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Trinity Health Plan of New England

Trinity Health Plan of New England is a private health insurance plan that offers both HMO and PPO options at an affordable price.  These plans are available to Connecticut residents in the counties of Hartford as well as Tolland.

To learn more about Trinity Health Plans; Click here

Both Trinity’s HMO and PPO plans offer many value based benefits that include:

1. A $0 plan premium
2. Primary care visits with no co-pay
3. Mail order, Tier 1 & 2 drugs have a  $0 copay
4. No cost virtual care visits (see SOB for details)
5. Some plans offer $0 medical deductibles
6. A travel allowance of up to $3,500
7. Dental coverage
8. Over-the-counter allowance
9. Vision hardware allowance
10. Acupuncture treatments are covered
11. ED drug coverage
12. Meals delivered to your home after an in-patient hospital stay

For a look at the 2023 PPO Summary of Benefits; click here

HMO 2023 Summary of Benefits; click here

Another great benefit Trinity Health Plan of New England offers is the extra $600 annually in your Social Security check!

This benefit gives members an extra $50 in their social security check each month.  It is basically a partial reimbursement for their Medicare Part B premium.  Take a look at the SOB for each plan for more details.

These plans cover Every one of the top 100 drugs.

If you don’t see your drug on our formulary?  Trinity can either provide formulary alternatives or a one-time (30-day) transition fill during the first 90 days of enrollment.
You may also request a formulary exception if you need to.  You can check the formulary on TrinityHelathofNE.org/Medicare and check applicable drug requirements as well as quantity limits for specific drugs.

Insulin is covered at an affordable rate so members receive access to necessary care for their diabetes.  Members do not pay more than $35 for a 1 month supply of each insulin product covered by your plan.

Take a look at the 2023 OTC catalog – Click here

Trinity Health Plan of new England – Pharmacy network:

Trinity is partnered with over 66,000 retail chains as well as independent pharmacies nationwide.

Some of the pharmacies include:

Costco Pharmacy, Saint FrancisRx Pharmacy, CVS Pharmacy, Sam’s Club Pharmacy, Medicine Shoppe, Shoprite Pharmacy, Price Chopper Pharmacy, Stop & Shop Pharmacy, Walmart Pharmacy & Walgreens.

To view a complete list of pharmacies either visit us online at; TrinityHealthOfNE.org/Medicare of call 866-934-9524 (TTY:711).

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Medicare Insulin $35

The Medicare Insulin $35 copay Part D Senior Savings Model (SSM) will continue in 2023.   The recently passed program called the “Insulin Now Act” will continue a program that began in 2001.  The program puts a cap of $35 for a one month supply of certain brands and types of Insulin.

Part D costs with the program

The cost for Insulin in the program will be capped at $35 per month for a one month supply.  There are a number of pharmaceutical manfaturers participating in the program. (See list below) The fixed cost will provide substantial savings to those with Part D drug plans (Either through a stand alone Part D plan or a Medicare Advantage plan).  The Insulin prescriptions will not be subject to the usual cost aspects of a Medicare Part D plan.  This includes any initial plan deductible, Initial coverage phase and Part D Coverage Gap.  It does not apply during the catastrophic coverage phase so the cost may change at that time.

The Medicare Insulin $35 copay SSM: Participating Pharmaceutical Manufacturers
1. Eli Lilly and Company
2. MannKind Corporation
3. Mylan Specialty L.P.
4. Novo Nordisk, Inc. and Novo Nordisk Pharma, Inc.
5. Sanofi-Aventis U.S. LLC

Medicare Insulin $35 copay:  Quoting plans

Please note; the $35 program does not cover every type of insulin.  Some of the more expensive name brand drugs for diabetics such as Jardiance or Trulicity will not be capped at $35. You can access a list of the Insulins that will be capped at $35 Part D insulin saver program list 2023

Starting with the 2023 Medicare AEP, drug comparisons on a number of systems will reflect the $35 cost cap on Insulin.  Online comparison sites such as Connecture, Sunfire and  Medicare.gov plan finder will all reflect the new cap of $35.

Changes to Medicare for 2023

In addition to the Medicare Insulin $35 copay cap, there will be other changes to Medicare for 2023.  There are the usual changes to the Medicare premiums, deductibles and copays.  In addition, there is a new type of Medicare Part B and new rules for those with delayed Part B enrollments.

Learn about the changes to Medicare benefits, premiums and enrollments here

Watch a video about the changes here

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SilverScript SmartRx 2023 PDP Changes for 2023

The SilverScript SmartRx 2023 PDP plan will have some changes.  It will be important for Medicare agents to know what is changing and how to quote and compare the plans for 2023.  The plan will not pay commission on new sales for 2023.   As a result, some quote and comparison sites will not show the plan when running drug comparisons.  Read below to learn more.

Commission

Name Change

Premium 

SilverScript SmartRx 2023: Quoting and comparing  

The plan not being commissionable for new sales in 2023 creates some challenges for us as agents.  The plan will continue to have a very low premium for 2023.  Depending on the medication list of clients it may still come out the best for them in 2023. Luckily commissions will still be paid on existing cases.   The challenge is quoting and comparing the plan for existing clients.   Since the plan will not pay commission for new 2023 sales, it is not on a number of quote and comparison sites.  Here is where you can and cannot look to see the plan in 2023:

Connecture 

Sunfire

MyMedicareBot 

SilverScript SmartRx 2023: Register for a webinar on Connecture, Sunfire and MyMedicareBot

Medicare.Gov Plan Finder: 

In addition to access to Connecture, Sunfire and MyMedicareBot at no cost, Crowe and Associates offers a number of other agents benefits

Click here for agent benefits and programs

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Medicare Savings Program CT 2023

If you are either a Medicare beneficiary, eligible to receive Medicare or a Medicare agent who offers plans in CT, you need to understand the Medicare Savings Program CT 2023.  This can be a very useful tool for some clients who have a lower income.

The amount of extra help you receive depends on your gross income level.  Single people will use their gross income to determine eligibility and level of help.  Married couples’ eligibility depends on their combined gross income.  The monthly income limits in the chart below are effective as of March 1, 2022.

If your income falls either at or below the income levels listed below, If you are not sure if you are eligible to receive extra help; we have listed the income levels below:

There are 3 different levels of MSP:

The level of help you receive is based on your gross income.  Please see below for MSP levels and what they provide:

Click here for income level chart.

QMB – this level of extra help pays your Part B premium, all Medicare deductibles and co-insurance.

Income levels for QMB are as follows:  Individual, $2,390 of gross income per month,  couples, $3,220 per month.

SLMB – this level pays your Part B premium only.

The income levels for SLMB are as follows:  Individual, $2,617 of gross income per month, couples, $3,525 per month.

ALMB – this level will provide payment of your Part B premium and is subject to availability of program funds. If you receive Medicaid, you cannot participate in this program.

Income levels for ALMB are as follows:  Individual, $2,786 gross income per month and couples, $3,754 per month.

To apply online, please visit www.connect.ct.gov, under ‘Apply for Benefits.’

Formulario de Renovación de programas de ahorro de Medicare (W-1QMBS)

Click here to download a CT MSP application

If you receive any of these levels of MSP coverage, you are automatically enrolled in the Low Income Subsidy (LIS), also called “Extra Help” with Medicare.  Once you are enrolled in LIS, Medicare pays the full cost of your Medicare (Part D) prescription drug coverage i fit is a benchmark plan.  Medicare will pay a portion of anon-benchmark plan.  They will also provide payment of your annual Part D deductibles, co-insurance or co-pays.  This does not change if you hi the coverage gap (donut hole).

Once you have LIS, you have a special enrollment period to change either Part D or Medicare Advantage plan.

If you need more information about the LIS, please visit www.socialsecurity.gov or call 1-800-Medicare (TTY: 1-800-325-0778).