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About Part C Medicare Advantage Plans in Connecticut

Medicare insurance comes in four major parts. Original Medicare is Parts A and B, which include benefits for inpatient and outpatient care, home health care and hospice care. Medicare Part D covers prescription drugs only. Medicare Part C, more often called Medicare Advantage, works differently from the other three. Users buy Medicare Advantage from private insurance companies. It combines Part A and B benefits. Most MA plans also include extra benefits. MA policies are sold by service area and are overseen by the states. Connecticut's Medicare Advantage plans may or not be available in other areas.

  1. Open Enrollment

    • Your initial enrollment period for Medicare starts during the month before your 65th birthday and continues until one month after. You can enroll in Medicare Advantage during this time, but you are not required to. If you have original Medicare and then decide you want to switch to Medicare Advantage, you must enroll during the annual open enrollment period. This open enrollment period lasts from November 15 to December 31. The enrollment period is nationwide and applies all over the United States.

    Health Maintenance Organizations

    • In 2011, Connecticut does not sell traditional fee-for-service Medicare Advantage plans. One of the most popular kinds of Medicare Advantage policies in Connecticut is the HMO. HMO plans are available in most areas and generally come with the lowest premiums. However, Medicare users who buy HMO plans will have co-payments and are limited in their choice of service providers. Members must get all non-emergency services from within an approved network, and may need to get a referral to see specialists. As of 2011, United Healthcare, Anthem, WellCare and ConnetiCare all offer HMO policies in Connecticut.

    Point-of-Service Option and PPOs

    • Connecticut allows MA vendors to sell POS plans, an HMO option that lets members go outside their network if they agree to pay higher costs. These are similar to preferred provider organization (PPO) plans. PPOs in Connecticut are separate plans that also come with their own network but allow you to go outside the network. In 2011, ConnectiCare sold two POS plans available in every county in the state.

    Costs

    • Companies that sell Medicare Advantage plans in Connecticut are allowed to set their own rules regarding premiums, co-payments and deductibles. Many MA plans have no monthy premiums but require larger co-pays than ones that do. In 2011, premium-free MA policies include the MediBlue Value, the AARP MedicareComplete Choice and the United Healthcare MedicareComplete Plan 2. Connecticare's VIP Prime 3 requires monthly premium payments, but has no annual deductible for prescription drug coverage.

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