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Medicare Plan Choices Connecticut 2017

Medicare plan choices connecticut 2017 will cover Medicare Advantage (Also called Managed Medicare or Medicare part C, Medicare Supplments (also called Medigap) and Medicare Part D plans.  Various companies in Connecticut offer all three types of plans for 2017.   This post will cover all three plan types. Also it will cover how a Medicare receipient can pick the best choice for him/her.  Benefit and rate comparisons have been provided below throughout the post.  Good luck.

NOTE: There are links below which provide Medicare supplement, Medicare Advantage and PDP plan comparisons for the State of CT.  We can run any additional quotes/comparisons that are needed for any product. (MAPD, Medigap, PDP)  Call or email our office with any questions (203)-796-5403 or email [email protected]  

Quick Medicare A and B Information before getting into the plans

First of all, you need to know the basics rules of Medicare A and B. While picking the right plan is important, having Medicare A and B is probably as important.  First of all, you must have Medicare A and B to enroll in a Medicare Advantage plan (MAPD) or a Medicare suplement plan (Medigap).  A part D drug plan (PDP) requires you to have Medicare part A and/or B.  Medicare part A cost nothing for almost everyone while part B costs money every month.  CLICK FOR PART B PREMIUMS  If you are drawing social security already, the part B premium will be taken out of your check every month.  If you are not drawing social security, you will be billed quarterly.

Part A of Medicare covers hospitalization while part B covers outpatient services such as doctors and testing. CLICK FOR MEDICARE A AND B BENEFITS  You will see that Medicare covers 80% of Medical costs, as a result,  most people want to cover some or all of the other 20%.  Finally, it does not cover prescriptions drugs, therefore many people purchase a PDP plan.  As a result, those aging into Medicare likely will enrol in a Medicare Advantage plan or a Medigap and/or a PDP plan.

Medicare Plan Choices Connecticut 2017- Medicare Supplements (Medigap Plans)

Medicare Plan Choices Connecticut 2017

A Medicare Supplement Insurance (Medigap) policy, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like foreign travel coverage. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare allowed amounts for covered health care costs. Then the Medigap pays its portion of the cost depending on the plan you have.

A Medigap policy is not a Medicare Advantge Plan.

Things to know about Medigap policies

1. You must have Original Medicare A and B
2. If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
3. You pay the Medigap premium and the Medicare Part B premium
4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
5. You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium. Furthermore, Connecticut is a guaranteed issue state for Medigap.  This allow a change form one Medigap to another throughout the year without any health underwriting.

Medigap policies don’t cover everything

Medigap policies generally don’t cover benefits such as long term care, vision and dental.

Click for Medigap rates Connecticut 2017

Dropping your Medigap and Part D Prescription Drug Coverage:

You have to pay a Part D late enrollment penalty when you join a new Medicare drug plan if:

• Either you drop your entire Medigap policy and the drug coverage wasn’t creditable prescription drug coverage, or
• You go 63 days or more in a row before your new Medicare drug coverage begins

Call or email us with any questions at 203-796-5403 or email [email protected] We do not charge a fee for our services.

Medicare Plan Choices Connecticut 2017-Medicare Advantage Plans

Medicare Advantage plans are sometimes referred to as Medicare Part C or Managed Medicare plans . They are Medicare-approved health insurance plans for individuals who are enrolled in Original Medicare, Part A and Part B. When you join a Medicare Advantage plan, you are still in the Medicare program and must continue paying your Part B premium. Original Medicare is not billed while in an Advantage plan, as a result, some people incorrectly think they are not part of the Medicare Program

Medicare Advantage plans provide all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. Sometimes, they offer additional benefits, such as vision, dental, and hearing, and most include prescription drug coverage. These plans often have networks, which mean you may have to see certain doctors and go to certain hospitals in the plan’s network to get care.

Medicare Advantage plans may potentially save you money vs using a Medigap and PDP plan because the monthly premium is much lower in most cases. Pricing (monthly premium, copays, dedutibles and co-insurance) will vary by plan provider, so it’s worthwhile to compare all plans in your area. Your costs will vary by the services you use and the type of plan you purchase.

Medicare Plan Choices Connectict 2017- Plan options can include:

• Health Maintenance Organization (HMO)
• Preferred Provider Organization (PPO)
• Private Fee-for-Service (PFFS)  (Not currently available in CT for 2017)
• Special Needs Plans (SNPs)
• HMO Point-of-Service (HMOPOS)
• Medical Savings Account (MSA) (Not currently available in CT for 2017)

You can generally join if you:

           live in the service area of the plan you want to join (Most plans in CT are offered in all CT counties with a few exceptions)

•  have Original Medicare, Part A and Part B, coverage.
•  don’t have end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant); however, there are a few exceptions.

Choose your plan carefully. Outside of when you first become eligible to enroll and other personal circumstances that may qualify you for a Special Election Period, you are only able to change plans once a year during the Annual Election Period. The Annual Election Period lasts from October 15 through December 7 of each year. (An exception to this rule is for those that have a “Trial Right” which allows  them to change from an advantage plan back to a Medigap and drug plan.

There is also a Medicare Advantage Disenrollment Period, which runs from January 1 through February 14. During this time, individuals enrolled in a Medicare Advantage plan can disenroll from their plan and return to Original Medicare coverage and buy a Medigap and PDP plan if they want to.

One more thing to note is that Medicare Advantage plans, with or without prescription drug coverage, vary depending on where you live. The name of this blog is Medicare plan choices Connecticut 2017.   In fact, the rules above apply to most states.

Medicare plan choices Connecticut 2017 – Click Here For 2017 MAPD Plan Comparison CT

Medicare Part D (PDP) Plans CT 2017

A prescription drug plan (PDP) is an option for those eligible that want to enroll in the Medicare Part D prescription drug coverage, which can lower the costs of prescription drugs for insured. A prescription drug plan (PDP) is a stand-alone plan, covering only prescription drugs. Enrollees who choose the option of prescription drug coverage through a Medicare Advantage plan would also have coverage for other medical expenses as part of that plan. Medicare Advantage drug plans and stand alone PDP plans are different but the drug coverage portion works in a similary manner.  Enrollees pay a co-pay for each prescription, a monthly premium (not with some advantge plans however) and an annual deductible.

Note: Please call or email our office for a full list of PDP plans available in CT

 What is Medicare Part A Coverage?

Medicare Part A coverage is hospital care coverage.  This plan covers both lab tests and surgeries.  Doctor care during the stay is also covered.  There is also coverage for supplies like wheelchairs and walkers when they are medically necessary to treat either a disease or a condition.  Part A covers in-patient hospital stays.  These plans also cover care in a skilled nursing facility or nursing home care as well as Hospice care and some home health services.  Note:  Part A will cover nursing home care for medical purposes.  Medicare will not cover the expense if custodial care is the only care necessary.

Part A includes benefits for hospital expenses.

Other expenses part A covers are, a semi-private room and meals as well as medications.  There is also coverage provided for nursing services and other supplies from the hospital.  Part A benefits will cover home health care services when deemed medically necessary.  Your doctor must order home health services in order for this expense to gain approval. Skilled nursing facility (SNF) stays coverage will only receive approval by Part A after a qualifying hospital inpatient stay for a related illness or injury. To qualify for SNF care, the hospital stay must be a minimum of three days.  A qualified stay begins on the day you are admitted. The day the hospital dischares you does not count toward the 3 day requirement.  Patients can be kept for observation.  Time spent under observation is considered outpatient.  This time does not count towards your qualifying stay.

If your doctor has certified that you have a terminal illness, you may be eligible for hospice care coverage.   Your doctor will need to determine a 6 month or less life expectancy.  In hospice care, the focus is on palliative care.  Hospice focus is not cure.  The goal is to relieve pain and make the patient as comfortable as possible.

Click here to learn how and when to enroll in Medicare.

Click here for more information regarding Medicare Part A  benefit coverage.

Connecticut residents looking to compare plan options can click here for more details about plans available.  If you still have questions or would like to set an appointment, please call the office at 203-796-5403.  In fact, we are leading Medicare experts in CT and are here to help.  We do not charge for our consultation services.

Click here for a no cost personal and confidential Medicare quote.

Medicare Supplement Rates Connecticut

Medicare Supplement Rates Connecticut are available at the bottom of this blog.  These Medicare Supplement plans are also called Medigap plans.  Connecticut is a standardized state for Medicare supplements.  Plans have identical benefits from one company to the next. The only difference is in price and value added features. Value added are things such as Silver Sneakers being available with a plan. A Medicare supplement plan is secondary coverage.  Original Medicare both A and B are the primary insurance with a supplement.  Providers bill Original Medicare first.  The portion not covered by Medicare is sent to the supplement.  The supplement covers some or all of the remainder depending on the the plan chosen. Plan F covers 100%, plan N covers most charges, plan L covers 75% and so on.  There are 9 supplement types in CT

How do you decide which one to take?

It depends on your situation.  People in very poor health may be better with a Plan F.  Someone in average health may look at plan N or plan L.  Supplements have some advantages: No network and ability to choose coverage level are two big ones.  Also, the ability to choose any Part D plan. There are also some negatives. The first is paying three premiums.

A part B premium of $121.80. The Supplement premium and the Rx premium.  Some people will make the decision to go with a Medicare Advantage plan instead. Connecticut does not allow companies to underwrite plans.  This simply means they can’t check your health.  This allows members to move from one supplement to another during the year.  Certain health conditions may cause an issue if you want to change plans.  They could also move either to an advantage during OEP or from an Advantage to a supplement.   Rates have been provided below.  In fact, the grid holds the rates for every company with a supplement in CT.

Click this link for CT rates 2016

Are you looking for Medicare Advantage Plan information instead?

If you need to sign up for Medicare A and B, Click for online enrollment with Social Security

Click here for a no obligation Medicare quote.

Anthem MediBlue Select HMO

Anthem MediBlue Select HMO is a Medicare Advantage plan with prescription drug coverage (MAPD).   In fact, Anthem Blue Cross Blue Shield offers this plan only in Hartford county in the state of Connecticut.   This, like all HMO plans, require that participants use in network providers.  If you choose to use out of network providers, this plan will not cover your expenses.  An exception to this would be urgent or emergency care which allows of of network services.

The plan has a monthly premium of $26. This would be in addition to the part B premium of $121.80.  There are no referrals required for this plan. Co-pays for a primary doctor are $15 and $40 for a specialist.  The plan has an annual out of pocket max of $6,100 per year.  Annual maximum indicates the most the insured would need to pay in medical claims for  the year.  You can not apply either Monthly premiums or cost-sharing for part D prescription drugs to the maximum out of pocket amount.

You can add dental services to the plan for an additional premium.  In Addition, Silver Sneakers is included in the $26 monthly premium and pays a local gym membership monthly fee.   If you use approved diabetic supply vendors your diabetic supplies are covered at 100%.

This plan offers prescription drug coverage with $220 annual deductible.  This deductible applies only to tiers 2-5.  The plan excludes both Tiers 1 and 6 from this deductible.  There is no limit to how much the plan will pay.

A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap).

MAPD plans offer both medical and drug benefits combined with the insurance company as the primary insurance.  With a Medicare Supplement, original Medicare is primary.  The insurance company would be the secondary insurance.  As a result, a Medicare Supplement plan does not have a network.  Because members may see any provider that participates with Original Medicare, it is different from an Advantage plan.

 HMO summary of benefits Anthem MediBlue Select

Anthem MediBlue Selelct HMO application

Click here to request a personal Medicare review.

Anthem MediBlue Plus HMO

Anthem MediBlue Plus HMO is a Medicare Advantage plan with prescription drug coverage (MAPD). This plan is offered by Anthem Blue Cross Blue Shield in 4 counties in the state of Connecticut.  Clients can purchase in either Fairfield, Litchfield, New Haven as well as Windham counties.  Given the plan is an HMO plan, participants must use in network providers.  In fact, if you use out of network providers  anthem will not cover your claims. An exception to this would be when getting urgent or emergency care which allows of of network services.

The plan has a monthly premium of $37 a month. This would be in addition to the part B premium of $121.80.  This plan does not require a referral. Copays for a primary doctor are $15 and $40 for a specialist.  The plan has an annual out of pocket max of $6,700 per year. Annual max indicates the most the insured would need to pay in medical claims for  the year. It does not include prescription drug out of pocket costs. You can add dental coverage to this plan for an additional premium. They include Silver Sneakers  in the $37 monthly premium and they pay a local gym membership monthly fee for members. Diabetic supplies are covered at 100% when using approved diabetic supply vendors.

A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap).  MAPD plans offered medical and drug benefits combined with the insurance company as the primary insurance. With a Medicare Supplement, Original Medicare is primary.  The insurance company would be the secondary insurance. As a result, a Medicare Supplement plan does not have a network.  In fact, members may see any provider that participates with Original Medicare.  This is not the case with an Advantage plan.

 MediBlue Plus HMO Anthem summary of benefits

Anthem Mediblue Plus HMO application

Click here to request a personal Medicare review.

Medicare Seminars in Connecticut

Crowe and Associates is offering Medicare Seminars in Connecticut.  We are an independent agency contracted with all Medicare companies in the state of Connecticut.  We conduct seminars to educate consumers on Medicare Advantage plans (also called Part C or Managed Medicare), stand alone part D RX plans and Medicare supplement plans (Also called Medigap plans).  Meetings run about 1 hour with the primary goal focusing on four main areas:

1)Explain how Original Medicare works as well as coverage provided by Medicare A and B.  It’s important to understand how Medicare benefits work so that you can make the most informed, best decision for you and your family members.

2)Detailing the difference between a Medicare Advantage and a Medicare Supplement plan.  They are distinctly different plans. Understanding the difference between them allows the Medicare beneficiary to make a more educated decision.

3)Explaining the strengths and weakness of both Advantage and Supplement plans.   How a Medicare beneficiary should use their own situation to determine which is better for them. (There is not a “best plan” or “best option”.)  Personal health/medical needs will be the biggest determination when it comes to finding the right plan.

4)Once the right type of plan has been determined (Medicare Advantage vs. Medicare Supplement) we will then provide a review of the company offerings for 2016.  It’s important to learn the differences between the companies that offer Medicare plans.  Understanding the details between companies and plans is vital to having proper coverage.

The primary goal:

will be for attendees to leave the meeting with the confidence to pick a plan that suits them best.  If interested in attending a meeting, please call our office at 203-796-5403 or email [email protected]

Crowe and Associates is a full service brokerage offering clients not only Medicare, but regular health, dental and life insurance.  We also offer property and casualty insurance as well as investment advice.  We do not charge any fees.  If you have questions or need additional information, please give us a call at 203-796-5403.

United Healthcare Medicare Complete Connecticut:

United Healthcare Medicare Complete Connecticut plans are a series of Medicare Advantage plans offered by United Healthcare.  Medicare Advantage plans are also called Part C plans or Managed Medicare Plans.  United Healthcare offers 3 Medicare complete plans in Connecticut for 2016. They are Medicare Complete plans 1,2 and 3.  Each plan has a different monthly premium and benefits.  All three have Rx coverage included in the benefits.

Plan 1 is a $99 a month plan with the lowest copays of the three plans.   This plan has additional extras such as vision, dental and hearing benefits. Plan 2 is a $29 a month plan with slightly higher copays than Plan 1 and comes with vision, dental, hearing and Silver Sneakers benefits.  In Plan 3 there is a $0 month premium with the highest copays of the three plans and requires a specialist referral.  It has the additional vision, hearing and Silver Sneakers benefits. Silver Sneakers is available on the United Healthcare Medicare Complete Plan 1 but there would be additional monthly premium to add it.  Full plan summaries are available in the links below for more detailed benefit descriptions.

United Healthcare Medicare Complete plans

Participating providers can be accessed in both CT as well as NY as in network providers.  The plans also come with the Passport program which allows members to access doctors in other states as in network providers (Assuming the participate with United in the other states.) UHC does have some benefits at a 20% co-insurance level which can lead to substantial out of pocket for some procedures.  We include both a summary of benefits and an application for all plans in the links below.

Feel free to either call our office at 203-796-5403 or send an email to [email protected] with any questions.

United Healthcare Plan 1 Summary 2016

 Plan 2 Summary 2016 United Healthcare

 Plan 3 Summary 2016 United Healthcare

When is The Medicare Advantage Dis-enrollment Period (MADP)

New Humana Medicare Plans 2016

New Humana Medicare Plans 2016 –  There are some new Humana Medicare plans that clients can purchase in 2016. The new plans have many great options for members to choose from.  Humana offers Medicare Advantage plans both with and without drug plans in multiple states.  Please note that in some states such as NY, they only offer a stand alone PDP plan while in others they offer both the PDP and Medicare Advantage plans.  They have multiple MAPD plan types with HMO and PPO plans in various states.  Click the link below to review Humana Medicare plans 2016 in all states. The link will also provide PDP Rx summaries.  Please call our office with any additional questions about plan designs, or benefits.

Click for Humana benefit summaries for all states 2016

Humana Medicare is also looking to fill a market void in the Long Island NY region.

This new HMO plan offers to it’s members:

• $37 monthly premium.
• $5 PCP co-pays.
• $30 specialist co-pays.
• $6,7000 Maximum out of pocket (MOOP) cost.
• This plan also includes a Silver Sneakers membership.
• It also provides preventive dental coverage.
• There is also a vision allowance of $200 toward the purchase of new glasses.
• They provide members hearing aid coverage.
• In addition this plan offers optional supplemental benefits (OSB), if you so choose.
• Travel options are built in to allow for in-network benefits in select Florida counties.

The network has been expanded to include the following:

• North Shore Lone Island Jewish Hospitals as in-network participants.
• Both Pro-Health providers as well as surgical centers are in-network participants.
• In addition, the network includes Advanced Urology.

What is the Medicare Part D Penalty

If you have gone without Part D or other credible drug coverage for a period of 63 days or more after your initial enrollment period. You may owe a Medicare Part D Penalty.  What is the Medicare Part D Penalty –

With Medicare as with all insurance plans it is wise to know all the ins and outs before you start.  If you find a knowledgeable insurance agent to help you sort things out, you will be ahead of the game.  Here at Crowe and Associates our job is to help clients understand insurance.  We want you to feel confident that you have chosen the right policy for both your health needs and your budget.  That is why it is important that you are aware of any possible penalties that can cost you money.

The dollar amount of the penalty

Medicare will officially calculate your penalty based on the number of full months you went without coverage.   The penalty is 1% of the national base beneficiary premium multiplied by the number of uncovered months and then rounded to the nearest $0.10.  That amount will be added to your monthly part D premium.  (Note: Since the national benchmark premium may increase each year, the penalty amount will also change accordingly.

Click Here for a Part D Late Enrollent Penalty Reconsideration Request Form

You should mail both completed forms as well as supporting documentation to the address below:

MAXIMUS Federal Services
3750 Monroe Avenue, Suite 704
Pittsford, NY 14534-1302

Or faxed to:
Fax number: (585) 869-3320 or  toll free fax number: (866) 589-5241

Do you have questions or need assistance navigating the Part D late enrollment penalty reconsideration process?  Please contact the office at either 203-796-5403 or at [email protected] if you have questions or require additional information about insurance.