Connecticut Medicare Supplement Plans (Medigap)
Connecticut Medicare Supplement Plans, aka Medigap Plans, were designed to work hand in hand with those already enrolled in Traditional Medicare. These plans are specifically designed to provide coverage for what Traditional Medicare will not cover. This includes, but is not always limited to, deductibles, copayments and coinsurance.
Private insurance companies sell these Medigap Plans nationwide. These plans are broken down into parts and plans and we are going to outline what is available to Connecticut residents here.
- Medicare Parts A: is your Traditional Medicare that covers hospitalizations and inpatient procedures.
- Medicare Part B: is your Traditional Medicare that covers your doctor’s office visits whether it’s with a PCP or Specialist. It also covers most outpatient procedures, labs and diagnostic imaging studies.
- Medicare Part C: aka Medicare Advantage, is insurance coverage offered by private insurance carriers. A Medicare Advantage Plan will take over coverage of your Original Medicare Parts A and B. In some plans you can include additional benefits such as dental, vision and prescription drug coverage. While it seems like a better options, this plan comes with limitations which will further be discussed.
- Medicare Part D: an individual plan specifically designed for prescription drug coverage.
- Connecticut Medicare Supplement Plans: are a supplemental insurance policy providing extra coverage for what Traditional Medicare doesn’t.
Original Medicare along with Connecticut Medicare Supplement Plans and a Prescription Drug Plan will ensure the best insurance coverage.
Connecticut Medicare Supplement Plans Benefits
While Medicare provides a percentage of your hospitalization and physician care coverage, it leaves some out of pocket costs remaining for the insured left to pay. Whether it’s Part A, hospital coverage or Part B, outpatient coverage, both are only covered at 80%.
This leaves the remaining 20% left for the beneficiary to pay. A Medigap Plan can help with these OOP costs and those residing in the state of Connecticut can choose from 10 Medigap Plans based on their individual needs.
Requirements for a Medigap Plan in Connecticut
To be considered eligible for a Medigap Plan in Connecticut there are a few determining factors:
- You must already be of 65 years in age and currently enrolled in Medicare Plan Part B.
- You cannot currently be enrolled in a Medicare Advantage Plan.
- If you currently receive Social Security benefits you’re automatically enrolled in Part B in the month of your 65th birthday.
It’s important to remember, you must sign up for your Plan B benefits during your Open Enrollment Period. The OEP for Part B begins three months leading up to your 65th birthday, the month of and the three months following your birthday. Failing to do so will result in the Part B late penalty.
The Part B penalty is an increase to your Medicare Part B premiums. This will increase by an extra 10% for each full 12-month period that you went without coverage. In 2018, the Part B premium is $134.00 per month.
Federal law does not require insurance carriers to to offer a Medigap Plan for those disabled under 65 however, some state laws do and Connecticut is one of them.
In the state of Connecticut, individuals who have been on Social Security for 24 months or hold certain Railroad Retirement Benefits qualify for Medicare Part A and Medicare Part B.
Your premium will likely be different than for those over the age of 65. Call us for more information if you’re disabled and have questions about Connecticut Medicare Supplement Plans coverage.
How to Apply for Medigap Coverage in Connecticut
The Open Enrollment Period is the surefire way to gain automatic coverage for a Medigap Plan. OEP eligibility begins on the 1st day of the month after turning 65 and having been enrolled in Medicare Part B. You have the next 6 months to enroll in which you have what is called the Guaranteed Issue right.
What the GI means is that despite any pre-existing medical conditions you cannot be denied coverage or charged more despite these issues. If you sign up for a Medigap Plan outside of your OEP you’re subject to undergo medical underwriting. Medical underwriting means the insurance carrier can deny coverage or increase your monthly premiums due to any pre-existing medical conditions.
Fortunately for the state of Connecticut, you have open enrollment year round. So while the above rules apply in most states, Connecticut residents are exempt. This means you can enroll as early as the 1st day of the month in which you turn 65 and any time after that without penalty.
Medigap Premiums in Connecticut
The individual insurance carrier you decide to go with for your Medigap Plan will determine the cost of the monthly premium. Age, gender, and location is factored in when they determine cost.
So while a person in Hartford pays one price a person in Stamford will pay a different price. In addition to age, gender and location there are an additional 3 different methods used to factor in monthly premiums. They are:
- Community rated: the same amount is charged for everyone regardless of age.
- Issue-Age rated: The age you are when the policy is purchased will determine the cost. A higher premium will be charged the older you are however, the rates will never increase due to aging.
- Attained-Age rated: based on the age you are when purchasing the plan will determine the cost. With this method your premiums will increase each year as you age.
The Best Medigap Plans in Connecticut
There are 10 letter plans to choose from when determining Connecticut Medicare Supplement Plans. The top plans in Connecticut are Plans F, G and N.
- Plan F: This plan is the most popular of all the plans as it provides the most extensive coverage. 100% of the Medicare Part A and Medicare Part B deductibles are covered as well as the remaining 20% of hospital and doctor’s costs not covered by Traditional Medicare. It also covers any coinsurance and copayments from Medicare Part B. There is also a high deductible Plan F that has lower monthly premiums but offers the same benefits.
- Plan G: Similar to Plan F benefits with the only difference being a lower cost and no Part B deductible coverage. As of 2018 the Part B deductible is $183 which you will be responsible to pay OOP.
- Plan N: Is considered a cost-sharing plan. While the most affordable of all the plans it requires a small co-payment for ER and physician office visits. While it covers you Medicare Part A deductible it will not cover any excess charges. In Connecticut this will not apply to you as physicians aren’t allowed any excess charges.
Regardless of which plan you decide to go with the insurance benefits will remain the same nationwide. The only difference between the plans will be your insurance premiums which will vary from state to state.
Medicare Advantage Plans in Connecticut
Medicare Advantage Plans, aka Medicare Part C, are offered by private insurance carriers approved by Medicare. These plans replace your Traditional Medicare and provides coverage for Medicare Parts A and B and come in HMO or PPO form.
These plans generally have lower monthly premiums however, the restrictions within the policies outweigh the benefits. These restrictions include treatment with only in-network physicians, coverage limitations and cancellation restrictions.
While a Part C Plan seems more affordable it tends to have higher OOP costs. Most people are better off with a Medigap Plan as it provides better coverage and you pay way less out of pocket.
Since Original Medicare and Medigap plans don’t include prescription drug coverage, the best option for those living in Connecticut is to enroll in a Medicare Part D plan.
Connecticut PDP’s work alongside with Traditional Medicare and the Medigap Plans. To avoid high OOP costs associated with medications, you want to purchase a Medicare Part D Plan.
Here is another case in which a penalty will be issued if you go without coverage. If you don’t obtain coverage within the eligibility time frame, after 63 consecutive days without a PDP you will be required to pay a penalty. This penalty will be added to your monthly premium.
To obtain the most comprehensive coverage, you would want to combine Medicare Parts A & B, a Medigap Plan and a Medicare Part D Prescription Drug Plan.
Medigap Plan Rates Compared in Connecticut
The various private insurance carriers offer the different Connecticut Medicare Supplement Plans. While we have outlined the most popular plans, there are a total of 10 Medigap Plans available for individuals living in Connecticut.
As stated previously, each plans coverage is the same regardless of where you reside. However, the cost will differ depending on your residence.
Fill out the online form or call today to compare these rates. Our licensed insurance agents are ready to help and our services are 100% free.
Medicare Savings Programs in Connecticut
Each individual state, including Connecticut, has Medicare assistance programs. These programs were designed to assist with the costs associated with Medicare and benefit those individuals whom have income limits or are disabled.
There’s a Nationwide program called State Health Insurance Assistance Programs or, “SHIP”, that provides free services for Medicare beneficiaries. In Connecticut, the program is called “CHOICES.” Also, the Centers for Medicare and Medicaid services can be visited for additional information.
For teachers on the Teacher Retirement Board, read what changes you can expect in 2018 to your healthcare coverage here.
Fun Medicare Facts in Connecticut
- Connecticut recorded over 630,000 residents were receiving Medicare benefits in 2015, that’s 18% of the total population in the state.
- In 2013, 87% of beneficiaries attained the age of 65 when they became receiving benefits. The remaining 13% was disabled. Less than 1% of those beneficiaries were diagnosed with ESRD.
- When is the Medicare open enrollment in Connecticut? OEP starts three months leading up to your 65th birthday, continues through your birthday month and then lasts for three months after turning 65.
- Does Aetna offer Medicare plans in Connecticut? Yes, Aetna, and the majority of the private insurance carriers offer Medigap Plans in Connecticut.
- Where can I compare Medicare plans for Hartford, CT? Any questions you have concerning the individual Medigap Plans can be answered by calling or filling out our rate form. Our licensed insurance agents are readily available to assist with any questions regarding your healthcare needs. And as always, our services are 100% free!