Connecticut Medicare Guide

Get personalized Medicare advice from a licensed Connecticut Medicare Advisor! Schedule a free consultation or give us a call at (888) 604-0055 to get started.

This guide is intended to help you understand the basics of Medicare in Connecticut. This will help you make informed decisions that get you the best value from Medicare!

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A Snapshot of Medicare in Connecticut

There are 703,000 Connecticut Medicare beneficiaries, making up 19% of the state’s population. Most people are on Medicare due to age, but about 11% of Connecticut residents are on Medicare because they have a disability. 27% of Connecticut Medicare recipients also receive Medicaid benefits. When it comes to Original Medicare vs. Medicare Advantage, 52% of beneficiaries stay on Original Medicare and 48% choose to move to a Medicare Advantage plan.

Connecticut Medicare Eligibility and Enrollment Steps

All US citizens who meet one of the following requirements are eligible for Medicare:

You’re 65 or older
You have certain disabilities like ALS and End-Stage Kidney Disease

Medicare Enrollment Steps

1. Enroll in Original Medicare (Part A & Part B)

Most people age into Medicare and are able to enroll during their Initial Enrollment Period (IEP). Your IEP is a seven-month period surrounding your 65th birthday. It starts three months before the month you turn 65 and ends three months after. Unless you're eligible for the Part B Special Enrollment Period, you don’t want to miss your IEP! If you do, you may be subject to late enrollment penalties.

2. Compare additional coverage options

Medicare beneficiaries have options. One of the big decisions you’ll make is between Original Medicare (also called Traditional Medicare) and Medicare Advantage (also called Medicare Part C). Medicare Advantage plans are provided by private insurance companies as an alternative to Original Medicare. If you stay on Original Medicare you can stack on additional coverage through a Medicare Supplement (also called Medigap) plan and/or a prescription drug (Part D) plan. There are pros and cons to both Original Medicare and Medicare Advantage, and we explain them in more detail later on in this guide. If you have questions about your Medicare options, we’re here to help! Call us at (888) 604-0055 to get free information and advice so you feel confident in your Medicare decisions.

3. Get the best value from Medicare

Choosing the best Medicare coverage option(s) for your needs is step one, but you also need to review your coverage and needs each year to be sure you’re always receiving the best value. The Medicare Open Enrollment Period, which occurs every year from October 15 - December 7, is a great time to do a coverage review.

During the Open Enrollment Period, you can change Medicare Advantage and prescription drug plans without consequence. Plans change every year and your healthcare needs may too, so even if you’ve been happy with your plan, this is a good time to check that you’re receiving the best value from your coverage.

Connecticut Medicare Advantage Plans

There are 45 Medicare Advantage plans in Connecticut, but exact plan pricing and availability varies by county. For example, Fairfield County has 29 Medicare Advantage plans from five insurance carriers and New Haven County has 40 plans from eight insurance carriers (in 2023). To compare Connecticut Medicare Advantage plans available to you, give us a call at (888) 604-0055 or schedule a free consultation with a licensed Connecticut state Medicare Advisor.

Medicare Advantage plans replace Original Medicare and must provide at least the same level of coverage. Most of them also provide Part D coverage and a variety of other benefits, which may include:

Dental, vision, and hearing coverage
Transportation
Meals
Over-the-counter flex cards
Telehealth
Fitness perks

Medicare Advantage plans are often chosen because they provide these added benefits, often with no (or a low) additional premium. Note: while these plans are advertised as $0 premium plans, enrollees are still responsible for their Original Medicare premiums.

While they aren’t free, more coverage for no (or a low) additional cost sounds great, so what’s the catch? Common complaints about Medicare Advantage plans include:

Network limitations
Preauthorization requirements (and denials)
High out-of-pocket costs

Connecticut Medicare Supplement Plans

While Medicare Advantage plans replace Original Medicare, Medicare Supplement (also called Medigap) plans stack on top of Original Medicare. Medigap plans were created to help cover the 20% of costs that Medicare doesn’t pay. While Medigap plans don’t provide additional coverage or benefits, they significantly reduce your out-of-pocket costs.

They also come with some big benefits, especially in comparison to Medicare Advantage plans.

They don’t limit which providers you can see
They don’t require prior authorization for covered services

There are ten types of Medigap plans, labeled by letters A through N. While pricing may vary from one insurance carrier to another, all plans of the same type (e.g., all Plan Gs) are identical.

Unlike other states, Connecticut has a flexible Medigap enrollment policy. Connecticut residents are guaranteed acceptance into any Medigap plan and will never need to answer questions about their health history. Furthermore, insurance companies cannot charge you more based on your age, gender, and health status.

Connecticut Part D Plans

Original Medicare does not cover prescriptions, which is why we have Medicare Part D. You can get Part D coverage through a Medicare Advantage plan that has it or through a stand-alone Part D plan. There are 24 stand-alone Part D plans available in Connecticut, with an average monthly premium of $45.01 (the second highest average in the country).

We recommend that everyone gets prescription coverage when they first enroll in Medicare, even if they don’t need it. This will ensure you don’t have to pay the Part D enrollment penalty when you do need prescription coverage.

If you have questions about your Medicare options or want to compare plan benefits and pricing, schedule a free consultation with one of our licensed Connecticut Medicare Advisors or give us a call at (888) 604-0055.

Get help paying for Medicare in Connecticut

There are three government programs that offer financial assistance for Medicare beneficiaries who have low incomes and resources.

Connecticut Medicaid

Medicaid is a joint federal and state program that’s operated by each state. The Connecticut Medicaid program is called HUSKY Health. Husky C (also known as Medicaid for the Aged/Blind/Disabled) provides Medicaid benefits for eligible individuals who are 65 or older and/or blind or disabled.

Connecticut also has three Medicare Savings Programs programs to help low-income individuals with their Medicare costs:

Qualified Medicare Beneficiary (QMB) Program
Special Low-Income Medicare Beneficiary (SLMB) Program
Additional Low-Income Medicare Beneficiary (ALMB) Program

Learn more about Connecticut’s Medicare Savings Programs here.

Medicare Extra Help

Extra Help is a federal program that helps pay for costs associated with Medicare Part D, including premiums, deductibles, and coinsurance/copayments. Extra Help is also sometimes called the Part D Low Income Subsidy (or LIS).

You automatically qualify for Extra Help if you:

Receive full Medicaid coverage from Connecticut
Connecticut pays your Part B premium
Are eligible for Supplemental Security Income (SSI)

If you don’t automatically qualify for Extra Help, you can learn more about the program here or talk to one of our licensed Connecticut Medicare Advisors to get free support with your application.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

You are 65 and older, blind, or have a disability
You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.

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