TABLE OF CONTENTS
Medicare Advantage Plans are an all-in-one alternative to Original Medicare offered by private, Medicare-approved insurance companies. These bundled plans provide the same coverage as Medicare Parts A and B and often include benefits that Original Medicare does not offer, such as vision, dental and hearing coverage. Some plans may provide even more benefits like wellness or transportation to doctor’s visits.
Since each Medicare Advantage Plan provider can set its own rates and benefit offerings, it’s important to compare your options before choosing a Medicare Advantage Plan. This article will go over everything you need to know about Medicare Advantage Plans in Connecticut.
Compare ratings of insurance companies offering Medicare Advantage Plans in Connecticut:
You have choices in Medicare coverage. While you can opt to stick with Original Medicare, a Medicare Advantage Plan – also known as Part C – may be a better alternative for you.
|Original Medicare||Medicare Advantage Plans|
|Original Medicare covers your Part A hospital insurance and Part B medical insurance.||Medicare Advantage Plans combine Part A, Part B, and additional benefits.|
|You can add Part D prescription drug coverage.||Prescription drug coverage is usually included.|
|You’re able to use any medical provider in the U.S. that accepts Medicare.||You’ll usually need to use doctors in your plan’s network.|
|You can buy supplemental coverage to manage out-of-pocket costs, including your coinsurance.||Your Medicare Advantage Plan may have lower out-of-pocket costs than Original Medicare.|
|Vision, hearing, dental, and other benefits aren’t covered.||Your plan may offer additional benefits, including vision, hearing, and dental.|
Medicare Advantage Plans cover benefits from Original Medicare Part A (hospital insurance), Part B (medical insurance), usually Part D (prescription drug coverage), and sometimes additional benefits that Original Medicare doesn’t cover. Each Medicare Advantage Plan insurer sets the rules about how you receive and pay for these benefits.
|Hospital and skilled nursing facility inpatient care||Home health care||Prescription drug coverage (if included in your plan)|
|Medically necessary outpatient services, such as:
||Preventive services, such as:
||Additional benefits (depending on your plan), such as:
With 65 Medicare Advantage Plans available in Connecticut, you likely have a few options in your area. To help you choose the best plan for you, consider what is most important to you before selecting a plan. There are several factors to keep in mind:
With only 22% of Connecticut residents choosing a Medicare Advantage Plan, Plan C isn’t as popular in the state as it is elsewhere in the country. This may be because there are fewer plans available in Connecticut than in many other states, but these plans are still an option worth exploring.
|Number of Medicare Advantage Plans available||Medicare Advantage Plan types available||Medicare Advantage Plans rated 3.5 or higher by NCQA|
In Connecticut, the most common Medicare Advantage plans available are HMOs or PPOs, although there are also a few SNPs and regional PFFS plans available. Seniors eligible for Medicare may choose from plans provided by multiple private insurers, although the choices available vary by county.
HMOs typically require that you receive all services from in network providers:
PPOs include a preferred network of providers, but you have the option of choosing doctors or hospitals from outside of the network for a higher cost.
PFFS plans don’t require a primary care physician or referrals for specialists:
SNPs are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
You’re eligible for Medicare when you turn 65 or if you’re younger and have a qualifying disability. A qualifying disability means at least one of the following applies:
When you become eligible for Medicare, you are also eligible for Medicare Advantage Plans. There are specific times of the year when you can enroll for the first time in a Medicare Advantage Plan: during your Initial Enrollment Period and the Open Enrollment Period.
Medicare Advantage Open Enrollment occurs between January 1 and March 31 of each year. This period is only for beneficiaries already in a Medicare Advantage Plan, and you can change plans or switch to Original Medicare. You cannot switch from Original Medicare to Medicare Advantage during Medicare Advantage Open Enrollment.
There are exceptions to these enrollment periods called Special Enrollment Periods. Certain events or circumstances may make you eligible to change your Medicare Advantage Plan outside of the open enrollment periods, such as if you move outside of your existing plan’s service area or to a location with new plan options you didn’t have before. If you think you may qualify for a Special Enrollment Period, call 1-800-MEDICARE and explain your situation.
|Enrollment period||When it happens||Medicare plans you can choose||What you can do|
|Initial Enrollment Period||Three months before you turn 65, the month you turn 65, and three months after||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Sign up for Medicare Part A and Part B. Complete your Part B enrollment to avoid a late enrollment penalty.|
|General Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan. If you enroll in Medicare during this period, your MAP enrollment is April through June.||Sign up for Medicare if you missed your IEP|
|Open Enrollment Period||October 15 – December 7||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Join, switch, or drop a plan|
|Medicare Advantage Open Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||If you’re enrolled in a Medicare Advantage Plan, you can change your plan or switch to Original Medicare|
|Special Enrollment Period||When you have a qualifying event||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Make changes to your plan|
Most Medicare Advantage HMO and PPO plans and all SNP plans provide prescription drug coverage like you would get from Medicare Part D. Some PFFS plans may provide prescription drug coverage, but not all do. Evaluate a plan’s prescription drug coverage when deciding which Connecticut Medicare Advantage Plan to use.
Prescription drug coverage may vary by cost, coverage, and convenience among Medicare Advantage Plans. Your monthly premium may include a premium for the drug coverage in the plan. There is usually a copayment or coinsurance amount that you have to pay for each prescription after you reach your annual deductible.
Some plans use different cost tiers with different costs for different drugs. For instance, you may pay less for generic drugs than brand-name drugs or less for brand-name drugs within different tiers. If your plan uses tiers, the formulary will list all covered drugs and their tiers. Verify your preferred or local pharmacies are included in the plan’s network.
|Resource||Contact||How they help|
|CHOICES||(800) 994-9422||CHOICES empowers, educates, and assists Medicare-eligible individuals, their families, and caregivers through objective outreach, counseling, and training to make informed health insurance decisions that optimize access to care and benefits|
|Connecticut Aging Committee||(860) 240‑0090||The Connecticut Aging Committee has cognizance of all matters relating to senior citizens|
|Connecticut Insurance Department||(860) 297-3800||A state website with helpful information on insurance issues within Connecticut|
|Connecticut Medicaid and CHIP Services||(877) 284-8759||HUSKY Health offers coverage to eligible children, parents, relative caregivers, elders, individuals with disabilities, adults without dependent children, and pregnant women|
|Connecticut Medical Assistance Program||N/A||This site provides important information to health care providers about the Connecticut Medical Assistance Programincluding enrollment, billing manuals, bulletins, program regulations, plus information on Electronic Data Interchange and the Automated Eligibility Verification System|
|Connecticut Medicare||(866) 466-4446
|Medicare is the Federal health insurance program for Americans age 65 and older and for certain disabled Americans|
|Connecticut Medicare Supplement & Medicare Info||N/A||A site containing information on Medicare and Medicare Supplement Insurance|
|Connecticut State Department of Aging and Disability Services||(860) 424-5055||The Connecticut State Department of Aging and Disability Services seeks to maximizing opportunities for the independence and well-being of people with disabilities and older adults in Connecticut|
|Resource||Contact||How they help|
|Brookfield Commission on Aging||(203) 775-7300||The Commission on Aging proposes and evaluates programs and services for older citizens in Brookfield|
|Darien Commission On Aging||203) 656-7300||The Commission on Aging is concerned with the needs of Darien’s seniors – and seniors-to-be – with regard to health, recreation, transportation and economics|
|Enfield Commission on Aging||(860) 253-6300||The Commission on Aging was established to study the needs of and coordinate the programs for the aging|
|Granby Commission on Aging||(860) 844-5351||The commission proposes and evaluates programs and services for the elderly in the community, and assists the town staff in the development, initiation, coordination, and implementation of programs and services for the elderly|
|Greenwich Commission on Aging||(203) 622-7700||The mission of the Commission on Aging is to improve the quality of life for older Greenwich residents through planning, coordination, advocacy, education and Senior Center programming|
|Montville Commission on the Aging||(860) 848-0422||The Montville Commission on the Aging plans, coordinate, develop and implement programs to meet the needs of the elderly and aging|
|New Fairfield Commission on the Aging||(203) 312-5665||The Committee studies the conditions and needs of elderly persons in the Community in relation to housing, economic, employment, health, recreational, and other matters|
|Newtown Commission on Aging||(203) 270-4310||The Newtown Commission on Aging coordinates programs for the elderly and aging in Newtown|
|North Central Connecticut Area Agency on Aging||(800) 994-9422
|NCAAA is a regional non-profit organization based in Hartford, CT, that provides planning, management of funding and advocacy services to older persons and their caregivers|
|Ridgefield Commission on Aging||(203) 438-6165||The Ridgefield Commission on Aging identifies the needs of senior citizens living in Ridgefield and coordinates services that further their well-being|
|Senior Resources Agency on Aging||(800) 690-6998
|Senior Resources Agency on Aging’s mission is to provide access to information and services to empower adults to live with dignity|
|South Central Connecticut Area Agency on Aging||(203-785-8533||South Central Connecticut Area Agency on Aging’s mission is to empower adults to remain as independent and engaged as possible within their communities through advocacy, information, and services|
|Southwestern Connecticut Area Agency on Aging||(203) 333-9288
|The mission of the Southwestern CT Agency on Aging is to provide leadership and resources to meet the needs of the rapidly growing older adult population and to maintain and improve the quality of life and independence of older persons and persons with disabilities|
|Stratford Commission on Aging||(203) 385-4035
|Stratford Commission on Aging studies the conditions and needs of elderly persons in the community in relation to housing, economic, employment, health, recreation and other matters|
|Western Connecticut Area Agency on Aging||(203) 757-5449||The mission of the Western Connecticut Area Agency on Aging, Inc., is to develop, manage and provide comprehensive services for seniors, caregivers and individuals with disabilities through person-centered planning in order to maintain their independence and quality of life|
|Resource||Contact||How they help|
|American Hospital Association – Medicare Advantage||1-800-424-4301||The AHA provides education for health care leaders and is a source of information on health care issues and trends.|
|CMS.gov – Medicare Advantage Applications||N/A||This page provides important information on the application process for Part C Medicare Advantage plans.|
|Medicare.gov – Medicare Advantage Plans||1-800-633-4227||This government website provides information on the Medicare Advantage program.|