Introduction to Medicare Advantage in Connecticut (Part C)

Basic Medicare (Parts A and B of the federal Medicare program) is unfortunately plagued by gaps in coverage which, if left unaddressed, could costs you thousands in hospital bills down the road. One solution for protecting seniors from such expenses is to purchase a Medicare Advantage (Medicare Part C) policy. It is a comprehensive, private health insurance plan which replaces your federal Medicare benefits with similar coverage.

Federal Regulations for Medicare Advantage

For the protection of seniors, federal laws regulate Medicare Advantage to make sure that you get equal to or better coverage than Parts A & B of Medicare. Most policies offer the basic Medicare benefits, as well as special coverage designed to protect you from costly Medicare gaps. Furthermore, you can bundle optional coverages to your policy, including Medicare Part D prescription drug benefits.

Medicare Advantage Enrollment In Connecticut

Medicare Advantage plans have a fairly strong presence in Connecticut, all things considered. Nearly a quarter of qualified seniors (24%) have signed up for one of these policies in order to protect themselves from gaps in Medicare coverage. Below, you can see how Medicare Advantage plans break down, and who typically signs up for them:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

Like any other type of insurance, there are dozens of factors which will alter your monthly rates. Your exact location will have a major influence, as well as health status, gender, and how much you can afford to spend on your policy. Below are some estimated rates for seniors in your area:

Most Popular Medicare Advantage Plans in Connecticut

Medicare Advantage plans vary most by location, by insurance provider, and – unlike some other Medicare supplements – by their provider network. Keep in mind, not all provider networks are the same. Some are more restrictive but affordable, like HMOs. Others give you more health care providers to choose from, like PPOs, but will likely cost more.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

If you don’t have a preferred doctor or hospital where you get your medical care, then network restrictions may not be a factor for you. But for many seniors, signing up for a Medicare Advantage policy could force them to start receiving medical care elsewhere. PPOs and PFFS networks are great if you need the flexibility of choice; however, restrictive HMOs will make your plan more affordable.

Doctor/Providers List

Drug, Vision and Dental Coverage

The biggest benefit of a Medicare Advantage policy, despite its drawbacks, is the convenience of bundling your coverage together under one policy. Dental, vision, prescription drugs, and your basic Medicare benefits are all covered under a single policy through a single entity. For some seniors, however, this means paying a premium price for that convenience.

Enrollment Options & Best Time To Enroll

Because you are applying for health insurance coverage from a private company, they are more likely to screen you for health problems before offering you a policy, or reject you for having serious pre-existing conditions. Complicated ailments, such as End Stage Renal Disease, will make it more complicated (but not impossible) to get covered. Your state department of insurance will have information and resources for any senior who is having trouble obtaining coverage due to ESRD or any other serious illness. For more information on enrollment, consult our Medicare Advantage Enrollment Page.

  • Initial Enrollment Period: For best results, try to enroll in a Medicare Advantage plan within your first 6 months of Medicare enrollment.
  • Annual Enrollment Period (AEP): You have the option of changing or cancelling your Medicare Advantage and Part D drug plan between October 15th and December 7th every year.
  • Special Enrollment Period (SEP): If you lose your employer plan coverage, move out of your coverage area, or lose coverage from your provider, you could qualify for an SEP.

What Medicare Advantage Plan Is Best For Me?

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