Medicare Options in Connecticut

The PPO is another popular health insurance plan that is a preferred healthcare provider organization consisting of medical professionals, facilities like primary and specialty physicians, and hospitals that are in contract with insurance providers that provide services to enrolled participants.

You’re not required to select the PCP or get specialty referrals. The PCP healthcare plans also include prescription drug coverage. Subscribers can seek coverage outside of the network but those premiums are costly.

Private Fee-For-Service (PFFS)

This Medicare Advantage health plan is offered by a State-licensed organization that has contracts with the Centers for Medicare & Medicaid Services (CMS).

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The PFFS plan pays on providers a fee-for-service basis so the providers aren’t on the brink of financial risk. This service also does not restrict the members’ choices among the providers that have lawful authorization to offer their services.

Any provider who accepts the terms and conditions of the Medicare plan is eligible for these Medicare benefits. Drug coverage is included but you can opt for a separate drug plan if you want.

Special Needs Plan (SNP)

This Medicare advantage plan limits membership to people who have been diagnosed with specific diseases or characteristics.

For this Medicare advantage plan, you will need a primary care physician (PCP), and a specialist’s referral. Prescription drug coverage is included and you can join this plan at any moment if you meet the requirements.

Each of these Medicare advantage plans has a different price plan and offers different levels of freedom in choosing your healthcare providers.

Medicare Supplement (Medigap) Plans in Connecticut

Medicare doesn’t cover all of your health insurance requirements when you turn 65. The Original Medicare Part A covers 80% of the inpatient care in the hospital along with skilled nursing facilities. While Medicare Part B covers 80% of the total outpatient care with the necessary medical supplies.

This is why many people opt for supplemental coverage called Medigap for the coverage for the leftover 20%.

Medigap of Medicare Supplement is a healthcare insurance policy that can be purchased from a private insurance company. These secondary coverage plans can only be applied to Original Medicare.

Since Medigap does not cover prescription drugs, it is recommended to enroll in Medicare Part D which specifically offers coverage for prescription drugs.

Who is Eligible for Medigap Health Insurance Plan?

To be eligible, you must already be enrolled in the Original Medicare plans including Part A and Part B. You must also be:

• 65 years old or older
• Under 65 and regularly receiving disability benefits
• Under 65 but diagnosed with amyotrophic lateral sclerosis
• Under 65 and diagnosed with end-stage renal disease (ESRD)

Medicare Plan F

The Medicare Supplement Insurance Program offers a Plan F that offers comprehensive healthcare coverage. This plan also provides coverage for international trips and this is what makes it one of the most popular plans in Connecticut. People from all over the US can enjoy the benefits and a visit to the doctor is much less stressful when there are no co-payments involved.

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