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Applying for Medicare in Connecticut

This post will try and give you some help when you are applying for Medicare in Connecticut.  This can be overwhelming for some people.  We want to make it easy for you.  If you are 65 years old, or are under 65 and qualify for Medicare because of a disability or other special circumstance, you are eligible for Medicare.  (Note:  You must be a US citizen or a legal resident for at least 5 consecutive years to be eligible for Medicare.)

Apply for Medicare can be done online by CLICKING HERE.  You can also enroll by phone at 1-800-MEDICARE.  Or, you can enroll in person at your local social security office.  You can call 1-800-772-1213 for help locating your local social security office.

Click here for more details regarding choosing a Medicare plan in CT.

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.

Medigap Insurance plans in Connecticut (Also called Medicare Supplement) confuse many people but it is actually very simple to understand once you understand the key points. This post is intended to provide a general overview of “Medigap” to help consumers make an educated decision when choosing one. We will start with the basics of the things you need to know about Medigap plans and then touch on the basics.

HOW A MEDIGAP INSURANCE PLAN WORKS:

The first thing to understand is how a Medigap plan works. A medigap plan works as a secondary coverage to Medicare A and B (also called original Medicare). Original Medicare parts A and B provide coverage for Medical Services. In general, original Medicare coverage 80% of medical costs. The Medicare supplement plan covers what original Medicare does not. As a result, medical providers will bill orginal Medicare and the cost share (patient responsibility) is then sent over to the Medigap company.

WHAT MEDIGAP INSURANCE  COVERS:

Medigap plans will only provide coverage on benefits that original Medicare covers to some extent. If Medicare does not provide any coverage for a procedure, the Medigap plan also will not provide coverage (There are some exceptions to this). There are a number of different plan in CT with plans A – M offered. Each lettered plan covers a different percentage of the costs that original Medicare does not cover. Some plans cover everything that Medicare doesn’t such as Plan F. Others only cover 75% such as plan L.

Supplements in the state of Connecticut are standardized which makes life much easier when choosing a plan. This means that they plans can not vary in the benefits they provide. For example, if you purchase a Plan F supplement, the coverage will be the same regardless of the company you choose. The only difference will be in the monthly cost of the plan. Some companies will add additional, value added benefits such as Silver Sneakers or other programs but the mandatory coverage must be the same for every plan.

Medicare Supplements do not cover drugs. If you want drug coverage, you must purchase it separately. (Called a Medicare Part D plan or “PDP plan)

WHO CAN BUY A MEDIGAP INSURANCE PLAN:

Medigap plans are guaranteed issue in CT. This means that you can enroll in any available plan regardless of your health or age. The only requirement is that you are on Medicare A and B. If you are willing to pay the monthly premium, you can have a plan. For people age 65 and older, the price is the same for everyone regardless of how old you are. (Example: If the AARP plan N costs $152.00 a month for a 65 year old, it costs the same for an 85 year old) People on Medicare under the age of 65 are also eligible for a supplement but they can have fewer choices if they are under the age of 50.

POPULAR PLANS AND COMPANIES:

Medigap comes down to plan type and price. If one company offers a plan L Medigap for less than the other companies, you should go with the one offering it for the least. Benefits are standardized so they can not be cutting out any benefits. They just have the best price. Having said that, the more popular plans over the last 24 months are Plan F, Plan N , Plan L and High Deductible Plan F. United AARP and Anthem BCBS currently have the lowest costs in CT which makes it easy to find the lowest cost company once you determine which supplement you want.

ABOUT MY AGENCY AND HOW I CAN HELP YOU:

My agency (Crowe and Associates) is independent and is based in Brookfield CT. The agency is A rated with the BBB and I have been in this business for 14 years. We are contracted to sell just about every Medigap plan in CT including, AARP , Anthem BCBS, Humana, Mutual of Omaha, Aflac, etc…. The companies pay me commission directly and I charge my clients nothing. I sit down with clients (in person, over the phone or by email) and help them determine which plan is going to work best for them. I also let them know if a new company comes out with the same Medigap they have at a lower price. I can help you understand Medigap and help you determine which plan is best for your specific situation. Feel Free to call my office at 203-796-5403 or email me at Edward@Croweandassociates.com

Would you like to learn More? Register for our “How to choose a Medicare plan” Webinar by clicking this link

Medicare Supplement plans in Connecticut (Also called Medigap) confuses many people but it is actually very simple to understand once you understand the key points. This post is intended to provide a general overview of “Medigap” to help consumers make an educated decision when choosing one. We will start with the basics of the things you need to know about Medigap plans and then touch on the basics.

HOW A MEDICARE SUPPLEMENT PLAN WORKS:

The first thing to understand is how a Medicare Supplement plan works. A medigap plan works as a secondary coverage to Medicare A and B (also called original Medicare). Original Medicare parts A and B provide coverage for Medical Services. In general, original Medicare coverage 80% of medical costs. The Medicare supplement plan covers what original Medicare does not. As a result, medical providers will bill orginal Medicare and the cost share (patient responsibility) is then sent over to the Medigap company.

WHAT MEDICARE SUPPLEMENT COVERS:

Medicare Supplement plans will only provide coverage on benefits that original Medicare covers to some extent. If Medicare does not provide any coverage for a procedure, the Medigap plan also will not provide coverage (There are some exceptions to this). There are a number of different plan in CT with plans A – M offered. Each lettered plan covers a different percentage of the costs that original Medicare does not cover. Some plans cover everything that Medicare doesn’t such as Plan F. Others only cover 75% such as plan L.

Supplements in the state of Connecticut are standardized which makes life much easier when choosing a plan. This means that they plans can not vary in the benefits they provide. For example, if you purchase a Plan F supplement, the coverage will be the same regardless of the company you choose. The only difference will be in the monthly cost of the plan. Some companies will add additional, value added benefits such as Silver Sneakers or other programs but the mandatory coverage must be the same for every plan.

Medicare Supplements do not cover drugs. If you want drug coverage, you must purchase it separately. (Called a Medicare Part D plan or “PDP plan)

WHO CAN BUY A MEDICARE SUPPLEMENT PLAN:

Medigap plans are guaranteed issue in CT. This means that you can enroll in any available plan regardless of your health or age. The only requirement is that you are on Medicare A and B. If you are willing to pay the monthly premium, you can have a plan. For people age 65 and older, the price is the same for everyone regardless of how old you are. (Example: If the AARP plan N costs $152.00 a month for a 65 year old, it costs the same for an 85 year old) People on Medicare under the age of 65 are also eligible for a supplement but they can have fewer choices if they are under the age of 50.

POPULAR PLANS AND COMPANIES:

Medigap comes down to plan type and price. If one company offers a plan L Medigap for less than the other companies, you should go with the one offering it for the least. Benefits are standardized so they can not be cutting out any benefits. They just have the best price. Having said that, the more popular plans over the last 24 months are Plan F, Plan N , Plan L and High Deductible Plan F. United AARP and Anthem BCBS currently have the lowest costs in CT which makes it easy to find the lowest cost company once you determine which supplement you want.

ABOUT MY AGENCY AND HOW I CAN HELP YOU:

My agency (Crowe and Associates) is independent and is based in Brookfield CT. The agency is A rated with the BBB and I have been in this business for 14 years. We are contracted to sell just about every Medigap plan in CT including, AARP , Anthem BCBS, Humana, Mutual of Omaha, Aflac, etc…. The companies pay me commission directly and I charge my clients nothing. I sit down with clients (in person, over the phone or by email) and help them determine which plan is going to work best for them. I also let them know if a new company comes out with the same Medigap they have at a lower price. I can help you understand Medigap and help you determine which plan is best for your specific situation. Feel Free to call my office at 203-796-5403 or email me at Edward@Croweandassociates.com

Would you like to learn More? Register for our “How to choose a Medicare plan” Webinar by clicking this link

Medigap Insurance plans in Connecticut (Also called Medicare Supplement) confuse many people but it is actually very simple to understand once you understand the key points. This post is intended to provide a general overview of “Medigap” to help consumers make an educated decision when choosing one. We will start with the basics of the things you need to know about Medigap plans and then touch on the basics.

HOW A MEDIGAP INSURANCE PLAN WORKS:

The first thing to understand is how a Medigap plan works. A medigap plan works as a secondary coverage to Medicare A and B (also called original Medicare). Original Medicare parts A and B provide coverage for Medical Services. In general, original Medicare coverage 80% of medical costs. The Medicare supplement plan covers what original Medicare does not. As a result, medical providers will bill orginal Medicare and the cost share (patient responsibility) is then sent over to the Medigap company.

WHAT MEDIGAP INSURANCE COVERS:

Medigap plans will only provide coverage on benefits that original Medicare covers to some extent. If Medicare does not provide any coverage for a procedure, the Medigap plan also will not provide coverage (There are some exceptions to this). There are a number of different plan in CT with plans A – M offered. Each lettered plan covers a different percentage of the costs that original Medicare does not cover. Some plans cover everything that Medicare doesn’t such as Plan F. Others only cover 75% such as plan L.

Supplements in the state of Connecticut are standardized which makes life much easier when choosing a plan. This means that they plans can not vary in the benefits they provide. For example, if you purchase a Plan F supplement, the coverage will be the same regardless of the company you choose. The only difference will be in the monthly cost of the plan. Some companies will add additional, value added benefits such as Silver Sneakers or other programs but the mandatory coverage must be the same for every plan.

Medicare Supplements do not cover drugs. If you want drug coverage, you must purchase it separately. (Called a Medicare Part D plan or “PDP plan)

WHO CAN BUY A MEDIGAP INSURANCE PLAN:

Medigap plans are guaranteed issue in CT. This means that you can enroll in any available plan regardless of your health or age. The only requirement is that you are on Medicare A and B. If you are willing to pay the monthly premium, you can have a plan. For people age 65 and older, the price is the same for everyone regardless of how old you are. (Example: If the AARP plan N costs $152.00 a month for a 65 year old, it costs the same for an 85 year old) People on Medicare under the age of 65 are also eligible for a supplement but they can have fewer choices if they are under the age of 50.

POPULAR PLANS AND COMPANIES:

Medigap comes down to plan type and price. If one company offers a plan L Medigap for less than the other companies, you should go with the one offering it for the least. Benefits are standardized so they can not be cutting out any benefits. They just have the best price. Having said that, the more popular plans over the last 24 months are Plan F, Plan N , Plan L and High Deductible Plan F. United AARP and Anthem BCBS currently have the lowest costs in CT which makes it easy to find the lowest cost company once you determine which supplement you want.

ABOUT MY AGENCY AND HOW I CAN HELP YOU:

My agency (Crowe and Associates) is independent and is based in Brookfield CT. The agency is A rated with the BBB and I have been in this business for 14 years. We are contracted to sell just about every Medigap plan in CT including, AARP , Anthem BCBS, Humana, Mutual of Omaha, Aflac, etc…. The companies pay me commission directly and I charge my clients nothing. I sit down with clients (in person, over the phone or by email) and help them determine which plan is going to work best for them. I also let them know if a new company comes out with the same Medigap they have at a lower price. I can help you understand Medigap and help you determine which plan is best for your specific situation. Feel Free to call my office at 203-796-5403 or email me at Edward@Croweandassociates.com

Would you like to learn More? Register for our “How to choose a Medicare plan” Webinar by clicking this link

If you are already enrolled in original Medicare or will be enrolling soon, you have a decision to make about your secondary coverage.   Many people find choosing a Medicare plan to be a daunting task but it really does not need to be complicated.   With a basic understanding of the options, you will be able to make a logical decision about the type of plan or company you choose.  This post will break down the choices and help provide a little insight about each.

So, what choices to you have?  There are really only 4 and we will go over each…..

Original Medicare A and B only-   Original Medicare A and B provides medical coverage on a basic level.  Some people choose to simply use original Medicare as the only coverage.  With A and B you are covered at 80% for doctors visits, testing and just about any other outpatient procedure. (after a $140 deductible for the year) Providers will bill original Medicare and you will pay what original Medicare does not cover.  You will pay the 20% that Medicare does not pay but you only pay 20% of what Medicare allows which is a much lower number than paying 20% of retail charges.  Hospital coverage is provided at 100% for 60 days after a deductible of $1,100.00.  A daily cost share is taken on after day 60.  Drug coverage is not included with A and B only.

Overall:  This option can be risky in the event that long term high volume/frequency care is needed. Not having drug coverage in place will lead to a potential penalty down the road in the event a drug plan needs to be purchased.

Original Medicare A and B and a stand alone Part D drug plan-  You may choose to have original Medicare  A and B for your medical coverage and then purchase a stand alone part D drug plan.  A part D drug plan is simply a plan you purchase from an insurance company to provide drug coverage.   The government or Medicare do not offer a plan you can buy.  The plans are only offered by private insurance companies.  Average part D Rx plans cost from $15 to $50 a month depending on the plan.   The key is to find the plan that covers your drugs at the lowest copay amounts.

Overall:  Still leaves risk on the Medical side but the drug coverage is in place so there will not be a future penalty.

Original Medicare with a Stand alone drug plan and a Medicare Supplement- This is  the same as above but in this approach a Medicare supplement plan is also purchased.  The Medicare supplement plan covers the medical expenses not covered by original Medicare.  It is secondary to original Medicare.  The provider bill Medicare first and the supplement picks up the difference. (or a portion of it depending on which supplement you choose).   A part D drug plan could also be purchased to provide drug coverage.   Supplements are standardized in most states.  This means that if you choose a plan F supplement, the benefits will be exactly the same no matter which company is offering it.  The only difference will be in the monthly premium.

Popular Medicare Supplement plans are Plan F, Plan N, Plan L and High Deductible F. Prices vary by state and company.  Supplements are very predictable and can cover 100% of Medical expenses if plan F is chosen.  They also do not have any type of network which is a common reason many people choose them.

Overall:  Supplements are a good choice. They offer very strong coverage and let you go to any doctor that accepts Medicare.   Supplements tend to be very popular with people that have health conditions.   The drawbacks to a supplement are that the monthly premium can be substantial and you need to buy drug coverage separately.

Medicare Advantage Plans– A Medicare Advantage Plan (called an MA or MAPD) is a plan offered by a private insurance company.  The Advantage plan offers Medical and Drug coverage with one program.  The plan is also primary and replaces original Medicare.   Advantage plans have providers networks and look similar to a group based under 65 health plan.   A copay structure is used  in these plans which is why they are sometimes called “pay as you go” plans.  When you go to the provider for services, they charge a set copay for each type of service provided.  There is no need to buy RX coverage with a Medicare Advantage Plan as the drug coverage is included.   Many companies offer the plans for no additional premium. (You still pay your Medicare Part B premium of $104.00 a month) The term $0 premium plan is often used.

Some MAPD plans are HMO type plans that are in network only plans.  Others are set up in a PPO or POS format which allows the member to go out of network.  There is a higher cost share/copay for using non participating providers.  Referrals for specialists are no longer required by most plans.

Overall- You need to check you plan network for your doctor and determine if you want plan with out of network coverage or not.  MAPD plans are very popular no and represent a larger share of enrollments than the other options above.  These plans are a good choice for people in relatively good health.  The copays can add up when there I a high volume of care being received.

Consider your own health and care needs when trying to determine which type of plan you would like.   Our agency is independent which allows us to hold contracts with a number of companies working with all three types of plans listed above.  We can help you determine the type of plan you want and then find the company that is the best fit for you.  The companies pay us a commission directly so we do not bill clients for our services.  Feel free to call or email us if you would like to discuss options further.

Would you like to learn More?  Register for our “How to choose a Medicare plan” Webinar by clicking this link

There are a limited number of Medicare Advantage plans available in Connecticut for 2012.  The list includes plans from Connecticare, AARP/United, Aetna, Anthem BlueCross BlueShield and Wellcare.   Our agency has clients with all companies and plan types in Connecticut and we are happy to share the good and bad of them with you.

Please click the link below to view the comparison.   Call or email with any questions or requests.  Email: Edward@Croweandassociates.com or phone at 203-796-5403   Review our BBB rating here   Click for BBB Rating

Medicare Advantage comparison 2012 CT