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Toni Aldridge
Kevin Hatfield
Shannon Davis
Tyler Eby
Kayla Torry
Brandon Kauffman
Calvin Fritz
Sara Morrissey
Matt Willenborg
Ariel De Jesus
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A Snapshot of Medicare in Connecticut
Statewide, 56% of Medicare enrollees have Medicare Advantage. The other 44% are on Original Medicare.
Connecticut residents enrolled in both Medicare Part A and Part B can choose to enroll in a Medicare Advantage plan as an alternative to their Original Medicare coverage. Medicare Advantage plans provide Medicare Part A and Part B benefits and may include additional benefits, such as prescription drug coverage. Since Original Medicare doesn't cover prescription drugs, enrollees can purchase a standalone Part D (prescription drug) plan.
Medicare Supplement and Medigap are interchangeable terms for optional insurance plans that people on Original Medicare can get to reduce their out-of-pocket costs. Medigap plans are standardized, meaning plans of the same type (e.g., every Plan G) offer the same basic benefits regardless of the insurance company.
The first time most people in Connecticut can sign up for Medicare is during their Initial Enrollment Period (IEP). Your IEP is a seven-month period that begins three months before the month of your 65th birthday and ends three months after. Some residents may qualify for Medicare earlier if they have certain disabilities or medical conditions. Not enrolling during your IEP can result in late enrollment penalties if you don’t have other qualifying coverage or a Special Enrollment Period. Many people who are still working choose to delay Part B enrollment. If you choose to do this, make sure you qualify for the Part B Special Enrollment Period to avoid penalties.
How to apply for Medicare in Connecticut?
Medicare eligibility in Connecticut follows the same nationwide rules as everywhere else in the country. You qualify for Medicare as a US citizen if you meet one of these criteria:
- You're 65 or older
- You have a qualifying disability, such as End-Stage Renal Disease or ALS
- You've received SSDI for 24 months or more
Enrolling in Connecticut takes three key steps:
- Sign up for Original Medicare (Part A and Part B)
- Decide on your supplemental coverage:
- Medicare Supplement (Medigap)
- Medicare Advantage (Part C)
- Part D (prescription drug coverage)
- Confirm your doctors are in network, update your pharmacy with your new plan, and activate any additional benefits included with your coverage
FAQs
What should I look for when getting Medicare help in Connecticut?
When getting help comparing Medicare options and enrolling in coverage, look for an independent Connecticut Medicare agent who will compare every plan based on your specific health and budget needs. Chapter's team of licensed Medicare agents offers free advice and support to Connecticut residents evaluating Medicare options. An agent can explain coverage options, help compare costs, and make sure your doctors and prescriptions are covered. To ask questions or schedule a free consultation, contact Chapter at (855) 900-2427.
What should Connecticut residents know about the state's guaranteed issue rights for Medigap?
Connecticut Medicare beneficiaries have continuous guaranteed issue for Medigap plans. This means that, if you are eligible for Medigap, you can enroll in or switch your Medigap plan at any point without limitations. Insurance companies cannot deny your application or charge you more based on your health history.
How can Connecticut residents check whether their doctors accept their Medicare coverage?
Connecticut residents with Original Medicare can ask their doctors whether they accept Medicare. On Original Medicare, they can see any doctor who accepts Medicare anywhere in the country. Medicare Advantage policyholders must check their plan's provider network to find in-network doctors and facilities. If they see out-of-network providers, they will be charged more—or may not receive any coverage at all.
What out-of-pocket costs should Connecticut residents consider when choosing Medicare coverage?
Original Medicare beneficiaries should know that they will generally pay 20% of the Medicare-approved amount for a Part B-covered service after meeting their deductible. Original Medicare also has no annual out-of-pocket limit. That’s why many people on Original Medicare get a Medigap plan to reduce their out-of-pocket financial risk.
Medicare Advantage plans each have specific cost-sharing rules and annual out-of-pocket limits. Connecticut residents should choose their coverage option carefully, considering potential out-of-pocket costs for the care and prescriptions they need.
