverage.
You’re eligible for Medicare in Connecticut if you:
- are age 65 or over
- are a citizen of the U.S. or a legal resident for 5 or more years
If you are not 65 years old, you can also qualify for Medicare if you:
- received Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) benefits for at least 24 months
- have amyotrophic lateral sclerosis (ALS)
- have end stage kidney disease (ESRD)
- received a kidney transplant
When can I enroll in Medicare Connecticut plans?
You must enroll in Medicare during the correct period, unless you meet the qualifications to be automatically enrolled.
Initial enrollment period
Your initial enrollment period begins 3 months before the month of your 65th birthday, then continues through your birthday month and for 3 months after.
If possible, sign up before you turn 65, so your benefits begin in your birthday month. If you wait until later in the initial enrollment period, your benefit start date could be delayed.
Special enrollment periods
Special enrollment periods allow you to sign up for Medicare outside of standard enrollment windows. They occur when you lose your health coverage for a qualifying reason, such as losing employer-sponsored coverage when you retire or moving out of your plan’s coverage area.
Annual enrollment periods
- General enrollment (Jan. 1–Mar. 31). If you miss your initial enrollment period, you can enroll each year during general enrollment; however, your coverage will not begin until July 1. You may also have to pay a late sign-up penalty if you miss your initial enrollment and don’t have other coverage (such as an employer-sponsored plan). During general enrollment, you can sign up for original Medicare (parts A and B) or switch between original Medicare and Medicare Advantage plans.
- Medicare Advantage open enrollment (Jan. 1–Mar. 31). During this time, you can change your Medicare Advantage plan or drop your plan and switch to original Medicare instead.
- Medicare open enrollment (Oct. 15–Dec. 7). During open enrollment, you may change your coverage for original Medicare, as well as sign up for or change Part D coverage. If you didn’t sign up for Part D during your initial enrollment period and you didn’t have other coverage (such as an employer plan), you may pay a lifetime late sign-up penalty.
Tips for enrolling in Medicare in Connecticut
Before you decide which Medicare plan is right for you, review each one carefully to see if it:
- includes the doctors and facilities where you want to get care
- has affordable premiums, deductibles, copays, and coinsurance
- is highly rated for quality care and patient satisfaction
These resources can help you get more information about Medicare in Connecticut.
Connecticut Insurance Department (860-297-3900)
Connecticut CHOICES (800-994-9422)
Other sources of help include:
- MyPlaceCT. This is a virtual “No Wrong Door,” a resource for older adults and people with disabilities sponsored by the Connecticut Department of Social Services.
- Medicare. Visit the Medicare website or call 800-633-4227 to speak to a person trained to help you navigate Medicare.
- State Health Insurance Assistance Program (SHIP) Connecticut. SHIP offers outreach, information, referrals, counseling, eligibility screening, and more for Connecticut residents.
- More than 690,000 Connecticut residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in Connecticut.
- There are also several Medigap plan options if you live in Connecticut and are looking for additional coverage.