Connecticut Medicare: All You Should Know

Medicare is a federally funded health insurance program that is available to people over the age of 65 and those who are disabled. In Connecticut, there are several different types…

May 20, 2022

Written by Nikki Grillo

Medicare is a federally funded health insurance program that is available to people over the age of 65 and those who are disabled. In Connecticut, there are several different types of Medicare plans approved by the government.

This blog will explain what each type of plan covers and help you determine which plan is right for you. We will also discuss eligibility requirements and provide other valuable information about Medicare in Connecticut.

What is Medicare? 

Medicare is a federally funded health insurance program that is available to people over the age of 65 and those who are disabled. In Connecticut, there are several different types of Medicare plans approved by the government.

There are four parts to Medicare: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Plans), and Part D (Prescription Drug Coverage).

What Does Medicare Cover?

Original Medicare (Parts A and B) covers most of your hospital and medical expenses. Part A helps pay for inpatient hospital care, skilled nursing facility care, hospice care, and home health care. Part B helps pay for doctor’s services, outpatient care, preventive services, and other medical services and supplies that Part A doesn’t cover.

If you have a Medicare Advantage Plan (Part C), it will provide all of your Part A and Part B coverage, and other benefits like prescription drug coverage.

Medicare Part D is prescription drug coverage. You can get this coverage through a Medicare Advantage Plan or a stand-alone Prescription Drug Plan.

Eligibility for Medicare in Connecticut

To be eligible for Medicare in Connecticut, you must be:

  • A resident of the state of Connecticut.
  • A United States citizen or legal permanent resident who has lived in the US for at least five continuous years.
  • Age 65 or older, OR under 65 and have a qualifying disability.

If you are under the age of 65 and have a qualifying disability, you may be eligible for Medicare. You must first be enrolled in Social Security Disability Insurance (SSDI) to receive benefits. Once you have received SSDI benefits for 24 months, you will automatically be enrolled in Medicare.

Those 65 or older may enroll in Medicare even if they are not receiving Social Security benefits. However, most people eligible for Medicare are also receiving Social Security benefits.

Medicare Enrollment

You can enroll in Medicare during your Initial Enrollment Period, a seven-month period that begins three months before you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

You can also enroll in Medicare during the General Enrollment Period, from January to March each year. If you enroll during the General Enrollment Period, your coverage will begin on July first of that year. 

Applying For Medicare in Connecticut

You can apply for Original Medicare in Connecticut by phoning the Social Security Administration or completing an online application. You may also visit your local Social Security office to register.

Online

To apply for Medicare online, visit the Social Security Administration website. You will need to create an account and provide your personal information, such as your name, address, date of birth, and Social Security number. Once you have created an account, you can begin the application process. 

Phone/Mail

To apply for Medicare by mail, you can request a paper application by calling the Social Security Administration at 800-772-1213. Once you have received the application, please fill it out and return it to your local Social Security office.

Receiving Your Card

You can also visit your local Social Security office to apply for Medicare in person. To find your nearest office, visit the Social Security Administration website and use their Office Locator tool.

Once you have applied for Medicare, you will receive your red, white, and blue Medicare card in the mail. Your card will have your name and Medicare number on it. You will need to show your card whenever you get health care services or supplies covered by Medicare.

Requirements

When you apply for Medicare, you will need to provide:

  • Your birth certificate or other proof of citizenship.
  • Proof of your Connecticut residency.
  • Your bank account information so that your benefits can be directly deposited into your account.

Medicare Plans Available in Connecticut

As of 2021, there are at least 39 different plan alternatives available across the state of Connecticut. There are four main types of Medicare Insurance in Connecticut; these are: Medicare Advantage, Part D Prescription Drug Plans, Medigap, and Medicare Supplement Insurance.

Advantage Plans

Private insurance companies offer Medicare Advantage plans and provide coverage for hospital stays, doctor visits, and prescription drugs. These plans must follow the rules set by Medicare and cover all of the benefits that Original Medicare covers. Some Medicare Advantage plans also cover extra benefits like routine vision or dental care.

Prescription Drugs

Part D Prescription Drug Plans help cover the cost of prescription drugs. These plans are offered by private insurance companies and must be approved by Medicare. Each plan has its own list of covered drugs (called a formulary) and its own rules about how you get your drugs (such as whether you need a prescription from your doctor or if you can get them through mail order).

Medicare Supplements

Medicare Supplements, also known as Medigap plans, are offered by private insurance companies. They can help pay some of the costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. These plans are standardized so that each plan must offer the same basic benefits, no matter which company sells it. You may want to compare several different Medicare Supplement Insurance plans before you decide which one is right for you.

Connecticut Medicare Statistics

The overall Medicare population in Connecticut rose by 6,258 people from November 2019 to October 2020, while Medicare Advantage enrollment grew by 27,662 people. 

Medicare Costs

Part A: Most people do not pay a premium for Medicare Part A (Hospital Insurance). This is also known as “premium-free” Part A. If you or your spouse paid Medicare payroll taxes for less than 7.5 years, you will have a monthly cost of $499 per month. If you paid Medicare payroll taxes for 7.5 and 10 years, the standard premium is $274 per month.

Part B: You pay the standard monthly premium of $170.10 or higher if your income is above a certain level.

Part C: The monthly premium varies by plan. 

Part D: The monthly premium varies by plan. You may also have to pay a deductible and copayments or coinsurance for some services. As of 2021, there are 27 different Medicare Part D plans to select from in Connecticut, with premiums starting at around $7 and going up to $135 per month.

Medigap:  The monthly premium varies by plan. However, Connecticut law (Section 38a-473 of the Connecticut General Statutes) requires insurers to use community rating, which means rates cannot differ depending on age, gender, or health status.

You may also have to pay deductibles, copayments, or coinsurance for some services.

Medicare Savings Program 

The Medicare Savings Program (MSP) can help pay your Medicare premiums through financial assistance in the state of Connecticut. These programs may help pay Medicare Part B premiums, deductibles, and coinsurance. To be eligible, you must have a limited income and resources.

Extra Help with Prescription Drug Costs

If you have limited income and resources, you may qualify for Extra Help to pay for the costs of your prescription drugs. To get Extra Help, you must apply through the Social Security Administration. Its total cost is approximately $5,100 per year. You must be on Medicare and have few resources and income to qualify for Extra Help.

Connecticut State Department of Aging and Disability Services

The Connecticut State Department of Aging and Disability Services (DDS) contracts with the Centers for Medicare and Medicaid Services (CMS) to provide quality assurance oversight of the state’s Medicare program. The DDS Office of Quality Assurance and Licensing is responsible for ensuring that nursing homes, home health agencies, hospices, personal care services providers, and other long-term care facilities meet federal and state requirements.

Nesso Senior Benefits Can Help You Get The Right Plan For You

At Nesso Senior Benefits, based in the state of Connecticut, we can help you choose the right medicare plan to fit all your needs. We understand that it can be confusing to try and figure out what you need on your own, so we’re here to help. We’ll present you with all the information regarding the different types of Medicare, so you can rest assured that you’ll get the best out of the plan you choose. 

Our team of Nesso Group experts can help you determine which programs you’re eligible for. We want you to have all the information you need to make the best decision for your health care, and we will work with you to find a plan that meets both your needs and your budget. Contact us today to get started. We’ll be happy to answer any of your questions and help you find the right Medicare plan for you.

GET STARTED NOW

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