Connecticut has several Medicare Advantage plan options, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), and private fee-for-service plans. Each has its own network of healthcare providers and offers varying levels of flexibility. You can use our Medicare Advantage plan comparison tool to find your best option. The state also offers a Medicare Savings Program to help pay premiums, deductibles, and copayments.

What are Medicare Advantage Plans?

Medicare Advantage (MA) Plans, also known as Medicare Part C, are offered by private insurance companies approved by Medicare. These plans provide all your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage and often include additional benefits such as prescription drug coverage and dental, vision, and hearing services.

Types of Medicare Advantage Plans Available in Connecticut:

Health Maintenance Organization (HMO):

1. Requires you to use doctors and hospitals within the plan’s network, except in emergencies.
2. Typically requires a referral from a primary care doctor to see a specialist.
3. Example: ConnectiCare Choice Plan 2 offers $0 monthly premiums, $0 copay for primary care, and $10 for specialists.

Preferred Provider Organization (PPO)

1. Allows you to see any provider that accepts Medicare, but you pay less if you use the plan’s network.
2. No referral needed for specialists.
3. Example: Anthem Medicare Advantage PPO offers flexibility with in-network and out-of-network providers.

Private Fee-For-Service (PFFS)

1. Allows you to receive care from any Medicare-approved doctor or hospital that agrees to the plan’s payment terms.
2. No network restrictions, but not all providers accept the plan.

Special Needs Plans (SNPs):

1. Tailored for individuals with specific diseases or characteristics, including those who are dual-eligible for Medicare and Medicaid.
2. Example: Anthem Dual Special Needs Plans (D-SNPs) offer coordinated care and additional benefits like prescription drug coverage, dental, vision, and hearing services.

How to Enroll in a Medicare Advantage Plan?

To enroll in a Medicare Advantage plan, you must first be enrolled in Original Medicare (Parts A and B). You can compare Medicare Advantage plans in Connecticut by entering your zip code. Then you can choose the plan that best fits your needs and budget. You can also contact a licensed insurance agent to help you make the right choice.

The Center for Medicare Advocacy is a nonprofit organization that works to improve access to comprehensive Medicare coverage. It provides education and advocacy and represents individuals in appeals and coverage disputes. It also collects stories from Medicare beneficiaries and uses them to advocate for improvements in the system.

How to Choose a Medicare Advantage Plan?

1. Compare Costs:
2. Monthly premiums, copayments, coinsurance, and deductibles vary by plan. For example, the average monthly premium in Connecticut for 2024 is $20.37, with some plans offering $0 premiums.
3. Coverage and Benefits:
4. Look for additional benefits like prescription drugs, dental, vision, and hearing coverage. Plans such as ConnectiCare Flex Plans include allowances for eyewear and over-the-counter items.
5. Plan Ratings:
6. Medicare Star Ratings can help you compare plan quality. In 2024, plans like those offered by Humana and Aetna received high ratings for their performance in preventive care and customer service categories.
7. Network of Providers:
8. Ensure your preferred doctors and hospitals are in the plan’s network. For instance, HMO plans like ConnectiCare Choice Dual require using network providers.
9. Location:
10. Plan availability can vary by county. Websites like Medicare.gov allow you to search for plans based on your ZIP code.

Connecticut Medicare Advantage Plans Enrollment Periods

• Initial Enrollment Period (IEP): When you first become eligible for Medicare.
• Annual Enrollment Period (AEP): October 15 to December 7 each year.
• Special Enrollment Period (SEP): Available under certain circumstances, such as moving out of your plan’s service area.