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Connecticut Medicare Plans 2017

The term “Connecticut Medicare Plans 2017” can mean different things. This blog will address the options a person aging into Medicare or already on Medicare will have in Connecticut for 2017.  For additional information including signing up for Medicare A and B and rates, you can look at our other blog Medicare Plan Choices Connecticut 2017.  We will focus on basic choices for Medicare eligible people in this post.  The intent is to provide a general understanding of options available.  Look to our other blog if you already know your choices and want more detail. Please email or call us with any questions at 203-796-5403 or email admin@croweandassociates.com.

There are three basic options or types of plans seniors typically use.  The Medicare Supplements (also called Medigap) plans,  Medicare Advantage plans (also called part C, Managed Medicare or Medicare replacement plans) and finally, there are Medicare part D plans (also called Medicare Rx/drug plans or stand along PDP plans).  Medicare Advantage plans (MAPD) include a part D prescription drug benefit.  Medicare Supplements (Med Supp) do not have drug coverage so you would need to buy a Medicare part D plan (PDP) if you want drug coverage.

Original Medicare A and B

Connecticut Medicare plans 2017: First things first:  In order to enroll in a Medicare Advantage plan or Medicare Supplement plan, you must have Original Medicare A and B.  There are rules for eligibility and costs associates with Medicare A and B we will not get into detail about here.  Use this link if you want to know the rules for enrolling and costs.  Medicare A and B provides medical coverage on its own.  It does not provide Rx coverage but does a good job on the medical side.  It is feasable to have Medicare A and B only and then a PDP plan for those that want drug coverage. The only flaw with A and B on its own is the lack of an out of pocket max on the benefits.

Other than that, the 20% cost share is not as bad as it sounds due to the Medicare allowable cost amount the providers can bill.  This just means Medicare controls how much you are billed for Medical services.  Its hard to get a set number but they usually have a discount rate for charges between 50% to 75% depending the service.

Medicare Supplement/Medigap Plans

Connecticut Medicare Plans  2017: Many people choose to limit and/or cap the cost share they would pay being on Original Medicare.  A Med Supp is a policy that covers some or all of the costs not covered by Medicare A and B.  There are 11 different Med Supp plans. Each plan has a letter name that differentiates it from others.  Companies offer plans A – N.  Not all companies offer all plans.  A Med Supp Plan A or B should not be confused with Medicare A and B.  They are in  no way related.  A Med Supp A or B is just two of the 11 supplement options to choose from.

There are a number of plans that are “good deals” in Connecticut.  Plans F,N,K, L and High F are available from companies at good prices in CT.  Multiple companies offer supplements in CT.   United Healthcare is the insurer of the branded supplement plans.

Contrary to the opinion of many,

There are NOT pre-existing condition clauses on Medicare supplements in CT if you have had any type of other coverage in the last 63 days. The only time there are pre existing conditions clauses is if someone did not have any other type of coverage for 63 days and then tries to sign up for a supplement.  Some states do allow pre-existing conditions clauses even if there was other coverage in place but Connecticut (and NY for that matter) is not one of them.

The other important thing to note in CT is a person can change from one Medicare Supplement plan to another the first of any month.  This is not the case in some states.  It is possible in CT.  CT is a guaranteed issue state.  Also note: If someone is under the age of 65, they do not have access to all the plans.  In most cases, clients under the age of 65  are limited to plans A-C.

Medicare Part D Rx Plans (PDP)

Connecticut Medicare plans 2017: PDP plans are stand alone drug plans offered by insurance companies.  Medicare does not offer a plan but instead determine what the standard benefit model should look like.   Click here for the standard part D benefit parameters. Various companies offer stand alone part D plans including United Healthcare, Aetna, Wellcare, Humana, Envison, Silverscript to mention a few.  They all have different benefits and prices but work in a similar manner.  Be sure to use a plan that has your drugs in the formulary and also has your pharmacy in network.  Some plans will have preferred vs. non preferred pharmacies. It may not be obvious which pharmacies are preferred for your plan. Be sure to use a preferred pharmacy as your copays for the medications will likely be lower there.

Please note: you cannot have a stand alone part D plan and a Medicare Advantage plan at the same time.  Enrolling in one will disenroll (kick you out) of the other.  The only exception to this is if you have a Medicare Advantage plan called a PFFS plan.  They do allow someone to enroll in a PDP at the same time.

Medicare Advantage Plans

A Medicare Advantage Plan, also known as Medicare Part C, Medicare replacement or a Managed Medicare Plan,  plans offered by private insurance companies. They often combine medical and drug coverage.  While they are not group health plans, they do work in a similar manner.  Members pay copays for medical services they recieve.  Different services have different copays such as a copay for a primary doctor and a higher copay a specialist doctor.   Copays vary from company to company and plan to plan.  Most advantage plans offer a part D drug benefit which works similar to a stand alone part D drug plan.  Some plans require referrals for specialists while others do not.

Not all HMO plans require referrals but they do require members to stay in network for most services. Advantage plans may cover benefits not covered by Original Medicare and/or a Medicare supplement plan. Benefits and value added services such as dental, vision, Telemedicine, Silver Sneakers , OTC benefits and other programs.

Types of Medicare Advantage Plans

1. Health Maintenance Organization (HMO) Plans
2. Preferred Provider Organization (PPO) Plans
3. Private Fee-for-Service (PFFS) Plans
4. Special Needs Plans (SNP)

People are able to change a Medicare plan during Open enrollment.  Open enrollment runs from Oct 1 to Dec 7th every year.  They can make any changes they want for a Jan 1 start date.  Please note:  In states that allow underwriting, the member will be subject to medical underwriting if moving to a Medicare Supplement plan.  There are additional periods when you can make plan changes such as the MADP, SEP’s and if there is a Trial Right.

Call or email us with any questions regarding this Connecticut Medicare plans 2017 blog.  We are able to quote plans options and provide advice at no charge to you.  Independent brokers receive commission pay from the insurance companies.  You can contact the office either by phone at 203-796-5403 or by email to Edward@croweandassociates.com

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 Edward@croweandassociates.com.  

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 Edward@croweandassociates.com. 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

Medicare Plans Connecticut

Medicare Plans Connecticut is a broad term that can refer to a number of companies or plan types in Connecticut.  Insurance companies offer either Medicare Advantage plans (MAPD), Medicare Supplement plans (Also called Medigap)  or Medicare Part D Rx plans.  A summary of both plans and companies has been provided below.  Choosing the right plan means matching up the needs of the insured (current health, doctors, as well as Medications and volume of care) with the strengths of the given plan type.

Medicare Advantage plans-

Managed Medicare plans offered with (MAPD) and without (MA) drug coverage.  Medicare Advantage plans take the place of Original Medicare.  They are the primary insurance and have a network as a result.  There  in network only (HMO) and out of network (PPO) plans available. In Connecticut, most plans are HMO style plans.  Connecticare, United Healthcare, Aetna and Wellcare as well as Anthem BCBS offer plans in Connecticut.

There are two plans with a $0 monthly premium. Both require referrals to specialists. There are a number of plans in the $29 to $44 a month range. The higher end HMO and PPO plans have a premium from $99 to $128 a month. The positive points with MAPD plans are, they have a very low to no monthly premium.  These plans include Medicare part D coverage and they offer some benefits that Original Medicare does not.  Some of the negatives can be, the copay for medical services, provider networks as well as referrals for specialists.  Click the links for plan designs of some of the more popular plans in CT.

Connecticut does not have medical underwriting which is important to consider.  Medicare rules allow someone to change plans every January 1st during OEP.  Without checking health, a member can change from a Medicare Supplement to a Medicare Advantage plan.  If someone develops a health condition, they could change to a supplement without any issues.

Medicare Plans Connecticut 

United Healthcare Medicare Complete Plan 1

UHC Medicare Complete Plan 2

United Healthcare Medicare Complete Plan 3

Aetna Medicare Plan HMO Connecticut

Anthem Mediblue Plus HMO

Anthem Mediblue Select HMO

Medicare Plans Connecticut can also be Medicare Supplement Plans (Medigap)– Medicare Supplement plans are offered by a number of companies in CT.  These plans are standardized. This means benefits are the same from company to company.  Common plans offered in CT are Plans F, High F, N, K, L and G.  AARP offered by United Healthcare tends to be the first choice in CT.  A number of companies including Humana, AARP, Anthem BCBS, Combined Life, United American and Cigna all offer a number of plan choices.

Click here for standardized Medicare supplement rates in CT

Medicare Part D plans (stand alone Rx plans)-  Medicare part D plans are offered by a number of companies in CT.  Some of the more popular choices are UHC branded Saver, UHC branded Preferred RX, Humana Walmart Rx, Silver Scripts, Express Scripts Rx.  There are too many plans to list them all.   You cannot purchase a stand alone Rx plan with a Medicare Advantage plan.  Clients can only purchase these plans along with a Medicare supplement.  You can also combine these plans with Medicare A and B.  If you buy a supplement plan, you do not have to use the same company for the Rx plan.  Clients can choose any company they feel is offering the best plan for them.  Note: The Humana Walmart Rx plan is  the current lowest cost (lowest monthly premium) plan in CT.

Need to sign up for Original Medicare A and B?  Click this link to sign up online through the Social Security Website.

States offer  programs to individuals in need of assistance.  In fact, you may qualify for assistance.  Click here to learn about programs offered and determine if you are eligible.

 If you have either additional questions or need a quote, Click here.

There are 5 companies offering Medicare Advantage Plans (MA or MAPD) in the state of Connecticut.  The 5 companies are Anthem BCBS, Aetna, United HealthCare, Connecticare and Wellcare.  They do not all offer their plans in all counties of Connecticut however.  This post provides an overview of what is available.  Please call or email us for a benefit summary on any of the plans listed below.

WellCare- Offers plans in Fairfield, Hartford and New Haven Counties.  Wellcare has a $0 premium plan that boasts the lowest copays of any $0 premium MAPD in Connecticut.  They also have the only Dual Eligible offering in the state.   Both plans are very strong from a copay and additional benefit standpoint.    Wellcare does have network limitation that need to be considered.  Networks tend to be best in and around cities.  They do not have network in northern Fairfield county.

Anthem BCBS- Anthem offers plans in all counties of Connecticut.  They have an HMO offering for $28 per month.  They also have a PPO (available in limited counties only) for $18.00 that boasts very strong benefits compared to all other PPO plans in Connecticut.   Anthem has a very large network but is missing some major Physician IPA groups in CT.

United HealthCare- United offers plans in all counties of Connecticut.  They have 2 HMO plans ($99 a month plan and $0 a month plan) along with an AARP branded PPO plan for $24.00 a month.   United has an extensive provider network through Connecticut.  The UHC plans do not participate with Quest Labs which should be taken into consideration.  All other major labs do participate however.

Aetna- Currently offer plans in Fairfield, Hartford, Litchfield and New Haven county.  They have a $0 premium plan HMO, $94.00 HMO and a $90 PPO plan.  The $0 premium plan has benefits second only to Wellcare when compared to the other $0 premium plans in the state.  They also have a substantial network to go with the plan and allow for access to any Aetna Medicare HMO provider nation wide.  The Aetna PPO is not competitive at this point due to a $1,000 out of network deductible.

Connecticare- We have a contract with Connecticare but they will not allow to post any comments about their plan.  Call the office if you want information on this company 203-796-5403 or email Edward@Croweandassociates.com

HOW CROWE & ASSOCIATES CAN HELP YOU:

Crowe & Associates is an independent based in Brookfield CT. We are A rated with the BBB and are contracted to sell every Medicare Advantage plan in Connecticut.  We are paid commission from the companies and do not charge clients a fee for our services as a result.  We work with seniors in Connecticut every day to help them find the right Medicare plan to meet their needs.  Feel Free to call our 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

There are 5 companies offering Medicare Advantage Plans (MA or MAPD) in the state of Connecticut. The 5 companies are Anthem BCBS, Aetna, United HealthCare, Connecticare and Wellcare. They do not all offer their plans in all counties of Connecticut however. This post provides an overview of what is available. Please call or email us for a benefit summary on any of the plans listed below.

WellCare- Offers plans in Fairfield, Hartford and New Haven Counties. Wellcare has a $0 premium plan that boasts the lowest copays of any $0 premium MAPD in Connecticut. They also have the only Dual Eligible offering in the state. Both plans are very strong from a copay and additional benefit standpoint. Wellcare does have network limitation that need to be considered. Networks tend to be best in and around cities. They do not have network in northern Fairfield county.

Anthem BCBS- Anthem offers plans in all counties of Connecticut. They have an HMO offering for $28 per month. They also have a PPO (available in limited counties only) for $18.00 that boasts very strong benefits compared to all other PPO plans in Connecticut. Anthem has a very large network but is missing some major Physician IPA groups in CT.

United HealthCare- United offers plans in all counties of Connecticut. They have 2 HMO plans ($99 a month plan and $0 a month plan) along with an AARP branded PPO plan for $24.00 a month. United has an extensive provider network through Connecticut. The UHC plans do not participate with Quest Labs which should be taken into consideration. All other major labs do participate however.

Aetna- Currently offer plans in Fairfield, Hartford, Litchfield and New Haven county. They have a $0 premium plan HMO, $94.00 HMO and a $90 PPO plan. The $0 premium plan has benefits second only to Wellcare when compared to the other $0 premium plans in the state. They also have a substantial network to go with the plan and allow for access to any Aetna Medicare HMO provider nation wide. The Aetna PPO is not competitive at this point due to a $1,000 out of network deductible.

Connecticare- We have a contract with Connecticare but they will not allow to post any comments about their plan. Call the office if you want information on this company 203-796-5403 or email Edward@Croweandassociates.com

HOW CROWE & ASSOCIATES CAN HELP YOU:

Crowe & Associates is an independent based in Brookfield CT. We are A rated with the BBB and are contracted to sell every Medicare Advantage plan in Connecticut. We are paid commission from the companies and do not charge clients a fee for our services as a result. We work with seniors in Connecticut every day to help them find the right Medicare plan to meet their needs. Feel Free to call our 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