Medicare Plan Options
When it’s time to select your Medicare plan, you have an assortment of options. If your health care needs are minimal, Original Medicare may be your best choice. Those who have more complex health care needs may want to consider a Medicare Advantage Plan. These plans include vision, dental and hearing coverage and many offer prescription drug coverage. If you only need a little extra to supplement Original Medicare, try a Medicare Supplemental Insurance plan. Those who regularly take medications may want to opt for a Part D prescription drug plan.
Original Medicare has two parts: Part A, which provides insurance for inpatient hospital care, lab tests, surgery, home health care, hospice care and stays in a skilled nursing facility; and Part B, which includes visits to the doctor’s office, medically necessary services, preventative care, ambulance services, mental health care and limited outpatient prescription drugs. With Original Medicare, you pay a deductible and then your share of the in-patient or out-patient visit. There’s no limit on what you pay out-of-pocket under Original Medicare. If you select Original Medicare and you want drug coverage, you’ll need to select a separate Part D plan.
Medicare Advantage Plans
Medicare Advantage Plans are provided by private health insurance companies that have been approved by Medicare. These plans include Medicare Parts A and B, and some plans also include prescription drug coverage. Medicare Advantage Plans provide additional benefits, such as vision, fitness programs, dental and hearing coverage. You can select one of four different Medicare Advantage Plans: HMOs, PPOs, Private Fee-for-Service Plans and Special Needs Plans. Some plans only let you use in-network providers, while others offer more flexibility for a price. You can only select a Medicare Advantage Plan that’s available in the county where you live in Connecticut.
Medicare Prescription Drug Coverage Plans
While Original Medicare doesn’t cover prescription drugs, you can add coverage from a Part D plan for a fee. How much your plan costs depends on several factors, including your pharmacy, the tier of the drug, and whether a drug company offers financial assistance to help you pay for their products. However, Medicare Advantage Plans often provide prescription drug coverage. In some plans, such as SNPs, prescription drug coverage is required. If you don’t select a Part D plan when you initially enroll in Medicare or select a Medicare Advantage Plan that offers prescription drug coverage, you can enroll later, but you may have to pay a permanent monthly penalty.
Medicare Supplement Insurance Programs
Payment gaps exist in Original Medicare, and you may not always be 100% sure about what is and isn’t covered. If there isn’t a Medicare Advantage Plan that works for you, you may want to consider purchasing a Medicare Supplement Insurance Plan, known as Medigap. These plans help plug the gaps in Original Medicare, cover the copays in Parts A and B, and may cover any excess Part B costs. If you need to go out of the country on a business or family trip, a Medicare Supplement Insurance Plan can provide medical coverage. Medicare Supplement Insurance won’t work with any Medicare Advantage Plan.
Medicare in Connecticut by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|377,091||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Connecticut
Selecting the best Medicare plan isn’t always easy. There are important questions you need to answer. Friends or relatives have some answers, but sometimes it’s best to speak with an expert. Fortunately, Connecticut has a variety of free and unbiased resources that can answer your questions about your Medicare choices. You may also be eligible for some forms of financial assistance.
Connecticut Area Agencies on Aging (AAA)
Founded by an act of Congress in the 1970s, every state has Area Agencies on Aging offices. The five AAA offices in Connecticut offer senior services throughout the state. The AAA operates numerous programs and supports other activities for seniors in their communities. It works with SHIP counselors to offer information and education about Medicare programs, along with other important public benefits, such as Medicaid, Social Security, state-funded nutrition programs, and caregiver services.
Contact information: Website | 860-424-5055
Medicare Savings Program
Offered by the state of Connecticut, this program provides financial assistance to eligible Medicare beneficiaries. It helps pay for Medicare Part B premiums, deductibles, and coinsurance, and it can help you pay for Medicare Part D prescription drug coverage. You may be eligible for one of three Medicare Savings Programs that can provide financial assistance on a monthly basis. Each program has different eligibility levels based on an individual’s or a couple’s gross income. These programs are funded by Medicare.
Contact Information: Website | 855-626-6632
CHOICES (Connecticut’s program for Health insurance assistance, Outreach, Information and referral, Counseling, Eligibility Screening)
The State Health Insurance Assistance Program (SHIP) is also known as CHOICES. Regardless of your age or income level, SHIP’s trained, volunteer staff provides free, unbiased counseling to seniors and Medicare-eligible individuals. They assist and educate older residents of the Nutmeg state, their families, and their caregivers to make informed decisions about their health care. SHIP staff can counsel you or others about Medicare, Medicare Advantage, Medicare Supplement, and prescription drug coverage.
Contact Information: Website | 800-994-9422
Learn from our sources
- HHS.gov | What is Medicare Part C? | Last accessed June 2021
- Medicare | What Part A covers | Last accessed June 2021
- Medicare | What Part B covers | Last accessed June 2021
- Medicare | Part D | Last accessed June 2021
- Medicare | Health Maintenance Organizations (HMO) | Last accessed June 2021
- Medicare | Preferred Provider Organizations (PPO) | Last accessed June 2021
- Medicare | Private Fee-for-Service Plans (PFFS) | Last accessed June 2021
- Medicare |Special Needs Plans (SNP) | Last accessed June 2021
- Medicare | How to Get Prescription Drug Coverage | Last accessed June 2021
- Patient Advocate Foundation | Understanding Drug Tiers | Last accessed June 2021