If you are going to turn 65 this year, are a legal resident of the state of Connecticut, and have a significant employment history in the United States, you qualify to enroll in any number of Medicare Plans in Connecticut. With Medicare, the federal government will help you manage your health care expenses for hospital visits and outpatient care during a period in your life when you need it most. The basic form of this coverage comes in two parts: Medicare Part A, and Medicare Part B. Together, they are often referred to as “Original/Traditional Medicare”.
Coverage and Benefits
How much you pay for Original Medicare coverage will depend on several factors. Part B charges a monthly premium, and you may have to pay a similar fee for Part A. However, your employment history could leave you exempt from the Part A premium. If you have at least ten (10) years, or 40 quarters, of employment in your past, the premium for part A will be waived.
If you’re applying for Medicare benefits, you should be aware of all your options. At the very minimum, once you qualify for Medicare, you will immediately receive and start paying for Part A benefits. Part A covers things like hospital stays and extended care (like hospice, for example). Part B covers many other services: medical supplies, doctor visits, outpatient procedures, and much more. In some cases, Part B benefits are optional; in others, Part B benefits are mandatory.
Medicare Part C is an option you may choose in lieu of Original Medicare (Parts A & B). But you should understand that those Original Medicare benefits are a package deal with Medicare Part C. You can’t choose to accept fewer benefits, but you may have the option to add things like dental, vision, prescription drug coverage, and more. If you choose to stick to Original Medicare but also want Part D prescription drug coverage, Part B is no longer optional in that case, either. You must accept and pay for Parts A & B if you want to purchase Part D.
|Medicare Part A (Hospital Coverage)
||Medicare Part B (Medical Insurance)
|Medicare Part C (Medicare Advantage)
||Medicare Part D (Drug Coverage)
Popular Medicare Plans in Connecticut
Currently, Medicare benefits are helping 586,545 Connecticut residents manage their health care needs. Of those, 24% (or 140,770) have opted into using a Medicare Advantage plan instead of Traditional Medicare. Medigap supplemental coverage, however, seems to be the more popular choice for 154,191 Connecticut residents. And the remaining 291,584 beneficiaries are either relying on Original Medicare by itself, or are a part of some employer-sponsored plan in order to cover the gaps in Traditional Medicare coverage.
Connecticut residents have seen their healthcare costs steadily rising over the past several years; unfortunately, there’s no sign of this trend slowing down. And the older you get, the more expensive your healthcare needs will become. To make things even more complicated, most retirees are budgeting their expenses around a fixed income. If you want to protect yourself from the potentially costly gaps in Medicare coverage, you’ll need to think about purchasing supplement coverage.
Thankfully, Medicare supplement coverage is largely affordable and easy to obtain – if you pick the right plan, that is. A Medigap policy is a small, private type of health insurance which is strategically designed to cover the gaps in Original Medicare for an affordable monthly premium. Medigap plans help protect you from unexpected medical expenses so that you can make the most out of your golden years.
After all, nobody wants their life savings to be wiped out due to a medical emergency or extended care needs. Some of the most expensive coverage gaps include extended hospital stays, blood transfusions, and hospice care under Medicare part A. Under Medicare Part B, you may have to pay a pretty penny for things like coinsurance, co-pays, and of course your monthly premium. Medicare supplement policies are specifically designed to help you mitigate these expenses.
Before you start shopping around for Connecticut Medicare supplement plans, make sure you are at least qualified for (if not already receiving) federal Medicare benefits.
In total, there are 10 different Medigap insurance plans to choose from; but if you want even more choices than that, you can consider a Medicare Part C (Medicare Advantage) plan. While Medigap and Medicare Advantage plans are both provided by private health insurance companies, this feature is one of the few things they have in common. It’s important to know the differences between these two plans if you want to get the best coverage for the most affordable rate.
A Cost-Benefit Analysis of Supplemental Coverage
It might be, depending on your unique circumstances. If you are younger, relatively healthy, and don’t anticipate needing much medical care, then Parts A and B might be enough to cover your needs. However, unexpected medical emergencies can happen to anyone. And if those emergencies require hospital time and outpatient rehab, the costs can add up before you know it.
|Medicare Part A Costs||Medicare Part B Costs|
Most people over the age of 65 are living on a fixed income. In such situations, paying for thousands of dollars in unexpected medical bills might become quite the strain on your budget. Most people don’t feel comfortable putting themselves in such a risky situation, which is why they buy supplemental coverage.
What is a Medigap Supplemental Policy?
Medigap was designed to offer you medical coverage in all of the areas – or gaps – where Medicare doesn’t cover you. The federal government has approved of ten (10) specific plans: A-D, F, G, and K-N. Plans E, H, I, and J also existed before 2010; however, the Medicare reform act which passed that year eliminated the need for them. Each plan offers the exact same type of coverage, regardless of your state or your insurance provider. The only thing that varies by location is the price.
Residents of Connecticut (and every other state) can expect the following benefits from these ten plans:
Top Medicare Supplement Plans in the Area
|Type||Starting From||Part A Deductible||Part B Deductible||Excess||Nursing||Travel|
|F||$206||$0||$0||100% Covered||100% Covered||100% Covered||Request Info|
|C||$242||$0||$0||Not Covered||100% Covered||100% Covered||Request Info|
|G||$200||$0||$147||100% Covered||100% Covered||100% Covered||Request Info|
|B||$172||$0||$147||Not Covered||Not Covered||Not Covered||Request Info|
|N||$140||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|D||$329||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|A||$119||$1||$147||Not Covered||Not Covered||Not Covered||Request Info|
|L||$109||$304||$147||Not Covered||75% Covered||Not Covered||Request Info|
|K||$69||$608||$147||Not Covered||50% Covered||Not Covered||Request Info|
|M||$369||$608||$147||Not Covered||100% Covered||100% Covered||Request Info|
What is Medicare Advantage?
Medicare Advantage is technically more of a replacement than a supplement for Original Medicare. It is also sometimes referred to as Medicare Part C. What an Advantage plan does is that it replaces your Original Medicare from the government with identical (or sometimes better) coverage from a private insurance company. At the very least, you will receive the exact same benefits as you would with traditional Medicare, because this is required by law. Some companies offer extra benefits, such as vision, prescription drugs, or dental, in order to persuade customers. However, the more coverage and benefits you sign up for, the higher your overall costs will be.
Another potential drawback for Medicare Advantage is the restrictive networks. Whether it’s an attempt to cut costs or provide premium treatment, Medicare Advantage providers are sometimes picky about which doctors and health services they allow into their network. There may be a very real risk that you will have to change doctors, which is something to keep in mind before deciding on a plan.
More information on HMO/PPO plans: these acronyms are short for “Health Maintenance Organization” and “Preferred Provider Organization”, respectively. Whichever organization you join will determine where, when, and how you receive your medical care.
What is the Difference Between Medicare Advantage and Medicare Supplement in Connecticut?
Medicare Advantage is a unique type of private health insurance which is designed to replace, not supplement, your Original Medicare benefits. But don’t worry; by law, your Medicare Part C plan must provide you with the same exact benefits that you would get from Medicare Parts A & B. Some companies may even let you choose extras, like prescription drug coverage or vision coverage.
A Medigap insurance plan – which is the short name for a Medicare supplement health insurance plan – does not replace Original Medicare. You can keep accepting your Medicare benefits straight from the government, including Parts A, B, and even Part D prescription coverage if you choose to purchase it. Your Medigap insurance plan only pays for the coverage gaps inherent in Medicare Parts A & B. Medigap policies are also named after letters: you can currently choose from plans A, B, C, D, G, F, K, L, M, Or N. Some plans, like Medigap plan A, don’t cover all of the gaps but are more affordable. Comprehensive plans like Plan F cost a little more each month, but are the most comprehensive.
Medicare supplement plans are a little bit more secure than a Medicare Advantage policy. As long as you qualify for Medicare, you can qualify for a Medigap policy. This isn’t always the case with Medicare Part C. Because it is a private form of health insurance, you may be required to take an exam or to go through some other pre-certification process before getting accepted. Furthermore, if your Medicare Advantage provider has a legal reason to do so, they can cancel your plan at any time.
You should also keep in mind that most Medicare Advantage plans restrict their network of accepted doctors and hospitals to only a few providers. This helps keep your health care costs low, and can even result in a lower monthly premium than you might pay otherwise. But it can be tricky to find a good provider in the event of emergency or if you happen to be traveling. Medicare supplement plans, on the other hand, are accepted everywhere that Medicare is. Unfortunately, you can’t purchase additional coverage options like dental, vision, or prescription drug coverage the way you could with a Medicare Part C plan.
So far, these are just the major differences between these two plans. There are other nuances which, depending on your personal circumstances, might make one plan significantly better for you than the other. you can find out this information by taking a look at our frequently asked questions below, or by contacting us directly and asking an associate to get you a free quote.
|Questions||Medicare Advantage||Medicare Supplement|
|How are expenses covered under each plan?||Your Medicare Advantage provider calculates the total costs of your care, including your monthly premium, and send the bill to the government. Whatever the government doesn’t pay, you do||When you purchase a Medigap policy from your provider, they will quote you a monthly premium that you must pay in order to maintain coverage|
|Will I still have to pay for Part B?||Yes||Yes|
|What will it cost me?||Whatever the government doesn’t pay for, those costs will be passed along to you; this may include part of your monthly premium, deductibles, co-pays, and more||If you purchase a comprehensive plan like Plan F, you will only have to worry about your monthly premium. Less comprehensive plans may have additional costs|
|What will the plan cover?||At the very least, your Medicare Advantage plan will provide the exact same coverage as Parts A & B of Medicare. You can choose additional coverage options if you can afford to do so||At the very least, your Medigap supplement will cover all of the gaps in Part A of Medicare and Part B coinsurance and/or co-payments. More comprehensive plants will cover things like your Medicare deductibles, excess charges, and even provide foreign travel insurance|
|Is it easy to budget my health care expenses?||The more care you require, the harder it will be to budget your expenses with a Medicare Advantage plan.||The more comprehensive your plan, the more effortlessly you can budget for your health care expenses|
|Is my plan guaranteed? Or can it be cancelled?||Because this is a private health insurance plan, your provider has the legal capacity to cancel your coverage at any time as long as they don’t do it illegally||The only ways you can lose your Medigap coverage RF your provider goes bankrupt or if you fail to pay your premiums|
|Do I have to clear a pre-approval or pre-certification process?||Almost all Medicare Advantage providers will require you to go through pre-approval or a pre-certification process and can deny you coverage if you don’t fit the bill||As long as you qualify for Medicare, you qualify for a Medigap policy. It’s as simple as that|
|Am I limited to specific doctors or hospitals?||Part of the reason why some Medicare Advantage plans are more affordable in certain areas is because they limit patient access to a small number of more affordable doctors and hospitals||Any doctor or Hospital which accepts Medicare will accept your Medigap insurance coverage, too|
|What type of plan is best for me?||Relatively healthy seniors who don’t travel often, who live in a high population area, and who want extra coverage options like dental or vision may get more out of a Medicare Advantage policy||If you travel frequently, if you’re worried about passing a pre-certification process, and if you want more predictable health care expenses, a Medigap policy may be best for you|
Informative Medicare Resources
This article is a broad analysis of Medicare supplemental coverage, and contains just enough helpful information to get you started. From here, you can take it the rest of the way by doing some investigation on your own. Below are links and contact information of various offices which specialize in Medicare plans in Connecticut. Talking to any of these experts can definitely help you start going down the right path.
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Help with my Medicare options & issues
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Complaints about my care or services
General health & health conditions
Claims & billing
Health care facilities & services in your area
Important Medicare-Related Healthcare Terms
- HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.
- PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.
- Co-Pay: Amount of money charged per visit to doctor, specialist, etc.
- Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.
- Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.