Connecticut Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
September 3, 2020

If you live in Connecticut, you may be aware that due to coronavirus, the state has opened up the health insurance market, which means that you don’t have to wait until November 1st to buy a plan. Keep in mind, however, that the market may close as scheduled (Dec 15) so it’s important that you begin shopping now if you’re not insured through an employer. Otherwise, you may have to wait another year to buy health insurance, unless you have a qualifying event.

When Is Open Enrollment in Connecticut?

November 1, 2020 - December 15, 2020. Coverage begins January 2021.

How to Get Health Insurance in Connecticut

To get started, understand that every person has individual needs. To buy the right plan you first need to know how much you use your health insurance. To project what your costs will be for the next year, look at last year’s behavior and health history. Did you see doctors often or rarely? Did you have a chronic condition and will it persist? Do you need surgery any time soon? How much were you spending on copays? All of these details will help you figure out which plan configuration makes sense for you. You can’t go by premiums alone. A more expensive plan may cover more, leaving you with less to pay. But that only makes sense if you visit doctors more frequently than not.

Comparing health insurance companies and health insurance quotes is a good way to start. After you submit a form from SmartFinancial, you’ll get several competing health insurance rates to choose from, and we’ll connect you with an agent in your area.

What Types of Health Insurance Are Available in Connecticut?

Most people in Connecticut buy HMOs, EPOs, PPOs and POS. However, you can buy a bare-bones catastrophic plan, but understand that it won’t cover much other than emergencies, and only partially in many cases. Your other option is to buy more comprehensive coverage from the tier-system that determines how much you’re covered. In Connecticut, you can choose from the following: bronze, silver and gold. Bronze covers 60% of total costs, silver covers 70% and gold covers 90%. The more coverage, the more you pay monthly. But that may mean you pay less when you visit doctors and buy medication.

Does Health Insurance Cover Pre-existing Conditions?

It is illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

Compare Health Insurance Plans in Connecticut

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • You may have lost a job, changed jobs or started a new business. This may qualify you to buy health insurance outside the enrollment period.
  • You may have turned 26 and are no longer covered by your parent’s insurance plan. You may buy a new health plan.
  • You may have moved to another state or out of an HMO coverage area. If your health plan is no longer valid, you can sign up for a new health plan.
  • You may have elected Cobra to extend you previous coverage. When you reach the deadline, you may buy a new health plan.
  • You may have divorced a spouse with whom you shared a health plan. You may now buy a new policy.
  • You may have just gotten married! How exciting. This means that you may buy a new health insurance plan together or separately.
  • If you’re a new parent, you may buy health insurance for the new member of your family.
  • If you were covered under your spouse or partner’s health plan but that person passed away, you can buy a new health plan.
  • If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you can buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in Connecticut?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC impose a tax penalty on those without health insurance. Even though it’s not required in every state, buying health insurance can prevent medical bankruptcy.

How Much Is Health Insurance in Connecticut?

The average cost of health insurance in Connecticut for a 40 year old is about $546 a month. Health insurance gets more expensive as you age. Tobacco use also increases health insurance rates.

How to Save on Health Insurance in Connecticut

The best way to save on health insurance in Connecticut is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs

Medicare in Connecticut

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Connecticut?

19% of Connecticut residents are insured through Medicare.

How Much Is Medicare in Connecticut?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be dis-enrolled from original Medicare.

How to Get Medicare Coverage in Connecticut

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Connecticut?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Connecticut State Health System Ranking

  • Connecticut: Overall State Ranking: 5 of 51
  • Connecticut: Overall Performance: Better than Average
  • Connecticut: Access & Affordability: 6
  • Connecticut: Prevention & Treatment: 9
  • Connecticut: Avoidable Hospital Use & Cost: 27
  • Connecticut: Healthy Lives: 1
  • Connecticut: Health Care Disparities: 22
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Connecticut Health Insurance Coverage

The people of Connecticut have different kinds of health insurance while some Connecticut residents are not insured at all. See the breakdown below:

  • Private coverage: 54%
  • Medicaid: 20%
  • Medicare: 19%
  • Uninsured: 7%

Connecticut Health Insurance Companies

  • Anthem Health Plans, Inc.
  • Aetna Life Insurance Company (Connecticut)
  • Cigna Health and Life Insurance Company - Connecticut
  • ConnectCare Insurance Company, Inc (CICI)
  • ConnectCare, Inc.
  • Connecticut General Life Insurance Company - Connecticut
  • Oxford Health Insurance Company, Inc. (Connecticut)
  • Oxford Health Plans (CT), Inc.
  • Anthem Blue Cross and Blue Shield of Connecticut
  • United Healthcare Services, Inc.
  • UnitedHealthcare Insurance Company - Connecticut
  • Cigna HealthCare of Connecticut, Inc.
  • Harvard Pilgrim Insurance Company, Inc. (CT)
  • Aetna Health Inc. (Connecticut)
  • Compass Rose Health Plan

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